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Menopause marks the end of menstrual cyclicity and, depending on individual vulnerability, has several consequences related to gonadal steroid deprivation, especially if it is premature. Menopause may be more burdensome for some women than for others. Individual factors, such as personal history, socioeconomic status, ethnicity, and current health conditions, affect symptomatology and, thereby, the menopausal experience. In addition, some menopausal symptoms, such as severe hot flashes, sleep disorders, and depression, are markers of future health risks. Counseling is a fundamental part of health care in the peri‐ and postmenopause periods. It must include an assessment of the patient's symptoms, needs, desires, and risk profile to address the benefits and risks of menopausal hormone therapy (MHT) on an individual basis and promote a healthy lifestyle. Indeed, healthcare practitioners can and must protect the health and lives of mid‐life women by increasing awareness of menopausal symptoms and ensuring healthcare options, especially MHT. The type and duration of MHT should be tailored based on the patient's history, menopausal age, physical characteristics, and current health status so that the benefits always outweigh the risks. This FIGO position paper focuses on the benefits and risks of MHT on health domains, target organs, and systems, and on systemic and vaginal MHT regimens, to provide indications that can be used in the clinical practice for menopausal counseling. Moreover, it offers insights into what FIGO considers the mainstay for the healthcare management of women in peri‐ and postmenopause, worldwide. Synopsis: The increase in life expectancy has made post‐reproductive health a global priority. Counseling on the benefits and risks of menopausal hormone therapy and lifestyle education is fundamental. [ABSTRACT FROM AUTHOR]

Plain language summary: Genitourinary syndrome of menopause (GSM) is the term used to describe the group of symptoms including vaginal pain, vaginal dryness, itching, pain during sexual intercourse and fragile vaginal tissues as well as urinary symptoms including urinary frequency, urgency, incontinence, blood in the urine (haematuria) and recurrent urinary tract infections that occur due to a lack of the hormone estrogen. These symptoms can have a significant negative impact on psychosexual issues, sexual function and quality of life in postmenopausal women. Traditionally women have been treated with vaginal lubricants, vaginal moisturisers or low‐dose vaginal estrogens. Lasers have been used in the cosmetic industry for collagen remodelling and repair of the skin. Therefore, it has been suggested that laser therapy may be used on the vagina as an alternative treatment for GSM. A review of all the published studies assessing the safety and efficacy of laser therapy for GSM have shown promising beneficial results. The majority of studies to date have been small, short‐term, observational studies. However, there are randomised controlled trials underway. Laser treatment may be beneficial for the symptoms of GSM but until more robust evidence is available it should not be adopted into widespread practice, and should be used as part of a research study only. [ABSTRACT FROM AUTHOR]

Plain language summary: This paper deals with the use of hormone replacement therapy (HRT) after the removal of fallopian tubes and ovaries to prevent ovarian cancer in premenopausal high risk women. Some women have an alteration in their genetic code, which makes them more likely to develop ovarian cancer. Two well‐known genes which can carry an alteration are the BRCA1 and BRCA2 genes. Examples of other genes associated with an increased risk of ovarian cancer include RAD51C, RAD51D, BRIP1, PALB2 and Lynch syndrome genes. Women with a strong family history of ovarian cancer and/or breast cancer, may also be at increased risk of developing ovarian cancer. Women at increased risk can choose to have an operation to remove the fallopian tubes and ovaries, which is the most effective way to prevent ovarian cancer. This is done after a woman has completed her family. However, removal of ovaries causes early menopause and leads to hot flushes, sweats, mood changes and bone thinning. It can also cause memory problems and increases the risk of heart disease. It may reduce libido or impair sexual function. Guidance on how to care for women following preventative surgery who are experiencing early menopause is needed. HRT is usually advisable for women up to 51 years of age (average age of menopause for women in the UK) who are undergoing early menopause and have not had breast cancer, to minimise the health risks linked to early menopause. For women with a womb, HRT should include estrogen coupled with progestogen to protect against thickening of the lining of the womb (called endometrial hyperplasia). For women without a womb, only estrogen is given. Research suggests that, unlike in older women, HRT for women in early menopause does not increase breast cancer risk, including in those who are BRCA1 and BRCA2 carriers and have preventative surgery. For women with a history of receptor‐negative breast cancer, the gynaecologist will liaise with an oncology doctor on a case‐by‐case basis to help to decide if HRT is safe to use. Women with a history of estrogen receptor‐positive breast cancer are not normally offered HRT. A range of other therapies can be used if a woman is unable to take HRT. These include behavioural therapy and non‐hormonal medicines. However, these are less effective than HRT. Regular exercise, healthy lifestyle and avoiding symptom triggers are also advised. Whether to undergo surgery to reduce risk or not and its timing can be a complex decision‐making process. Women need to be carefully counselled on the pros and cons of both preventative surgery and HRT use so they can make informed decisions and choices. [ABSTRACT FROM AUTHOR]

The aim of this International Menopause Society White Paper on premature ovarian insufficiency (POI) is to provide the latest information regarding this distressing condition. The impact of POI has far-reaching consequences due to its impact on general, psychological, and sexual quality of life, fertility prospects, and long-term bone, cardiovascular, and cognitive health. Progress in fully understanding the etiology, diagnosis, and optimal management options has been slow thus far due to the complexity of the condition and fragmented research. Recent advances in epidemiological and genetic research have improved our understanding of this condition and randomized prospective trials are being planned to determine the intervention strategies, which will optimize quality of life and long-term well-being. The International Menopause Society has commissioned a number of experts at the forefront of their specialty to define the state of the art in the understanding of this condition, to advise on practical management strategies, and to propose future research strategies. It is hoped that a global task force will subsequently be convened in order to formulate a consensus statement across key societies, to accelerate date collection and analysis of a global POI registry, and to facilitate progress in the key defined areas of research. [ABSTRACT FROM AUTHOR]

Self-tracking in general, and by women in particular is increasingly researched. In the literature, however, women's interactions with selftracking technologies in menopause—a change that (almost) every woman will go through—is largely taken for granted. This paper addresses this lacuna by asking whether and how menopausal women use self-tracking technologies, and how this (non-) usage mediates their self-experiences. In doing so, it elaborates on another understudied phenomenon: the constitutive significance of "un-tracking"—that is, of various shades and levels of not using self-tracking technologies—in menopause. Most of the 13 interviewed women in this study reported that they stopped, drastically reduced, or resisted self-tracking in menopause. By framing the discussion of these accounts of "un-tracking" within the tradition of post-phenomenology and a phenomenology of situated bodily self-awareness, we show that these women experience their bodies as (1) wise and eu-appearing, (2) unmoldable and dysappearing, and (3) longing for disappearance. Herein, their experientially mediating un-tracking practices are temporally and socio-culturally contextualized in complex ways and bear substantial existential significance. This study establishes the potential harmful ways in which self-tracking mediates self-experiences, as well as the fruitful ways in which un-tracking may do so. Against the background of this observation, this paper makes an appeal to take a step back from uncritically celebrating self-tracking in healthcare contexts, and critically evaluates whether (the promotion of) using (more) self-tracking technologies in these contexts is desirable to begin with. [ABSTRACT FROM AUTHOR]

