The menopausal transition is characterized by numerous physiological changes associated with the hormonal modifications that occur during this period, such as increased body weight and visceral body fat, reduced energy expenditure and fat oxidation rates, and increased risk of cardiometabolic disorders. While the influence of ovarian hormones on the regulation of energy balance has been widely investigated, the effects of the menopausal transition, also called perimenopause, on the different compartments of energy expenditure (i.e. resting, sleeping, thermic effect of food and physical activity energy expenditure) are less described. Furthermore, substrate metabolism adaptations to the menopausal transition are also poorly described despite their significant influence on health. To address this knowledge gap, this narrative review considers the energetic adaptations of the resting and non-resting components during the menopausal transition, as well as central and peripheral estrogen-associated cellular mechanisms that may play a role. Although research on energetic adaptations during the menopausal transition remains limited, current evidence indicates declines in resting and sleeping energy expenditure and fat oxidation, as well as physical activity energy expenditure and peak fat oxidation. These alterations appear to result from central and peripheral adaptations triggered by the menopausal decline in estrogen and the concomitant rise in follicle stimulating hormone (FSH).

Objective Gastroesophageal reflux disease (GERD) is a highly prevalent disorder that diminishes quality of life. Hormonal fluctuations during the perimenopausal transition (age 45–54 years) may heighten susceptibility to GERD, yet the magnitude of the burden in this group remains poorly characterized. This study aims to quantify GERD trends in women of perimenopausal age and forecast disease trajectories to 2045. Method Data from the 2021 Global Burden of Disease (GBD) database were utilized. Age-standardized rates were calculated, annual percentage changes were estimated (EAPC) and Bayesian age–period–cohort (BAPC) models were employed to project trends to 2045. Results From 1990 to 2021, the global age-standardized prevalence rate (ASPR) and age-standardized disability-adjusted life year rate (ASDR) of GERD in women of perimenopausal age exhibited a decreasing trend (EAPC for both: −0.09, 95% confidence interval [CI] − 0.14 to −0.04), despite a marked rise in the prevalent cases. Latin America recorded the highest ASDR. Middle Socio-demographic Index regions experienced the greatest growth in prevalent cases. The BAPC model predicts a rise in the age-standardized incidence rate. Conclusion The burden of GERD in women of perimenopausal age exhibits significant global heterogeneity. Incidence rates have risen persistently and are projected to increase through 2045.

Objective There are many menopauses; bilateral oophorectomy is associated with the worst cognitive outcomes. Compared to females with intact ovaries, females with bilateral oophorectomy experience early, abrupt ovarian hormone loss and are at increased risk for later-life Alzheimer’s disease. They also have double the odds of developing later-life sleep disordered breathing (SDB) – a modifiable Alzheimer’s risk factor. With respect to bilateral oophorectomy, it is unknown when respiratory disturbances occur or whether estradiol therapy (ET) ameliorates them. Also unknown is whether SDB influences cognition in this group. Method Females with risk-reducing bilateral salpingo-oophorectomy (BSO) taking ET (BSO+ET, n = 19) or not (BSO, n = 16) and premenopausal age-matched controls (AMC, n = 17) were assessed for SDB markers using take-home polysomnography and for working memory performance. Results The BSO group showed signs of respiratory disturbance compared to the AMC group. Memory performance was uncorrelated with respiratory metrics. While the BSO+ET group showed an intermediate sleep phenotype, estrone glucuronide levels correlated with improved respiratory metrics. Conclusion The results suggest that respiratory disturbances manifest as early as 5 years post-BSO in younger females; ET offers some amelioration. The close relationship between sleep disruption and Alzheimer’s risk emphasizes the importance of SDB screening post-BSO for early intervention.

