Search Results (1,258)

Background: Temporomandibular disorders (TMDs) exhibit a marked female predominance, suggesting a potential role for estrogen in their pathophysiology. However, evidence linking estrogen status to TMD remains inconsistent. Objective: To systematically review the association between estrogen-related factors and TMD prevalence and clinical presentation in women. Methods: PubMed, Embase, Scopus, Web of Science, and Google Scholar were searched through September 2025. Observational studies evaluating hormonal contraceptive use, menopausal status, menstrual cycle variation, pregnancy, or estrogen receptor polymorphisms in women with TMD were included. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment using the Newcastle-Ottawa Scale. Due to substantial heterogeneity, a narrative synthesis was conducted. Results: Seven studies met the inclusion criteria, including six clinical studies involving 2735 participants and one mechanistic supportive study. Moderate-certainty evidence suggested associations between hormonal contraceptive use, menopausal/climacteric status, and increased TMD risk or symptom severity. Additional low-certainty evidence supported associations involving menstrual cycle variation, pregnancy, and estrogen receptor polymorphisms. Conclusions: Current evidence suggests that hormonal factors may influence TMD risk and symptom presentation in women. However, heterogeneity in definitions of hormonal exposure and diagnostic criteria limits definitive conclusions. Further prospective studies using standardized diagnostic protocols and real-time biochemically validated hormonal assessments correlated with clinical symptoms are needed. Full article

Background: Menopausal symptoms may adversely affect women’s overall health and well-being. Aim: This study investigated the effects of menopausal symptoms on subjective well-being in women in the 40–65 age group. Methods: The study sample consisted of 510 women, with 318 postmenopausal and 192 perimenopausal participants. Data were gathered using a Sociodemographic Information Form, the Menopause Rating Scale (MRS), and the Subjective Well-being Scale (SWBS), all administered as self-report instruments. Menopausal status was determined using the Stages of Reproductive Aging Workshop +10 criteria. Descriptive statistics, Chi-square test, Pearson correlation, and regression analyses were used. Results: Three regression models were specified to investigate the relationship between menopausal symptoms and subjective well-being. Model 1 demonstrated that overall menopausal symptoms were significant negative predictors of subjective well-being (B = −0.749, SE = 0.156, β = −0.260, t = −4.788, p < 0.001, 95% CI [−1.06, −0.44], R² = 0.068). Model 2 showed that both urogenital symptoms (B = −1.208, SE = 0.517, β = −0.139, t = −2.336, p = 0.020, 95% CI [−2.22, −0.20]) and somatic symptoms (B = −2.068, SE = 0.731, β = −0.168, t = −2.830, p = 0.005, 95% CI [−3.50, −0.64]) were significant negative predictors. Model 3 indicated that psychological symptoms significantly and negatively predicted subjective well-being (B = −1.114, SE = 0.262, β = −0.233, t = −4.253, p < 0.001, 95% CI [−1.63, −0.60], R² = 0.054). Conclusions: The findings highlight the importance of comprehensive health strategies and demonstrate that psychological symptoms significantly impact overall well-being. Full article

Background/Objectives: This study aimed to examine whether psychological resilience mediates the relationship between religious coping behaviors and menopausal symptoms among postmenopausal women. Methods: A cross-sectional study was conducted in Türkiye between July 2024 and July 2025 with women aged 45–60 years in the natural menopausal period (n = 190). Data were collected using a sociodemographic questionnaire, the Menopause Rating Scale (MRS), the Religious Coping Styles Scale (RCSS), and the 10-item Connor–Davidson Resilience Scale (CD-RISC-10). Descriptive statistics, Spearman correlation analysis, and structural equation modeling (SEM) with robust estimation were performed. The potential mediating role of psychological resilience was examined using SEM. Results: Negative religious coping was significantly associated with lower psychological resilience (β = −0.17, p = 0.050). However, psychological resilience did not show a significant association with menopausal symptoms in the structural model (β = −0.11, p = 0.134). Positive religious coping was not significantly related to resilience (β = −0.04, p = 0.649). The overall model explained a low proportion of variance in menopausal symptoms (R² ≈ 0.05). No evidence of a mediating effect of psychological resilience was found. Bootstrapped indirect effects indicated that the mediating role of psychological resilience was not statistically significant, as the confidence interval included zero. Conclusions: Although psychological resilience and religious coping were associated at the correlational level, no evidence of a mediating effect was found. The low explanatory power of the model suggests that menopausal symptoms are influenced by broader biological and contextual factors. The findings should be interpreted cautiously, and further longitudinal research is needed. Full article