Osteoporosis and associated fractures present a major challenge in improving global health outcomes. Key clinical aspects are the definition of osteoporosis and associated fractures, fracture risk prediction, stratification of risk of fracture, intervention thresholds and the most appropriate intervention based on integration of aforementioned. Correct understanding and application of these concepts are essential to stem the increasing tide of fragility fractures associated with an aging population. The role of muscle strength and function, sarcopenia, and the newly emerging concept of osteosarcopenia in maintaining bone health are discussed in detail. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death in women. After menopause, sex-specific and gender-specific factors may play an important role in increasing CVD risk, with changes in sex hormones, body fat distribution, lipid and metabolic profile, and structural and functional vascular modifications. Premature and early-onset menopause are detrimental to cardiovascular health due to the early cessation of the protective effect of endogenous estrogen. An independent association of menopause with an increased risk of CVD has been documented in early menopause (<45 years). Sex-related differences are relevant in pharmacokinetics and pharmacodynamics; different enzyme formations, drug compatibility, efficacy, and side effects vary for different sexes. Despite some progress in sex and gender research in CVD, disparities remain. Menopausal hormone therapy (MHT) is available at mid-life for symptoms of menopause and may impact cardiovascular risk. Taken early, MHT may reduce CVD morbimortality. However, this is balanced against the risk of increased thrombosis. This paper reviews physiologic changes that contribute to cardiovascular risk in postmenopausal women and discusses clinical implications. Specifically, it explores the atheroprotective effects of estrogen and MHT and the associations between menopause with lipid levels, hypertension, body composition, and diabetes for women at mid-life and beyond. [ABSTRACT FROM AUTHOR]

For many women, menopause transition can be a period of emotional and physical changes, with different menopausal stages associated with varied risk for depressive symptoms and diagnosis. This review aimed to conduct a systematic review and meta-analyses to provide an estimate for the risk of developing a) clinical depression and b) depressive symptoms at different menopausal stages. We searched Medline, PsycInfo, Embase and Web of Science from inception to July 2023. Seventeen prospective cohort studies with a total of 16061 women were included in the review, and risk of bias was assessed using the Quality in Prognosis Studies tool (QUIPS). Seven papers with a total of 9141 participants were included in meta-analyses, using random effects models and pooled odds ratios (OR) calculated for depressive symptoms and diagnoses. Perimenopausal women were found to be at a significantly higher risk for depressive symptoms and diagnoses, compared to premenopausal women (OR = 1.40; 95 % CI: 1.21; 1.61, p <.001). We did not find a significantly increased risk for depressive symptoms or diagnoses in post-menopausal, compared to pre-menopausal women. Studies used different criteria to classify the menopausal stages and different measures for depression, which may have contributed to the heterogeneity seen in some models. We were unable to include a model that compared peri to post-menopause, due to a lack of longitudinal studies comparing the two stages. The risk of depression in perimenopause, shown in an ethnically diverse sample; highlights the clinical need for screening and support in this potentially vulnerable group. • Menopause transition is a period of emotional changes for women which have not yet fully been explored in research. • Data from 9141 women showed that perimenopause is the stage associated with the most elevated risks of depression. • Identifying menopausal stages associated with risk of depression may enable provision of appropriate support and services. [ABSTRACT FROM AUTHOR]

This writing is born out of our experiences of becoming older women, academy hags, facing the performative demands of the neoliberalizing patriarchal university. We are raging. With the figure of the Crone, and feminist-killjoy-croning as our creative and livid research method (Ahmed, S. 2023. Feminist Killjoy. London: Penguin Random House), we squeeze time out/with impossible university spaces and schedules to tend to grey matters. This paper traces the normalization of menopause policies in workplaces and universities, following the social trending and capitalization of menopausal and ageing matters. We question what menopause policies do and argue they constitute a failed project for the advancement of gender equality and should be abandoned. Inspired by Barad’s (2021. “Dialogue with Karen Barad Dialogues on Agential Realism.” In Dialogues on Agential Realism: Engaging in Worldings through Research Practice, edited by H. P. Juelskjær and A. W. Stine, 118–141. London: Taylor and Francis) call to engage in ‘spacetimemattering’, we create webs of entanglement through the objects of university menopause policies. We grey, fade out/ fit in, sweat, bleed, scowl. Powered by fury and frustration, we scrape away the genealogical underpinnings of menopausal bodyminds. [ABSTRACT FROM AUTHOR]

Background: Significant scientific research has been conducted concerning menopausal syndrome(MPS), yet few bibliometric analyses have been performed. Our aim was to recognise the 100 most highly cited published articles on MPS and to analytically evaluate their key features. Methods: To identify the 100 most frequently cited articles, a search was conducted on Web of Science using the term 'menopausal syndrome'. Articles that matched the predetermined criteria were scrutinised to obtain the following data: citation ranking, year of publication, publishing journal, journal impact factor, country of origin, academic institution, authors, study type, and keywords. Results: The publication period is from January 1, 2000, to August 31, 2022. The maximum number of citations was 406 and in 2012. The median citations per year was 39.70. Most of the articles focused on treatment and complications. These articles were published in 36 different journals, with the Journal of MENOPAUSE having published the greatest number (14%). Forty-eight articles (48%) were from the United States, with the University of Pittsburgh being the leading institute (9%). Joann E. Manson was the most frequent first author (n = 6). Observational studies were the most frequently conducted research type (n = 53), followed by experimental studies (n = 33). Keyword analysis identified classic research topics, including genitourinary syndrome of menopause, bone mineral density (BMD), and anti-mullerian hormone (AMH) loci. Conclusion: Using bibliometrics, we conducted an analysis to identify the inadequacies, traditional focal points, and potential prospects in the study of MPS across current scientific areas. Treatment and complications are at the core of MPS research, whereas prediction and biomarkers have less literature of high quality. There is a necessity for innovative analytical metrics to measure the real effect of these papers with a high level of citation on clinical application. [ABSTRACT FROM AUTHOR]

A significant decrease in estrogen levels puts menopausal women at high risk for major depression, which remains difficult to cure despite its relatively clear etiology. With the discovery of abnormally elevated inflammation in menopausal depressed women, immune imbalance has become a novel focus in the study of menopausal depression. In this paper, we examined the characteristics and possible mechanisms of immune imbalance caused by decreased estrogen levels during menopause and found that estrogen deficiency disrupted immune homeostasis, especially the levels of inflammatory cytokines through the ERα/ERβ/GPER-associated NLRP3/NF-κB signaling pathways. We also analyzed the destruction of the blood-brain barrier, dysfunction of neurotransmitters, blockade of BDNF synthesis, and attenuation of neuroplasticity caused by inflammatory cytokine activity, and investigated estrogen-immuno-neuromodulation disorders in menopausal depression. Current research suggests that drugs targeting inflammatory cytokines and NLRP3/NF-κB signaling molecules are promising for restoring homeostasis of the estrogen-immuno-neuromodulation system and may play a positive role in the intervention and treatment of menopausal depression. [ABSTRACT FROM AUTHOR]