Objective This study aimed to report the prevalence of menopausal hormone therapy (MHT) usage in symptomatic postmenopausal women in Australia. Method The Australian Midlife Years Study is a nationally representative, cross-sectional questionnaire-based study of women aged 40–69 years that included current MHT usage and menopausal symptoms. Data were collected during October 2023–March 2024. Results Of 8086 participants, 10.8% of postmenopausal respondents reported MHT use. Further analysis was limited to 2503 potential MHT users (postmenopausal with vasomotor symptoms; 77.5%, n = 1941) or current users (22.5%; n = 562). The absolute number of MHT users was greatest amongst those aged 50–59 years (n = 309/1304, 24%), but the greatest proportion of use was amongst those aged 40–49 years (96/319, 30%). MHT use was less likely for participants who had body mass index (BMI) of 18.5 kg/m2 or ≥30 kg/m2 versus BMI of 18.5–29.9 kg/m2 (p < 0.05 for all), were smokers (p < 0.001), were unemployed but seeking work versus in paid employment (p = 0.003) or were of non-European ancestry (p < 0.05). Education beyond high school (p = 0.002) and past hysterectomy and/or oophorectomy were associated with greater likelihoods of MHT use (p < 0.001). Conclusions Fewer than one-quarter of symptomatic postmenopausal Australian women were using MHT, with socio-demographic variables predicting use. The overall use remains similar to that reported a decade ago.

Objective Climacteric symptoms can significantly impair quality of life. Although various non-pharmacological interventions have been explored, the mid-term and long-term effects of yoga remain insufficiently investigated. This study aimed to evaluate the impact of Shivam Yoga practice on climacteric symptoms and hormone levels over 6, 12 and 24 months. Method In this quasi-experimental controlled trial, 373 women aged 40–65 years were assigned to either a yoga or control group. Symptoms and hormone levels were assessed at baseline, 6, 12 and 24 months. Results A total of 182 women completed at least 6 months of follow-up. The yoga group showed a significant reduction in the frequency of moderate-to-severe symptoms (Kupperman Index >19) across all time points. Median Kupperman scores decreased by 12 points (p < 0.001) at 6 months, 12 points (p = 0.008) at 12 months and 16.5 points (p = 0.027) at 24 months. Improvements were observed in hot flashes, insomnia, nervousness, depressive symptoms, fatigue, arthralgia/myalgia, headache, palpitations and tinnitus. After 24 months, the yoga group also showed significantly higher estrogen and total testosterone levels than the control group. Conclusion Regular Shivam Yoga practice significantly reduced climacteric symptoms over 24 months. These benefits may be mediated by hormonal changes, positioning Shivam Yoga as a promising complementary therapy for menopausal symptoms.

Objective The aim of this study was to explore the independent and combined effects of age at menarche (AAM) and age at natural menopause (ANM) on postmenopausal women’s mental health and to evaluate healthy life expectancy (HLE) in different AAM and ANM groups based on mental disease dimensions. Method Logistic regression was used to assess the associations of AAM and ANM with mental health. A period life table was used to calculate life expectancy, and HLE was calculated via the Sullivan method. Results A total of 11,908 postmenopausal women were included in this study. Compared with menarche at 12–15 years, multiple adjusted odds ratios (95% confidence intervals) for depression, anxiety and mental disorder were 2.313 (1.079, 4.960), 2.401 (1.161, 4.966) and 2.103 (1.051, 4.205) for menarche age <12 years and 1.219 (1.013, 1.468), 1.244 (1.039, 1.491) and 1.210 (1.029, 1.421) for menarche age >15 years; early menopause was associated with depression and anxiety compared to the normal range of ANM. The early AAM and ANM groups tended to have the lowest HLE. Conclusion Abnormal AAM and ANM are not only associated with increased risk of mental problems, but also affect mental HLE in postmenopausal women.