Women are twice as likely to suffer from major depressive disorder (MDD). The underlying mechanism between estrogen and depression is still unknown. We used ovariectomized rats to simulate menopausal status and established a depression model of chronic and acute stress. The therapeutic effects of estrogen were systematically studied through behavioral testing, Western blotting, ELISA, LC-MS, and cell experiments. In chronic stress, OVX rats showed depressive-like behaviors, and elevated hippocampal ER, BDNF, IL-1β/IL-18, and body weight. ERT reduced depression-like behavior by 64% to 76% in the behavioral test. ERT also reversed the molecules without affecting GPR30. In acute stress, ERT reduced depression-like behavior by 20% to 58% in the behavioral test. OVX decreased ER, BDNF, P2X7, IL-1β/IL-18, spine density, and microglia and increased the expression of GPR30. ERT reversed all the above. ERT normalized metabolic abnormalities caused by CUMS. Our study demonstrates that estrogen deficiency contributes to the onset and progression of depression in a rat model of menopause-like estrogen deficiency. Estrogen replacement therapy appears to alleviate depressive-like behaviors by reducing brain inflammation and supporting the brain’s adaptive capacities through ER. Furthermore, the dual function positions GPR30 as a promising potential target for future treatments of menopausal depression, and GPR30 regulates neuroinflammation and neuroplasticity through the NLRP3/P2X7/IL-1β pathway. Full article

Osteoporosis in women is strongly influenced by menopause, a major physiological transition that reshapes bone metabolism. Although low bone mineral density (BMD) in premenopausal women and osteoporosis in postmenopausal women share the clinical outcome of skeletal fragility, it remains unclear whether they reflect a shared molecular program or distinct regulatory mechanisms. Here, we compared genetic signals associated with premenopausal and postmenopausal low BMD in Korean women using two independent genotyping platforms with distinct variant coverage. After allele harmonization and heterogeneity testing, variants were classified as reversal signals, showing directionally discordant effects across menopausal status, or stable signals, showing concordant effects. Gene-level association analysis was performed using Multi-marker Analysis of GenoMic Annotation (MAGMA), followed by functional enrichment and network-based analyses. Reversal and stable signals showed distinct biological patterns. Reversal signals consistently converged on cyclic nucleotide-related pathways, including cyclic adenosine monophosphate/cyclic guanosine monophosphate (cAMP/cGMP) signaling and nitric oxide-mediated processes, whereas stable signals were more broadly distributed across pathways related to ion homeostasis, cell–substrate adhesion, and structural maintenance. These pathway-level patterns were reproducible across platforms despite limited SNP-level overlap. These findings suggest that low BMD across the menopausal transition is better resolved at the gene and pathway levels than at the level of individual SNPs. Full article

Background: Postmenopausal women are at high risk of Alzheimer’s disease (AD) incidence and progression. Irisin, an exercise-induced myokine, has neuroprotective and antiaging effects against AD, especially in menopausal women suffering from insulin resistance (IR). For the first time, the novel role of irisin induced by melatonin (MTN) or/and physical exercise (PHE) was investigated in the current ovariectomized (OVX)/AD rat model by modulating brain neuroinflammation and IR-related markers. Methods: Fifty female Wistar rats were divided into five groups, with one representing a sham group. AD was induced in the other four bilateral OVX rat groups by daily intraperitoneal injection of D-galactose/AlCl₃ (60 and 10 mg/kg, respectively) for 42 days. Group III–V: Animals were exposed to MTN (10 mg/kg/day; i.p.), PHE, and a combination of these, respectively, in the final 14 days of the experiment. Results: The OVX/AD rats showed significant deterioration in learning, memory, neurochemical, and histopathological examinations, while the MTN or/and PHE treatments significantly increased serum and brain irisin, improving memory in a Y-maze assessment. Thus, hippocampal histopathological alterations and IR-related markers decreased. In addition, suppressed hippocampal amyloid-beta protein expression and neuroinflammatory content of tumor necrosis factor-alpha (TNF-α), p38 mitogen-activated protein kinase (p38 MAPK), and NOD-like receptor protein-3 (NLRP3) were associated with an increase in peroxisome proliferator-activated receptor-gamma (PPAR-γ) protein expression and insulin-like growth factor-1 content in hippocampal tissues, collectively suppressing glial fibrillary acidic protein (GFAP) content, leading to an increase in brain-derived neurotrophic factor expression. Conclusions: Irisin induction may serve as a novel avenue in AD/menopause treatment and prevention via modulating the TNF-α/p38 MAPK/PPAR-γ/NLRP3/GFAP pathway. Full article