A significant decrease in estrogen levels puts menopausal women at high risk for major depression, which remains difficult to cure despite its relatively clear etiology. With the discovery of abnormally elevated inflammation in menopausal depressed women, immune imbalance has become a novel focus in the study of menopausal depression. In this paper, we examined the characteristics and possible mechanisms of immune imbalance caused by decreased estrogen levels during menopause and found that estrogen deficiency disrupted immune homeostasis, especially the levels of inflammatory cytokines through the ERα/ERβ/GPER-associated NLRP3/NF-κB signaling pathways. We also analyzed the destruction of the blood-brain barrier, dysfunction of neurotransmitters, blockade of BDNF synthesis, and attenuation of neuroplasticity caused by inflammatory cytokine activity, and investigated estrogen-immuno-neuromodulation disorders in menopausal depression. Current research suggests that drugs targeting inflammatory cytokines and NLRP3/NF-κB signaling molecules are promising for restoring homeostasis of the estrogen-immuno-neuromodulation system and may play a positive role in the intervention and treatment of menopausal depression. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is the most prevalent cancer among women. Extensive research has been conducted on eating patterns, and increasing evidence suggests that diet significantly influences the development, progression, and prevention of breast cancer. However, besides the well-known role of alcohol and red and processed meat, the impact of other dietary components remains a subject of debate. Specifically, the potential connection between sugar, dairy components, and soy with breast cancer risk raises questions. Focusing on the studies conducted in the last decade, our literature review shows a negative association between breast cancer incidence and both dairy product and soy consumption, while complex data emerged about sugar intake by itself. However, high heterogeneity across studies' findings was observed, thus highlighting the need for comprehensive investigations considering both patient- and cancer-related factors to develop preventive strategies that should be incorporated into international guidelines. Breast cancer (BC) constitutes a prevalent health condition among women. Recent years have witnessed the identification of dietary proto-oncogenic factors that deserve attention. Besides the well-known role of alcohol and red and processed meat in BC development, the impact of other dietary components remains unclear. Our narrative review aims to explore the diet-BC relationship, focusing on sugar, dairy, and soy consumption. We conducted a PubMed literature search covering the last decade (2013–2023) and included 35 papers. We found limited evidence on the association between high sugar intake and BC incidence. On the other hand, dairy and soy consumption displayed a protective effect in the majority of the analyzed papers. However, a significant degree of heterogeneity was reported among the results. Menopausal status and the specific BC molecular subtypes were the main factors influencing the interpretation of the results. Exploring dietary factors and BC revealed inconsistencies: high glycemic index post-menopause may be a risk factor, while sugar-sweetened drinks and artificial sweeteners yielded conflicting results; fermented dairy showed potential benefits, non-fermented dairy presented inconsistent findings; soy impact on BC varied according to molecular subtype, with some studies suggesting a positive association in luminal-like BC. Hence, further investigation is crucial to obtain a uniform consensus on the diet-BC relationship. [ABSTRACT FROM AUTHOR]

Studies have shown racial/ethnic differences in the prevalence of vasomotor symptoms (VMS), sleep disturbance and VMS treatment in menopause. To assess the reproducibility of these differences, we systematically reviewed observational studies, published in 2000–2021, reporting the prevalence/incidence of VMS, sleep disturbance or treatment use in menopausal women stratified by race/ethnicity. We screened 3799 records from PubMed and Embase and included 27 papers (19 studies). No incidence data were found. Prevalence data varied widely, but some common patterns emerged. In all five studies comparing VMS between Black women and White, Hispanic and/or East Asian women, the prevalence was highest in Black women and lowest in East Asian women. The prevalence of sleep disturbance overall was compared among Black, White and East Asian women in two study populations, and was highest in White women in both papers. Sleep disturbance was more common than VMS in East Asian women. In all four studies comparing hormone therapy use between White women and Black and/or East Asian women, treatment use was more common in White women. These results highlight the need for individualized counseling and treatment, outreach to under-served minorities, and standardized definitions and outcome measures for VMS and sleep disturbance for future studies. [ABSTRACT FROM AUTHOR]

Sexual well-being frequently declines following the menopause transition and can be associated with significant personal and relationship distress. This distress is the hallmark of female sexual dysfunction (FSD). FSD is highly prevalent in postmenopausal women. The prevalence of sexual problems increases with age, but conversely this is associated with decreasing distress with advancing age. This pattern has been seen across multiple international populations with varied cultural norms. While the etiology of FSD is multifactorial, the physiological changes of sex hormone insufficiency and postmenopausal symptoms, such as dyspareunia, are primary factors contributing to FSD at midlife. The International Menopause Society is working to increase awareness of FSD and to provide a framework for practitioners to address sexual medicine concerns. This White Paper aims to review the process of care for female sexual well-being following menopause, from initially approaching the discussion of FSD, to identifying clinical signs and symptoms, and ultimately determining the best available biopsychosocial therapies. As with most processes of care, the first step is often the most difficult. Health-care practitioners need to broach the topic of sexuality in the clinical setting. Lack of information on, comfort with, and biases about the topic of sexuality after menopause are significant hurdles that the International Menopause Society addresses in this document. Each member of the Writing Group remains committed to continued advocacy for the validity of FSD as a diagnosis, the need for therapies for women to be both available and included in health insurance coverage, and continued therapeutic research to provide evidence-based solutions. [ABSTRACT FROM AUTHOR]

Simple Summary: Explanations for the evolution of menopause in humans and other animals concern the indirect fitness benefits that older females can receive by caring for the offspring of their children and grandchildren. Knowledge about the post-reproductive lifespan is still incomplete and until recently was documented only in nonhuman primates, a few species of toothed whales, and guppies, though it has also been documented in insects for gall-forming aphids and parthenogenetic ants. In our paper, we provide evidence that menopause also exists in honeybee societies. Honeybee workers are usually sterile. Nevertheless, the absence of a queen and her pheromones in a nest stimulates workers to activate their ovaries and lay unfertilized eggs that develop into males. However, even in queenless colonies, some workers do not activate their ovaries. In this study, we show that physiologically older workers have less activated ovaries than physiologically younger individuals, indicating that the possibility of workers' reproduction decreases with workers' physiological age. This may happen because bees require a minimum of two weeks to activate their ovaries, meaning physiologically older workers can die before producing their own eggs. Thus, investing energy in helping relatives care for their offspring rather than channelling that energy into one's own reproduction can positively influence workers' fitness. The post-reproductive lifespan is an evolutionary enigma because the cessation of reproduction in animals seems contrary to the maximization of Darwinian fitness. Several theories aim to explain the evolution of menopause, one of which suggests that females of a certain age receive more fitness benefits via indirect selection (kin selection) than they would directly from continuing reproduction. Post-reproductive lifespans are not very common in nature but have been described in humans, nonhuman primates, a few species of toothed whales, guppies, and in some insect societies consisting of clonal colony members, such as aphid and ant societies. Here, we provide evidence that menopause also exists in honeybee societies. Our study shows that workers with a short life expectancy (older and/or injured workers) invest fewer resources and less time in their own reproduction than workers with a long life expectancy (younger and/or uninjured workers), even if their colony is hopelessly queenless. These results are consistent with the kin selection explanation for the evolution of menopause and help us understand the net effects of relatedness and social cooperation in animals. [ABSTRACT FROM AUTHOR]