Objective Social media is an increasingly relevant tool for health education, enabling information exchange, promoting autonomy and supporting informed decision-making. This study introduces Menopausando, a predominantly Portuguese-language digital platform designed to support women during menopausal transition and postmenopause. Method This cross-sectional study has been carried out in the Gynecology Discipline, São Paulo University, Brazil, since 2019. In the pre-implementation phase of the digital platform, interviews were conducted with 287 Internet users about their experiences and preferences to be disclosed on the digital platform. The chi-square test or Fisher’s exact test and analysis of variance with Stata 16 SE were utilized. Results Interviewees were 83.3% white with mean age 54.3 (1.82) years, and 78.8% were interested in a menopause digital platform. The platform reached 21,617 website users, 3048 Instagram users, 133 Facebook users and 1126 Spotify users. Facebook users were older, men age 51.3 (9.3) years, than Spotify users, mean age 45.6 (12.2) years (p < 0.001). Female gender was present in all social networks (p < 0.001). The largest number of Brazilian users was on the website, with 21,000 (97.1%) (p < 0.001) (all groups), and other countries’ websites and Instagram (p < 0.001). Conclusion Menopausando effectively supports women during menopausal transition and postmenopause via multiple digital channels. The results expose digital access tendencies and inequalities.

Objective Sarcopenia is a multifactorial skeletal muscle disease commonly observed in the geriatric population. It is influenced by hormonal changes that occur during the postmenopausal period. This study aims to evaluate the sarcopenia status of postmenopausal women. Method The study included 300 postmenopausal women. Sarcopenia was defined according to the updated European Working Group on Sarcopenia in Older People (EWGSOP-2) definition. Results Of the evaluated patients, 44.7% (n = 134) and 15.4% (n = 46) were sarcopenic and sarcopenic obese, respectively. Older age, the number of chronic diseases, medications used and the status of polypharmacy were significantly higher in the sarcopenic group (all p < 0.050). Non-obese patients with sarcopenia showed greater dependence in activities of daily living (ADLs) (p = 0.002) and instrumental ADLs (IADLs) (p = 0.001). In ADLs (p = 0.001) and IADLs (p = 0.001), non-sarcopenic obese patients showed greater independence. Postmenopausal sarcopenia was related to older age (hazard ratio [HR]: 1.07, 95% confidence interval (CI): [1.04–1.10]; p < 0.001), the presence of osteoporosis (HR: 1.86, 95% CI: [1.05–3.30]; p = 0.034) and the existence of vasomotor symptoms (HR: 2.30, 95% CI: [1.31–4.04]; p = 0.004). Conclusion This study highlights the importance of sarcopenia awareness among specialists providing healthcare services to postmenopausal patients. The study underscores the significance of initiating preventive and treatment strategies for at-risk patients before they reach old age.

Objective Testosterone may have a role in brain health. Whether older women who exhibit a decline in blood testosterone are at an increased risk of cognitive decline is uncertain. Method A subset of Australian female participants in the Aspirin in Reducing Events in the Elderly (ASPREE) trial had testosterone concentrations measured by liquid chromatography–tandem mass spectrometry and underwent a comprehensive cognitive test battery at baseline and study year 3. Cognitive decline was defined as a lower test score at year 3 compared with baseline. The mean change (baseline to year 3) of testosterone concentration was examined by paired-sample t-test. Stable or increased (reference) versus a decline in testosterone concentration was used to investigate the association with cognitive decline using logistic regression. Results A total of 395 women (median [interquartile range] age 78.1 [73.7–82.3] years) provided data for analysis. In total, 154 women (39%) had a decline in blood testosterone which was not associated with a decline in any cognitive measure (Modified Mini-Mental State Examination: odds ratio [OR] = 0.96, 95% confidence interval [CI] 0.63 to 1.49, p = 0.86; Hopkins Verbal Learning Test – Revised: Immediate Recall, OR = 0.71, 95% CI 0.44 to 1.13, p = 0.151 and Delayed Recall, OR = 1.42, 95% CI 0.89 to 2.26, p = 0.14; Controlled Oral Word Association Test: OR = 0.79, 95% CI 0.49 to 1.25, p = 0.31; and Symbol Digit Modalities Test: OR = 0.83, 95% CI 0.53 to 1.29, p = 0.40). Limiting the analysis to 237 women aged 70–79 years (74.5 [interquartile range 72.2–77.1] years), no association was observed between a decline in blood testosterone and any cognitive outcome. Conclusion : A decline in blood testosterone concentrations over 3 years was not associated with a decline in cognitive function in community-dwelling Australian women aged 70 years and older.