Background: Endometrial cancer outcomes differ among Black women when examined by nativity, and timely evaluation of postmenopausal bleeding (PMB), the most common presenting symptom, may contribute to these disparities. Methods: This qualitative study explored cultural, societal, and behavioral factors shaping PMB appraisal and anticipated care-seeking among US-born Black, Caribbean-born Black, and Haitian Creole-speaking women in South Florida, guided by the Safer–Andersen Model of Total Patient Delay. Ten focus groups were conducted with 55 Black women aged ≥50 years recruited through purposive and snowball sampling. Discussions were held in English or Haitian Creole, audio-recorded, professionally transcribed, translated when needed, and analyzed thematically using a hybrid deductive–inductive approach. Reporting followed the Consolidated Criteria for Reporting Qualitative Research. Results: Three themes emerged: limited awareness and information-seeking regarding menopause and PMB; cultural and societal influences, including faith-based coping, traditional remedies, and limited family discussion of health history; and healthcare system barriers, including cost, lack of insurance, distrust, and communication challenges with providers. Subgroup differences were noted in preferred information sources, perceived susceptibility, and the role of religion in care-seeking. Conclusions: Findings suggest that PMB appraisal and anticipated care-seeking vary by nativity and language among Black women. Nativity- and language-tailored community education and navigation strategies may improve symptom recognition and support timely evaluation, but future quantitative studies are needed to test whether these approaches reduce pre-diagnostic intervals for endometrial cancer. Full article

Background/Objectives: Evidence-based nutritional recommendations for obesity management require understanding of sex-specific and age-specific body composition patterns and their associations with metabolic biomarkers, habitual dietary intake and chronic low-grade inflammation. This study aimed to characterize body composition phenotypes in a large clinical cohort of adults with obesity, to evaluate associated metabolic and inflammatory biomarker patterns, to contextualise these patterns against habitual nutrient intake assessed in a dietary subcohort, and to derive age- and sex-specific nutritional recommendations based on the identified patterns. Methods: We performed a cross-sectional analysis of 29,544 adults with obesity (BMI ≥ 30; 21,374 women, 8170 men; age 30–69) who underwent multi-frequency bioelectrical impedance analysis (BIA; InBody 770). Biochemical assessments (fasting glucose, lipid profile, uric acid, HbA1c, insulin) were available for 2019 hospitalized patients from the same population. Habitual dietary intake was quantitatively assessed in a dietary subcohort of 423 patients using the validated Russian software-based questionnaire “Scientific Nutrition Analysis Tool”. Inflammatory biomarkers (high-sensitivity CRP, IL-6) and adipokines (leptin, adiponectin) together with serum 25(OH)D were measured in an inflammation/adipokine subcohort of 116 patients. A body composition phenotype with low relative muscle mass and high visceral fat (VFA ≥ 100 cm²) was defined using FNIH criteria (ALM/BMI < 0.789 men, <0.512 women). Benjamini–Hochberg FDR correction (q < 0.05) was applied for multiple comparisons. Results: The body composition phenotype prevalence increased progressively with age: men 24.6% (30–39) to 42.0% (60–69); women 10.3% (30–39) to 31.8% (60–69). Skeletal muscle mass (SMM) was positively associated with uric acid (r = +0.347, p < 0.001, FDR q < 0.05) and inversely associated with HDL-cholesterol (r = −0.321, p < 0.001, FDR q < 0.05)—both associations with direct nutritional implications. BMI was associated with fasting insulin (r = +0.233, p < 0.001, FDR q < 0.05). Women showed significant age-related metabolic differences between the 30–39 and 60–69 age groups: fasting glucose +12.9%, triglycerides +34.8%, uric acid +15.0% (all p < 0.001); in men, significant differences were observed for fasting glucose (+7.0%) and HbA1c (+5.2%) (both p < 0.001), while lipid parameters did not reach significance. In the dietary subcohort, habitual saturated-fat intake exceeded recommended values in 70–72% of patients of both sexes, dietary fibre intake was below recommended levels in 73–85%, and habitual calcium intake decreased significantly with age in women (1022 → 746 mg/day, p = 0.028). Serum CRP was elevated (median 5.59 mg/L, n = 59). In a separate extended laboratory subcohort, serum oestradiol declined markedly with age in women (55.0 → 16.8 pmol/L between 30–39 and 50–59 years, p < 0.001), consistent with the menopausal transition; serum testosterone in men remained stable across age groups; and 25(OH)D insufficiency (<30 ng/mL) was prevalent in 49.7–55.8% of patients. Conclusions: The identified sex-specific and age-specific body composition patterns provide a rationale, supported by observed dietary and inflammatory patterns, for targeted nutritional intervention: increased dietary protein, omega-3 fatty acids supplementation, low-glycemic-index dietary patterns, and purine restriction with hyperuricemia. Routine BIA-based nutritional screening combined with quantitative dietary assessment should begin at age 30, with preventive monitoring at age 40 and intensification of control at age 50, to guide personalized dietary planning in obesity. Full article