Background: Significant scientific research has been conducted concerning menopausal syndrome(MPS), yet few bibliometric analyses have been performed. Our aim was to recognise the 100 most highly cited published articles on MPS and to analytically evaluate their key features. Methods: To identify the 100 most frequently cited articles, a search was conducted on Web of Science using the term 'menopausal syndrome'. Articles that matched the predetermined criteria were scrutinised to obtain the following data: citation ranking, year of publication, publishing journal, journal impact factor, country of origin, academic institution, authors, study type, and keywords. Results: The publication period is from January 1, 2000, to August 31, 2022. The maximum number of citations was 406 and in 2012. The median citations per year was 39.70. Most of the articles focused on treatment and complications. These articles were published in 36 different journals, with the Journal of MENOPAUSE having published the greatest number (14%). Forty-eight articles (48%) were from the United States, with the University of Pittsburgh being the leading institute (9%). Joann E. Manson was the most frequent first author (n = 6). Observational studies were the most frequently conducted research type (n = 53), followed by experimental studies (n = 33). Keyword analysis identified classic research topics, including genitourinary syndrome of menopause, bone mineral density (BMD), and anti-mullerian hormone (AMH) loci. Conclusion: Using bibliometrics, we conducted an analysis to identify the inadequacies, traditional focal points, and potential prospects in the study of MPS across current scientific areas. Treatment and complications are at the core of MPS research, whereas prediction and biomarkers have less literature of high quality. There is a necessity for innovative analytical metrics to measure the real effect of these papers with a high level of citation on clinical application. [ABSTRACT FROM AUTHOR]

Menopause eventually happens to all people with typically functioning ovaries, and almost one billion women worldwide are postmenopausal. Although the biology of typical menopause is ubiquitous, the experience varies substantially. Factors contributing to the experience include not only individual factors, such as the nature and severity of symptoms, but also psychological, social, and contextual considerations, many of which are modifiable. In this first paper in the Lancet Series on menopause, we argue for a new approach that goes beyond the treatment of specific symptoms, to encompass a broad model to support women transitioning this life stage, using the model of empowerment. WHO defines empowerment as an active process of gaining knowledge, confidence, and self-determination to self-manage health and make informed decisions about care. Rather than focusing on menopause as an endocrine deficiency, we propose an empowerment model that recognises factors modifying the experience, in which the patient is an expert in their own condition and the health-care worker supports the patient to become an equal and active partner in managing their own care. [ABSTRACT FROM AUTHOR]

The typical age at menopause is 50–51 years in high-income countries. However, early menopause is common, with around 8% of women in high-income countries and 12% of women globally experiencing menopause between the ages of 40 years and 44 years. Menopause before age 40 years (premature ovarian insufficiency) affects an additional 2–4% of women. Both early menopause and premature ovarian insufficiency can herald an increased risk of chronic disease, including osteoporosis and cardiovascular disease. People who enter menopause at younger ages might also experience distress and feel less supported than those who reach menopause at the average age. Clinical practice guidelines are available for the diagnosis and management of premature ovarian insufficiency, but there is a gap in clinical guidance for early menopause. We argue that instead of distinct age thresholds being applied, early menopause should be seen on a spectrum between premature ovarian insufficiency and menopause at the average age. This Series paper presents evidence for the short-term and long-term consequences of early menopause. We offer a practical framework for clinicians to guide diagnosis and management of early menopause, which considers the nature and severity of symptoms, age and medical history, and the individual's wishes and priorities to optimise their quality of life and short-term and long-term health. We conclude with recommendations for future research to address key gaps in the current evidence. [ABSTRACT FROM AUTHOR]

The genitourinary syndrome of menopause (GSM) has been proposed as a diagnosis by a consensus of clinicians and investigators. Our purpose for this paper is to review extant evidence about: 1) the breadth of symptoms and symptom clusters as related to the syndrome; 2) the prevalence of GSM (includes vulvar and vaginal atrophy); 3) factors that are associated with, predict, or explain the syndrome; and 4) what should be pursued for expanding meaningful evidence. Within recent literature, we found a wide range of prevalence estimates, likely a function of the differing populations studied, study design, and methods of data collection. Factors related to the prevalence of GSM included age and aging; reproductive aging stage; hormones, especially estrogen; and culture and language. We recommend further specification of diagnostic criteria for GSM; clarification of urinary symptoms in GSM; use of longitudinal study designs; validation of GSM-related measures; exploration of cultural equivalence of GSMmeasures; and assessing biases in completed research. [ABSTRACT FROM AUTHOR]

A systematic review with meta-analysis was conducted to establish the impact of menopause health education on quality of life (QoL) among menopausal women. Research suggests that specific educational programs can support and enable women during the physical and emotional transition through menopause. The CINAHL, Medline, APA, Embase and Google Scholar databases were searched between 30 November 2021 and 9 January 2022 using the PRISMA guidelines. The Cochrane risk of bias tool was used to critically evaluate the included studies. Review Manager software was used to conduct the meta-analysis of suitable studies. Eight papers were eligible for this review. The participants were aged between 40 and 60 years, with diagnosis of menopause stemming from changes in the menstrual cycle to a last menstrual period of 7 years. Follow-up data were collected between 1 and 4 months post education. Meta-analysis of both the primary outcome (QoL) and secondary outcome (symptom control) demonstrated statistically significant improvements post intervention. Papers not suitable for meta-analysis were reviewed narratively; two papers assessing the primary outcome (QoL) demonstrated an improvement, but only one to a statistically significant level. Secondary outcomes revealed improvements, with all bar one paper doing so to statistical significance. Menopause health education demonstrated an improvement in both QoL and symptom control in menopausal women; however, given some weaknesses in the included studies, further research is justified. Limitations include participants' level of education, geographical location, risk of bias, that only half of the papers addressed participant use of hormone replacement therapy and length of follow-up. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the publication trends on the psychological health of postmenopausal women by performing a bibliometric and visualization analysis that can be used as a foundation for understanding current and future research plans. Publications were retrieved from Dimensions database from 2012 to June 2022. VOSviewer software was used for data mining and visualization. A total of 1718 papers were selected by keyword search and delimiting criteria. To evaluate the productive nations, authors, journals, articles and frequent joint citations, citation analysis, author keyword co-occurrence analysis, co-authorship analysis and co-citation analysis were performed. Results depict that the USA contributed the most papers (n = 457). Maximum articles (n = 192) were published in 2021. The highest number of articles are published in Menopause: The Journal of the North American Menopause Society and Climacteric: The Journal of the International Menopause Society. Out of the top 10 contributing organizations in the field, six organizations were from the USA. R. Nappi of Italy is the most productive author with 20 articles and 1138 citations. From the point of average citations per article, H. Joffe has the highest score (71.5). The data reported in this analysis contribute to discussions about the development, growth and current state of psychological health of postmenopausal women as well as its impact. These findings offer helpful guidance for researchers in choosing their potential fields of study and integrating different approaches to solve complicated issues, finding potential co-authors and choosing the right institutions for supporting academic studies or collaborative research. [ABSTRACT FROM AUTHOR]

The summaries of several papers about women's health are presented. These papers include: fetal reduction from twins to a singleton; symptomatic patients with an early viable intrauterine pregnancy; effect of soy protein containing isoflavones on menopausal women; and effects of estradiol on left ventricular diastolic function in hypertensive postmenopausal women. Also included are: effects of a full bladder and patient positioning on pelvic organ prolapse assessment; human papillomavirus genomes in squamous cell carcinomas of the uterine cervix; and role of reduction mammaplasty in primary prevention strategies for women at high risk of breast cancer.

The article presents information on various papers related to women's health that appeared in the 2004 issue of the "Journal of Women's Health." One of such papers is "Caloric Restriction and Incidence of Breast Cancer," by K.B. Michels and A. Ekbom. The context of the study is: Restricting caloric intake is one of the most effective ways to extend lifespan and to reduce spontaneous tumor occurrence in experimental animals, but whether similar associations hold in humans has not been appropriately studied. Another paper is "Induction of Labor After One Prior Cesarean: Predictors of Vaginal Delivery," by J. Grinstead and W.A. Grobman. The objective was to estimate the characteristics most associated with vaginal birth in patients undergoing induction of labor after one prior cesarean delivery. Another paper is "Long-term Effects of Oestrogen Therapy on Bone Loss in Postmenopausal Women: A 23-year Prospective Study," by H.G. Ahlborg, O. Johnell and M.K. Karisson. The aim of the study was to determine the long-term effect of oestrogen therapy on bone loss after menopause. The study findings revealed that the use of oestrogen seems to reduce the rate of bone loss over a period of 23 years, and the longer the duration of the therapy, the less bone loss.

The article offers several papers related to study of different diseases. Analysis on postoperative urinary incontinence after total abdominal hysterectomy or supracervical hysterectomy showed no statistical difference in the risk of developing stress or urge urinary incontinence in women who underwent supracervical hysterectom. The study of factors associated with worsening and improving urinary incontinence across the menopausal transition concludes that in midlife incontinent women, worsening of incontinence symptoms was not attributable to the menopausal transition. The study of racial disparity in the success and complications of vaginal birth after cesarean delivery conludes that African American women are less to experience a uterine rapture.

In this article, the author explores the ethical tensions that emerged when she attempted to write autoethnographically about her ongoing experience of early menopause. It brings to life the journey that resulted from the acceptance of a conference abstract which promised to reveal the lived experience of this unexpected bodily "betrayal." The abstract included the promise to illuminate the intense physical and emotional effects of this (in)visible transition. However, in the process of writing and considering the ethical dimensions of such storytelling, the author ended up constructing something completely different which, in its own way, led to new understandings of her past and present. [ABSTRACT FROM AUTHOR]

The article presents abstract of medical research. They include "Tamoxifen treatment after adjuvant chemotherapy has opposite effects on bone mineral density in premenopausal patients depending on menstrual status", "Hypertension, menopause, and coronary artery disease risk in the Women's Ischemia Syndrome Evaluation (WISE) Study" and "Neoadjuvant chemotherapy in vulvar cancer: Avoiding primary exenteration".

Several abstracts of articles about human diseases is presented, including "Gabapentin for Hot Flashes in 420 Women With Breast Cancer: A Randomised Double-Blind Placebo-Controlled Trial," "Testosterone Patch Increases Sexual Activity and Desire in Surgically Menopausal Women With Hypoactive Sexual Desire Disorder," "Does Maternal Race or Ethnicity Affect the Expression of Severe Preeclampsia?" "The Probability for a Pap Test to be Abnormal is Directly Proportional to HPV Viral Load: Results From a Swiss Study Comparing HPV Testing and Liquid-Based Cytology to Detect Cervical Cancer Precursor in 13,842 Women" and "Comorbidity and Survival Disparities Among Black and White Patients With Breast Cancer."

Background: Menstruation is a major physiological change in a woman's life, but lack of knowledge, poor practices, socio-cultural barriers, poor access to products and their improper disposal have significant consequences on health, dignity and well-being of women and adolescent girls. Objectives: This study aimed to assess the knowledge and practices related to menstrual health and hygiene amongst females of 10–49 years of age; explore the experiences and challenges of women during menstruation; and identify the key predictors of healthy menstrual health and hygiene. Methods: Using a cross-sectional study design, we adopted a mixed methods approach for data collection. For quantitative household survey, a total of 921 respondents were selected from three districts of Odisha. Qualitative findings through focus group discussions and in-depth interviews supplemented the survey findings and helped to identify the barriers affecting good menstrual practices. Epi data version 2.5 and R 4.2.2 was used for data entry and data analysis, respectively. Descriptive statistics was used to calculate proportion, mean and standard deviation; Chi square test was used to measure the association between categorical variables. Bivariate and multivariate logistics analyses were done to identify predictors of healthy menstrual health and hygiene. For qualitative data analysis, thematic analysis approach was adopted using software Atlas.ti 8. Results: For 74.3% respondents, mothers were the primary source of information; about 61% respondents were using sanitary pad. The mean age at menarche was 12.9 years and almost 46% of respondents did not receive any information about menstruation before menarche. Lower age and education up to higher secondary level or above had statistically significant associations with the knowledge about menstruation. Age, caste, respondent's education, mother's education, sanitation facility, availability of water, accessibility and affordability for sanitary pads were found to be strongly associated with good menstrual hygiene practices. Conclusion: Traditional beliefs regarding menstruation still persists at the community level. Educating mothers, increasing awareness about safe menstrual hygiene, providing adequate water and sanitation facilities and ensuring proper disposal of menstruation products need priority attention. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death for women across the developed and developing world. Beyond traditional cardiovascular risk factors, a number of reproductive milestones have been recognized. The goal of this White Paper, issued by the International Menopause Society in conjunction with World Menopause Day 2023, is to highlight female reproductive milestones in terms of potential cardiovascular risk and to review recommendations for minimizing that risk. The primary milestones discussed relate to menstrual cyclicity, adverse pregnancy outcomes, breast cancer treatments and menopause. Each of these categories has a number of permutations that have been shown in observational studies to be associated with increased cardiovascular risks. In current clinical care, recognition of these reproductive milestones has been encouraged so patients can be informed and motivated to engage in primary prevention of CVD early in their life course rather than retrospectively later in life. Options for specifically targeted care with specialist teams are designed to enhance success with risk identification, screening and possible detection of CVD and, optimally, primary or secondary prevention of CVD. Promoting cardiovascular health of women has far-reaching effects for themselves, their families and their progeny. It is time to make women's cardiovascular health a priority. [ABSTRACT FROM AUTHOR]

Identifying menopause-related breast cancer biomarkers is crucial for enhancing diagnosis, prognosis, and personalized treatment at that stage of the patient's life. In this paper, we present a comprehensive framework for extracting multiomics biomarkers specifically related to breast cancer incidence before and after menopause. Our approach integrates DNA methylation, gene expression, and copy number alteration data using a systematic pipeline encompassing data preprocessing and handling class imbalance, dimensionality reduction, and classification. The framework starts with MutSigCV for data preprocessing and ensuring data quality. The Synthetic Minority Over-sampling Technique (SMOTE) up-sampling technique is applied to address the class imbalance representation. Then, Principal Component Analysis (PCA) transforms the DNA methylation, gene expression, and copy number alteration data into a latent space. The purpose is to discard irrelevant variations and extract relevant information. Finally, a classification model is built based on the transformed multiomics data into a unified representation. The framework contributes to understanding the complex interplay between menopause and breast cancer, thereby revealing more precise diagnostic and therapeutic strategies in the future. The explainable artificial intelligence model Shapley based on the XGBoost regressor showed the power of the selected gene expressions for predicting the menopause status, and the potential biomarkers included RUNX1, PTEN, MAP3K1, and CDH1. The literature confirmed the findings. [ABSTRACT FROM AUTHOR]