Background/Objectives: Blood iron biomarkers are commonly interpreted using fixed clinical reference intervals, although iron metabolism varies by age, sex, menopausal status, and race. This study aimed to characterize the distribution of iron biomarkers across demographic subgroups and to examine their distribution relative to commonly used reference intervals. Methods: In this cross-sectional study, 7990 adults (≥18 years) from the All of Us Research Program were classified as premenopausal women, postmenopausal women, men < 53 years, or men > 56 years. Serum iron, ferritin, total iron-binding capacity, unsaturated iron-binding capacity, and transferrin saturation (TSAT) were summarized across groups and compared descriptively with commonly used reference intervals. Results: Iron biomarkers varied across demographic groups. Mean serum iron was 82.3 µg/dL overall, with lower levels in premenopausal women (79.5 ± 36.7 µg/dL) and higher levels in men < 53 years (86.8 ± 41.8 µg/dL). Mean TSAT was 25.6% and generally located toward the lower end of commonly used reference ranges. Ferritin showed substantial variability, with higher mean levels in younger men (258.0 ± 581.0 ng/mL) and lower levels in premenopausal women (102.1 ± 224.9 ng/mL). Premenopausal women had higher iron-binding capacity, whereas older men had lower values. Black participants had lower serum iron and TSAT but higher ferritin compared with White participants. A substantial proportion of participants had values outside commonly used reference intervals, particularly for serum iron and TSAT. Conclusions: Iron biomarker distributions differ across demographic subgroups and may not be fully reflected by commonly used reference intervals. These findings highlight the importance of context-specific interpretation and underscore the need for further studies to evaluate the applicability of current reference intervals across diverse populations. Full article

Background: The vagina undergoes important changes across the life course that are shaped not only by hormonal transitions but also by shifts in the vaginal microbial environment. Despite growing interest in the vaginal microbiome, research has disproportionately centered reproductive-aged populations, leaving the aging vagina comparatively understudied. Objective: This article examines the aging vagina through a life-course lens, with emphasis on microbial and clinical transitions associated with midlife and older adulthood. Key Content: The article highlights menopause-related changes and approaches for reducing stigma and missed clinical opportunities. Particular attention is given to menopause-related declines in estrogen, reduced glycogen availability, increased vaginal pH, and accompanying changes in microbial balance, as well as their relationship to dryness, irritation, genitourinary symptoms, and susceptibility to adverse outcomes. The article also provides health professionals with a practical educational framework for symptom recognition, patient communication, vaginal health assessment, menopause-related education, stigma reduction, and prevention of missed clinical opportunities. Conclusions: Positioning the aging vagina within life-course and microbial-health frameworks can strengthen prevention, improve symptom recognition, and support more age-inclusive, informed, and responsive care for older women. Full article