A 12‐week longitudinal study with 247 US menopausal women was undertaken to investigate the perceptual efficacy of a tablet formulated with an extract of Siberian rhubarb to provide relief from menopausal symptoms. The 5‐point menopause rating scale (MRS) (0 = none; 1 = mild; 2 = moderate; 3 = severe; 4 = extremely severe) was used to measure symptom intensity. The MRS scale, an ordinal categorical scale, was transformed into an R‐index, a ratio scale, using the frequencies of the MRS categories. Symptom relief was compared to an initial week baseline measure; defined as R‐index = 0.5. An index, A.RDEX, which is based on area under the R‐index curve (AUC) in the range of 0–84 days was used to measure percentage efficacy of symptom relief. Results show that symptom relief occurs through the first 17 days in terms of R‐index = 0.64 for the total score and improves with continued use, reaching an A.RDEX = 0.42 by 84 days, suggesting about 42% relief considering all 11 MRS attributes. Practical Applications: MRS ratings data can be transformed into an R‐index using MRS category frequencies at an initial week and a subsequent week. Functional data analysis for R‐index values provides an advanced statistical model for analysis of perceptual differences throughout longitudinal studies that can examine MRS attribute effects over time. R codes are developed and provided in the paper to transform MRS data into R‐index measures and to conduct functional data analysis for R‐index measures obtained from different time points (weeks or days). [ABSTRACT FROM AUTHOR]

This article presents information about current research in the field on women's health published in December 2003, issue of "Journal of Women's Health." Oral Oestrogen Replacement Therapy (ERT) activates blood coagulation and increases the risk of Venous Thromboembolism (VTE) in postmenopausal women. Transdermal ERT has little effect on haemostasis, but data assessing its effect on thrombotic process are scarce. Researchers aimed to examine the effect of the route of oestrogen administration on VTE risk. Current use of Hormone Replacement Therapy (HRT) increases the incidence of breast cancer. The million women study was set up to investigate the effects of specific types of HRT on incident and fatal breast cancer. Many young patients with breast carcinoma have not started, or completed, their desired families. How childbearing after a diagnosis of breast carcinoma affects survival is of importance to these women and their families. Researchers measured relative mortality among young patients with breast carcinoma with and without births occurring after diagnosis.

Objective: Menopause and the changes it brings to a woman's life necessitate a comprehensive approach to face and experience the transition. This paper aims at synthesizing results from qualitative studies of menopausal experiences among Chinese and other women of similar ethnicity and culture. Design and method: A comprehensive search strategy of multiple databases along with bibliographic hand searches was employed to identify qualitative studies published in English peer-reviewed journals between 2008 and 2022 focused on the menopausal experiences (peri and post-menopause) of Chinese and other women of similar ethnic backgrounds. Twelve studies met the inclusion criteria. The final sample consisted of 238 women aged between 40 to 60 years who had experienced menopausal symptoms. This qualitative systematic literature review adopted Noblit and Hare's seven-stage theoretical meta-ethnographic approach to construct an inductive and interpretive form of synthesis and subsequent analysis. Syntheses of findings: The synthesis of primary data identified four key concepts that entitle women's menopausal experiences: being menopausal, ramifications on well-being, family and social support around menopause, and healthcare throughout menopause. The subsequent second-order interpretation revealed that women accepted the inevitability of the natural aging process in the decline of sexual drive, reinvented relationships with partners, and expressed the significance of a supportive environment in order to successfully navigate the transition. Third-order interpretations sought to establish a link between physiological complications, loss of femininity, patriarchal-dominated societal norms, and a support system that spans the entire menopause experience. Healthcare's contribution has also been deemed to be insufficient due to a lack of information and empathy from health experts. Negligence or reluctance to seek healthcare and skepticism toward hormone replacement therapy (HRT) had also been a source of concern, as they have had the potential to exacerbate medical difficulties and emotional turmoil. Conclusions and implications for practice: A comprehensive approach that considers women's physiological and psychological well-being and major attempts to change cultural beliefs and norms about women's sexual health may be effective in aiding menopausal women during their transition. Additionally, appropriate guidelines and management should be in place to enable women to address menopause difficulties effectively with the assistance of healthcare experts and the support of their families and community. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aimed to review the research on the quality of life after hysterectomy (surgical removal of the womb) to prevent endometrial (womb) cancer. We conducted a systematic review on this topic, and found only four papers. After this operation, women had reduced worry about cancer, and were generally satisfied. There was a severe impact from the removal of both ovaries, which resulted in menopause-symptoms, particularly for women not taking hormone-replacement. We also looked at papers reporting quality of life after hysterectomy to treat heavy or abnormal periods. We found 25 papers, and generally these reported that women were satisfied after this operation, with improved quality of life, and were very unlikely to have worse sexual function or urinary problems. This review demonstrates that there is very little evidence on quality of life after this surgery to prevent endometrial cancer, and highlights how more research is needed. Background: Risk-reducing hysterectomy (RRH) is the gold-standard prevention for endometrial cancer (EC). Knowledge of the impact on quality-of-life (QoL) is crucial for decision-making. This systematic review aims to summarise the evidence. Methods: We searched major databases until July 2022 (CRD42022347631). Given the paucity of data on RRH, we also included hysterectomy as treatment for benign disease. We used validated quality-assessment tools, and performed qualitative synthesis of QoL outcomes. Results: Four studies (64 patients) reported on RRH, 25 studies (1268 patients) on hysterectomy as treatment for uterine bleeding. There was moderate risk-of-bias in many studies. Following RRH, three qualitative studies found substantially lowered cancer-worry, with no decision-regret. Oophorectomy (for ovarian cancer prevention) severely impaired menopause-specific QoL and sexual-function, particularly without hormone-replacement. Quantitative studies supported these results, finding low distress and generally high satisfaction. Hysterectomy as treatment of bleeding improved QoL, resulted in high satisfaction, and no change or improvements in sexual and urinary function, although small numbers reported worsening. Conclusions: There is very limited evidence on QoL after RRH. Whilst there are benefits, most adverse consequences arise from oophorectomy. Benign hysterectomy allows for some limited comparison; however, more research is needed for outcomes in the population of women at increased EC-risk. [ABSTRACT FROM AUTHOR]

Objective: To chart peer-reviewed literature regarding the psychological and social health outcomes of physical activity (PA) around menopause in a systematic manner.Methods: Nine electronic databases and 10 core journals were searched using specific search strings to identify eligible articles. Manual checking of reference lists was also performed. The selection process was guided by the stages in PRISMA-ScR.Results: Eighty peer-reviewed articles representing 67 studies from 25 countries were included. All articles were published between 1994 and 2021. For all studies, surveys were the primary method of measuring psychological and social health outcomes, in cross-sectional studies (36 papers), intervention studies (33), longitudinal cohort studies (10) and one paper reporting a mixed-method study. The dataset comprised a total of 103,826 women, with an average age of 52.6 and a variety of menopausal states. Most of the studies involved primarily Caucasian, relatively healthy, married and employed participants. Nineteen psychological and social health outcomes were assessed, including psychological menopause symptoms (N = 34), quality of life (N = 33), depression (N = 30), anxiety (N = 11), mental wellbeing (N = 21), perceived stress (N = 9), satisfaction with life (N = 7) and self-esteem (N = 5).Conclusions: Collectively, the findings of these studies indicate a relatively evident positive impact of PA on the respective health outcomes, with only a few studies reporting no association. It is also noteworthy that most studies did not report any difference related to menopausal status. Future studies would benefit from, inter alia, a qualitative approach to lived experiences of psychological and social health outcomes of PA during the menopausal transition. [ABSTRACT FROM AUTHOR]

• Menopause symptoms can result in adverse work outcomes, including loss of productivity, missed days, and negative career repercussions such as changing jobs or early retirement. • Supportive work environments, including flexible working hours, increased awareness about menopause, strong supervisor support, and individual control over the work environment have been shown to attenuate the impact of menopause symptoms in the workplace. • Future research should prioritize easily assessed, meaningful measures such as lost work productivity, utilization of workplace resources, employee satisfaction and engagement, and retirement intentions. • Interventions should focus on ease of implementation, cost-effectiveness, and providing a variety of options tailored to women's unique menopause experiences. Menopause is a natural part of a woman's life that coincides with a time when many women play significant roles in the workforce. Menopause symptoms, such as hot flashes, fatigue, and difficulty with concentration and memory, can have a negative effect on work productivity and efficiency. This paper summarizes the impact of menopause in the workplace, with an emphasis on the impact of symptoms on employed women and how the workplace influences their experiences. It highlights economic implications, promotes awareness, and suggests potential next steps. A search for papers was conducted between August and November 2023 in the PubMed and Medline databases. Papers were selected based on personal experience and interpretation of the findings. Recommendations for managing menopause symptoms in the workplace and guidance on an optimal workplace intervention strategy were provided. Women experiencing severe menopause symptoms are more likely to report adverse work outcomes, including absenteeism and job-related decisions such as quitting, retiring early, or declining promotions than women experiencing few symptoms. Factors such as a lack of awareness about menopause, inflexible work conditions, and high-stress jobs can exacerbate the severity of these symptoms. Additionally, unaddressed menopause symptoms contribute to both direct and indirect economic costs, including medical resource utilization and lost work productivity, resulting in a substantial economic burden. Menopause symptoms impair women's work experiences and productivity. In addition to dismantling the stigma associated with menopause, it is critical to create and implement menopause workplace policies and interventions aimed at supporting women in this universal life stage. [ABSTRACT FROM AUTHOR]

Given the increase in the incidence of breast cancer during the past decades, several studies have investigated the effects of variables on breast cancer, especially obesity. This systematic review and meta-analysis aims to evaluate any effects of obesity on breast cancer risk in women, before and after menopause, and in different continents. All forms of relevant literature examining any association between obesity and breast cancer, including cohort, case–control, and cross-sectional studies, were identified in the PubMed, Scopus, EMBASE, and Web of Science databases from January 1, 1990 until January 13, 2023. Body mass index (BMI) > 30 was used to indicate obesity. Every type of breast cancer was examined as outcome factors. The quality of the papers was evaluated using the Newcastle–Ottawa scale checklist. The Egger and Begg test was used to evaluate publication bias. To assess any extra impact of each research on the final measurement, a sensitivity analysis was carried out. One hundred and two studies were included in this meta-analysis. Respectively, 48 and 67 studies reported associations between obesity and breast cancer in pre and post menopausal women. Combining all studies, the pooled OR of the association between obesity and breast cancer in pre-menopausal women was OR = 0.93 CI: (0.85–1.1), (I2 = 65.4%), and for post-menopausal woman, OR = 1.26 CI: (1.19–1.34), (I2 = 90.5%). Obesity has a protective role in breast cancer among pre-menopausal women, but this relationship is statistically significant only in European women. The chance of developing breast cancer increases in post-menopausal women who are obese. This relationship is significant among Asian, North American, African and European women. [ABSTRACT FROM AUTHOR]

Trifolium pratense L., commonly known as red clover, is a dicotyledonous allogamous diploid plant. It is known to have antioxidant, anti-inflammatory, chemo-preventive and anti-spasmodic capabilities among other medicinal properties. Studies have indicated that it is extremely beneficial in managing postmenopausal symptoms and has a positive role to play in moderating rheumatoid arthritis. Products obtained from the plant, specifically phytoestrogens, are being explored for their role in cognitive therapeutics. It is also being studied as a potential cure for cancers, such as breast cancer. In this paper, we have reviewed the genomic details of Trifolium and its possible applications in the field of medicine. Phytoestrogens, their mechanism of action, isoflavones and their biosynthetic pathway along with factors affecting isoflavone concentration are also reviewed. Thus, this review summarizes the existing literature about the phytoestrogens of T. pratense and their potential use for human health and the gaps in this information. Future prospects have been enumerated to guide further research on phytoestrogens of T. pratense. [ABSTRACT FROM AUTHOR]

Middle aged women in majority undergoing menopausal symptoms are unaware of the physiological changes happening in their body, necessary lifestyle changes and alternate therapies to overcome the symptoms. All major electronic sources of relevant information were systematically searched and collected data were pooled under specific subheadings. From the reviewed papers, the awareness on symptoms and related complications of menopause in the middle aged women were consolidated. Studies helped to identify alternative therapies replacing or in parallel with the Hormone Replacement Therapy to overcome the menopausal symptoms. Reduced oestrogen and progesterone level causes physiological, psychological, and genitourinary symptoms. Prolonged consequences cause libido, osteoporosis, and cardio vascular diseases. Hypo-estrogenic status is well managed with alternative therapies including dietary intervention, acupuncture, aromatherapy, exercise, and yoga. Dietary interventions involving foods like Fennel, Soy, Black Cohash, St. John Wort, Red Clover and Date Pollen were found to be managing vasomotor symptoms and sexual dysfunction. Non-Hormonal and Non-Pharmacological impact behind acupuncture treatment was well accepted. Various studies proved inhaling and massaging with Lavender, Neroli oil, Fennel, Rose, and Geranium essential oils balance cortisol hormone and reduce stress and anxiety. Impact of yoga therapy on neurohormonal pathways reduce both psychological and physiological symptoms. Reviews summarizes various symptoms and complications during menopausal transition and alternate ways of better management with dietary intervention, yoga, exercise, aromatherapy, and acupuncture to improve the quality of menopausal women's life. [ABSTRACT FROM AUTHOR]

Introduction This article quantifies the research contribution related to endometrial hyperplasia (EH). Materials and Methods We searched the Scopus database in 2002 to 2021. Results A total of 6,422 were retrieved; 1,906 were open access; 5,602 in English. The number of published papers showed rising productivity over the last 20 years ranging from 261 to 425. There were 5,034 research articles and 1,388 reviews. The most prolific authors were Zullo, F (30), Mirkin, S (28), Archer, DF (27), and Insabato, L (26). The top involved journals were the Gynecologic Oncology Journal (144), European Journal of Gynaecological Oncology (114), and International Journal of Gynecological Pathology (105). The United States was the most dominant country, with 1,592 articles, followed by China (601) and Italy (435). The most actively involved institutions were the University of Texas MD Anderson Cancer Center (77), followed by Fudan University (63) and Harvard Medical School (62). The top funding sponsors were the National Cancer Institute (178), the National Institutes of Health (177), and the National Natural Science Foundation of China (107). The top three most cited articles received 1,182, 746, and 600 citations, respectively. Conclusion This study defines the prolific researchers, institutions, journals, and countries as a good starting to bridge gaps in research activity. [ABSTRACT FROM AUTHOR]