Background/Objectives: Lower circulating testosterone concentrations in postmenopausal women have been associated with adverse sexual, skeletal, and metabolic outcomes, yet population-level prevalence estimates remain inconsistent. In the absence of universally accepted diagnostic thresholds for androgen deficiency in women, interpretation of serum testosterone concentrations remains variable. This study aimed to describe the distribution of serum total testosterone and to evaluate demographic and hormonal correlates among physiologic postmenopausal women in the United States. Methods: This cross-sectional study analyzed women meeting criteria for physiologic menopause from the 2011–2016 and 2021–2023 National Health and Nutrition Examination Survey (NHANES) cycles. Participants using androgenic medications were excluded. Because no universally accepted diagnostic threshold exists for testosterone deficiency in women, serum total testosterone <30 ng/dL was used as an operational, population-based reference point, with <20 ng/dL evaluated as a sensitivity threshold. Survey-weighted analyses characterized the cohort and examined associations between testosterone concentrations below the <30 ng/dL operational threshold and demographic and hormonal variables using logistic regression. Results: Among 2707 postmenopausal women, the weighted mean total testosterone was 25.2 ± 1.1 ng/dL. Using operational, distribution-based thresholds, 56.0% of women had testosterone concentrations <20 ng/dL and 79.9% had concentrations <30 ng/dL (Rao–Scott χ², p < 0.001). In the weighted distribution, both thresholds lay above the weighted median, with 30 ng/dL exceeding the 75th percentile. The proportion of women with testosterone concentrations below the <30 ng/dL threshold differed significantly by race/ethnicity (p < 0.01) and age group (p < 0.01), highest among Non-Hispanic Asian (87.7%) and Mexican American (89.4%) women and lowest among Non-Hispanic Black women (75.5%). In multivariable models, higher sex hormone binding globulin (SHBG) (adjusted OR = 0.720; 95% CI: 0.633–0.820; p < 0.001) and higher estradiol (adjusted OR = 0.577; 95% CI: 0.389–0.856; p < 0.05) were independently associated with lower odds of testosterone concentrations below the <30 ng/dL threshold. Conclusions: Testosterone concentrations below operational thresholds are highly prevalent among U.S. postmenopausal women, although estimates vary depending on the cutoff applied. Higher SHBG and estradiol levels were inversely associated with testosterone concentrations below these thresholds, underscoring the physiologic interrelationship of these hormones in postmenopausal women. These findings highlight the need for standardized, population-specific reference thresholds and clearer clinical frameworks for interpreting androgen levels in women. Full article

HIV is primarily acquired in women at the female genital mucosa through heterosexual contact. Mucosal immune cells reside adjacent to, within, below, and distant from the epithelium that lines the surface of the female genital tract (FGT) mucosa. Innate immune cells play dual roles in HIV acquisition, both poised to rapidly recognize and respond to HIV, but are also capable of promoting HIV infection locally and distantly in the lymph nodes. In this review we emphasize recent human research on the roles of specific innate immune cells in HIV pathogenesis in the FGT, including dendritic cells, macrophages, neutrophils and innate lymphoid cells. We review how FGT mucosal dynamics, including anatomical compartmentalization, menstrual cycle regulation, reproductive history, menopause and chronological aging contribute to tissue conditioning of these cells and changes in HIV susceptibility in women throughout their lives. Full article