Menopause is one the most crucial stages in a female's life. Identifying the education gaps regarding menopause is important, thus this study aims to explain the health-related needs of females during menopause. Scopus, PubMed, Scientific Information Database, and Web of Science databases were searched for the available observational (cohort, case-control, and cross-sectional), systematic review, meta-analysis, and clinical trial studies (2007-2021) using keywords, such as 'Educational Needs Assessment,' 'Assessment of Healthcare Needs,' 'menopause,' 'climacteric,' 'premenopause,' and 'postmenopause.' A total of 180 out of 5,705 papers were evaluated after considering the inclusion and exclusion criteria. The educational needs of females during menopause in the reviewed studies include osteoporosis, oral and dental problems, metabolic disorders, cardiovascular diseases, hypertension, lung diseases, infectious diseases, musculoskeletal problems, urinary problems, breast cancer, defecation problems, genital disorders, special diseases such as eye diseases and hypothyroidism and hormone therapy, mental disorders, cognitive function, sleep disorders, sexual disorders, physical activity, supplement consumption, public health issues, health education, fall, and nutrition. The study results reveal that females during postmenopause require training, counseling, and support in all aspects to get through this challenging time, and providing these services, infrastructure, appropriate policy, and the use and support of the medical team's capacity are all required. [ABSTRACT FROM AUTHOR]

Early and premature menopause, or premature ovarian insufficiency (POI), affects 1% of women under the age of 40 years. This paper reviews the main aspects of early and premature menopause and their impact on cognitive decline. Based on the literature, cognitive complaints are more common near menopause: a phase marked by a decrease in hormone levels, especially estrogen. A premature reduction in estrogen puts women at a higher risk for cardiovascular disease, parkinsonism, depression, osteoporosis, hypertension, weight gain, midlife diabetes, as well as cognitive disorders and dementia, such as Alzheimer's disease (AD). Experimental and epidemiological studies suggest that female sex hormones have long-lasting neuroprotective and anti-aging properties. Estrogens seem to prevent cognitive disorders arising from a cholinergic deficit in women and female animals in middle age premature menopause that affects the central nervous system (CNS) directly and indirectly, both transiently and in the long term, leads to cognitive impairment or even dementia, mainly due to the decrease in estrogen levels and comorbidity with cardiovascular risk factors, autoimmune diseases, and aging. Menopausal hormone therapy from menopause to the age of 60 years may provide a "window of opportunity" to reduce the risk of mild cognitive impairment (MCI) and AD in later life. Women with earlier menopause should be taken care of by various specialists such as gynecologists, endocrinologists, neurologists, and psychiatrists in order to maintain their mental health at the highest possible level. [ABSTRACT FROM AUTHOR]

Genitourinary syndrome of menopause (GSM) is a group of syndromes, including atrophy of the reproductive tract and urinary tract, and sexual dysfunction, caused by decreased levels of hormones, such as estrogen, in women during the transition to, or late stage of, menopause. GSM symptoms can gradually become severe with age and menopausal time, seriously affecting the safety, and physical and mental health, of patients. Optical coherence tomography (OCT) systems can obtain images similar to "optical slices" in a non-destructive manner. This paper presents a neural network, called RVM-GSM, to implement automatic classification tasks for different types of GSM-OCT images. The RVM-GSM module uses a convolutional neural network (CNN) and a vision transformer (ViT) to capture local and global features of the GSM-OCT images, respectively, and, then, fuses the two features in a multi-layer perception module to classify the image. In accordance with the practical needs of clinical work, lightweight post-processing is added to the final surface of the RVM-GSM module to compress the module. Experimental results showed that the accuracy rate of RVM-GSM in the GSM-OCT image classification task was 98.2%. This result is better than those of the CNN and Vit models, demonstrating the promise and potential of the application of RVM-GSM in the physical health and hygiene fields for women. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is a chronic non-communicable disease. It is a metabolic syndrome (MS) in the liver. Menopause is a physiological phenomenon of women due to the decline of ovarian function, which is characterized by the deterioration of hypothalamic-pituitary function. Clinical and epidemiological studies have shown that the incidence trend of NAFLD has gender differences and is related to metabolic parameters such as glucose, lipids, and blood uric acid. The incidence of NAFLD in premenopausal women is lower than that in males, while the incidence of NAFLD in postmenopausal women gradually increases to the same as that in males. The mechanism may be mainly related to the changes of sex hormones in postmenopausal women (mainly the decrease of estrogen). The changes of sex hormones such as the decreased levels of estrogen and sex hormone binding globulin (SHBG) and the relatively increased level of androgen can increase the incidence of MS components such as abdominal obesity, abnormal blood lipid metabolism and insulin resistance (IR), making menopause an important independent risk factor for NAFLD in women. Estrogen, androgen receptor antagonists and phytoestrogens can improve hepatic steatosis and IR through many ways, reduce the severity of NAFLD and delay its progression to liver fibrosis, which have certain therapeutic significance for postmenopausal women with NAFLD, but also have some limitations. This paper reviews the research progress in the relationship between menopause and NAFLD in recent years, so as to provide ideas and reference for the prevention and treatment of NAFLD in postmenopausal women. [ABSTRACT FROM AUTHOR]

The paper traces the gradual transition from a society in which the age structure graph for female deaths has two distinct peaks punctuated by an area of low mortality at menopause (as if menopause reverses the trend, giving women a new life expectancy), to a model in which the age structure for men and women is similar, but women die later. The change observed was that the local minimum for female deaths (aged 41-45) remained the same, but one of the maxima (the group of women for whom life expectancy ended at the end of childbearing age) disappeared. Male deaths do not exhibit such a pattern, which can account for why men have benefited much less from the increase in life expectancy. The analysis is based on 470,000 Polish newspaper obituaries from 1845 to 1939 in which 205,000 people were listed, and from these 165,000 were selected for whom the age at death is known. [ABSTRACT FROM AUTHOR]

Menopause just like birth and death is an inevitable part of a woman's life. This event is significant as it is believed to have a substantial impact on a woman's life. The objective of this paper is to assess the age-specific variance in anthropometric measurements and adiposity levels among tribal post-menopausal women. The study was conducted in the Guwahati City of Assam. Observation and interview with pre-tested schedule and anthropometric measurements with the standard technique and spss were used for collecting and analyzing the data. The findings show that, 64.4% of the post-menopausal women were found to be normal (BMI: 18.5-22.9 kg/m2), 27.7% of the respondents were at the increased risk of adiposity (BMI:23.0-27.5 kg/m2) and 4.0% belonged to category grade I obesity or higher risk of adiposity (BMI:>27.5 kg/m2), whereas another 4% were underweight (BMI:<18.5 kg/m2). Regarding WHR, 39.0% of the post-menopausal women were at high risk, 36.4% belonged to moderate risk and 24.6% at low risk. The relative risks of co-morbidity related to excess adiposity were also quite high among the Mishing post-menopausal women. [ABSTRACT FROM AUTHOR]

Midlife women commonly experience changes in their cognitive function as they transition through menopause and express concern about whether these changes represent the initial stages of a more serious cognitive disorder. Health-care practitioners play an important role in counseling women on cognitive changes at midlife and normalizing women's experience. The aim of this commissioned International Menopause Society White Paper on cognition is to provide practitioners with an overview of data informing the clinical care of menopausal women and a framework for clinical counseling and decision-making. Among the topics presented are the specific cognitive changes occurring in menopause, the duration of such changes and their severity. The role of estrogen and menopause symptoms is reviewed. We present talking points for clinical counseling on the effects of hormone therapy on cognition and dementia risk in women, including discussion of absolute risk. Lastly, a brief review of modifiable risk factors for age-related cognitive decline and dementia is presented, with guidance for counseling patients on optimizing their brain health at midlife and beyond. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include the study on the effect of osteoporosis treatment on mortality, the risk of subsequent fracture and mortality within 5 years after a non-vertebral fracture, and the relationship to rates of bone loss in postmenopausal women.