Background/Objectives: The menopausal transition involves bodily, emotional, and sexual changes that may be relevant to body image. This study examined whether intrapersonal and relational dimensions of perceived self-attractiveness were associated with multidimensional body image among partnered women during the menopausal transition, after adjustment for BMI and sociodemographic factors. Methods: This cross-sectional study was conducted in 2024–2025 in primary health care clinics in Lublin Province, Poland, and included 474 partnered women in perimenopause or early postmenopause. Body image was assessed with the Body Esteem Scale subscales, namely Sexual Attractiveness, Weight Concern, and Physical Condition, and perceived self-attractiveness with the Scale of Assessment of Self-Attractiveness in a Relationship. Hierarchical linear regression models were adjusted for BMI, age, education, and socioeconomic conditions. Results: Body Acceptance was positively associated with Sexual Attractiveness (β = 0.193, p = 0.002), Weight Concern (β = 0.225, p < 0.001), and Physical Condition (β = 0.206, p = 0.001). Sexual Satisfaction was positively associated with Sexual Attractiveness (β = 0.299, p < 0.001) and Physical Condition (β = 0.143, p = 0.023). Appearance Evaluation was positively associated with Weight Concern (β = 0.126, p = 0.023). Higher BMI was negatively associated with Weight Concern (β = −0.356, p < 0.001) and Physical Condition (β = −0.209, p < 0.001), whereas older age was negatively associated with Sexual Attractiveness (β = −0.127, p = 0.002) and Physical Condition (β = −0.137, p = 0.001). Conclusions: In partnered women during the menopausal transition, body image was associated not only with BMI and age, but also with body acceptance and selected intimacy-related dimensions of perceived self-attractiveness. Full article

Background: Given the higher incidence of adrenocortical carcinoma in peri-menopausal women, this study investigates the associations between sex, age, and ACC prognosis. Methods: We analyzed the National Cancer Database (NCDB) for adult patients with ACC (n = 2384) from 2004 to 2022. Overall survival (OS) was the primary endpoint. Patients were stratified by sex and menopausal status (pre- and post-menopausal age of ≤45 and ≥55, respectively). Data from The Cancer Genome Atlas (TCGA) cohort (n = 92) were analyzed to examine clinical characteristics, genetics, transcriptomics, and methylation profiles of primary ACC samples by age group. Results: The analysis of the NCDB cohort revealed that younger men and pre-menopausal women had significantly longer OS compared to older groups. However, age was the only independent variable associated with OS. Using 50 years as the optimal age cutoff, we found no differences in clinical characteristics, rates of pathogenic driver mutations, methylation or gene expression profiles, or enriched molecular pathways in the TCGA ACC cohort by age group. Conclusions: While age ≥50 years is an independent factor associated with shorter OS in ACC, no differences in clinical characteristics or multi-omic profiles were observed by age. These findings suggest that age-related prognosis may be influenced by other factors such as microenvironmental changes or epigenetics. Full article

Background/Objectives: In ovarian cancer, the association between low muscle mass and outcomes is unclear, despite well-established evidence in other cancer diagnoses. Overall body composition may have greater prognostic value. This study aimed to investigate associations between body composition and clinical outcomes. Methods: Retrospective study of women diagnosed with ovarian cancer between August 2020 and March 2024. Clinical characteristics were extracted from medical records. Body composition phenotypes (low skeletal muscle index [SMI], low skeletal muscle density [SMD], high subcutaneous [SATI], visceral [VATI] and total adipose tissue index [TATI]) were assessed from pre-treatment CT images. Logistic regression, chi-squared, Fisher’s exact tests, and Mann–Whitney U tests were used to assess associations between body composition phenotypes, patient characteristics and study outcomes. Cox proportional hazards models were fitted to examine associations with survival. Results: Ninety-nine patients [mean (SD) age 61 (12.7) years, 80% stage III/IV] were included. Overall, 67 (67%) women had low SMI, 57 (57%) low SMD, and 49 (49%) high TATI. Thirty-seven (37%) women had low SMI and low SMD, 23 (23%) low SMI with high TATI, and 33 (33%) low SMD with high TATI. Post-menopausal status was associated with higher VAT (p = 0.004). Low SMI or low SMD co-occurring with high adiposity was associated with a 1.91–2.03 and 2.15–2.49 higher hazard mortality. There was insufficient or weak evidence of an association between body composition and other treatment outcomes. Conclusion: These findings suggest additive effects when phenotypes co-occur. In ovarian cancer, singular assessments may be an oversimplification. Future studies should continue to consider co-occurring phenotypes to adequately capture risk. Full article