{"generated_from":"content/_sources/sources.yaml","count":88,"sources":[{"id":"fda-mht-labeling-changes-2026","title":"FDA Approves Labeling Changes to Menopausal Hormone Therapy Products","authors":[],"publisher":"U.S. Food and Drug Administration","year":2026,"type":"regulator_statement","url":"https://www.fda.gov/news-events/press-announcements/fda-approves-labeling-changes-menopausal-hormone-therapy-products","doi":null,"accessed":"2026-11-06","population":"U.S. prescribing labels for menopausal hormone therapy products","key_finding":"On February 12, 2026 the FDA approved labeling changes to six menopausal hormone therapy products, removing risk statements on cardiovascular disease, breast cancer and probable dementia from the boxed warning. 29 companies had submitted proposed changes; the first six span systemic combination, systemic estrogen-alone, systemic progestogen-alone and vaginal estrogen products.","funding_conflict":null,"verified":true,"notes":"Trade press (Contemporary OB/GYN, 2026-10-30) reports three more estradiol patches approved on October 30, 2026; that report cites an HHS release we have not yet opened, so it is not used.","cited_by":["/tools/treatment-questions/","/treatments/hormone-therapy/boxed-warning/","/treatments/hormone-therapy/","/treatments/hormone-therapy/vaginal-estrogen/"]},{"id":"fda-mht-labeling-request-2025","title":"FDA Requests Labeling Changes Related to Safety Information to Clarify the Benefit/Risk Considerations for Menopausal Hormone Therapies","authors":[],"publisher":"U.S. Food and Drug Administration","year":2025,"type":"regulator_statement","url":"https://www.fda.gov/drugs/drug-alerts-and-statements/fda-requests-labeling-changes-related-safety-information-clarify-benefitrisk-considerations","doi":null,"accessed":"2026-11-06","population":"U.S. prescribing labels for menopausal hormone therapy products","key_finding":"On November 10, 2025 the FDA asked makers to remove cardiovascular disease, breast cancer and probable dementia language from the boxed warning, remove endometrial cancer boxed language except for systemic estrogen-alone products, and remove the 'lowest effective dose for the shortest time' recommendation. For systemic products, labels add consideration of starting therapy for moderate to severe hot flashes before age 60 or within 10 years of menopause, and retain cardiovascular and breast cancer information in the warnings.","funding_conflict":null,"verified":true,"cited_by":["/groups/surgical-menopause/","/tools/treatment-questions/","/treatments/hormone-therapy/boxed-warning/","/treatments/hormone-therapy/"]},{"id":"hhs-mht-fact-sheet-2025","title":"FACT SHEET: FDA Initiates Removal of “Black Box” Warnings from Menopausal Hormone Replacement Therapy Products","authors":[],"publisher":"U.S. Department of Health and Human Services","year":2025,"type":"regulator_statement","url":"https://www.hhs.gov/press-room/fact-sheet-fda-initiates-removal-of-black-box-warnings-from-menopausal-hormone-replacement-therapy-products.html","doi":null,"accessed":"2026-11-06","population":"U.S. women considering menopausal hormone therapy","key_finding":"The FDA is not seeking to remove the boxed warning for endometrial cancer on systemic estrogen-alone products, and its labeled recommendation will be to start systemic HRT within 10 years of menopause onset or before age 60.","funding_conflict":null,"verified":true,"notes":"The fact sheet also states relative benefits (for example a 50% reduction in heart attack risk and 35% lower Alzheimer's risk) without inline citations. Do not repeat these figures; see content/_review/unverified-claims.md.","cited_by":["/treatments/hormone-therapy/boxed-warning/"]},{"id":"veozah-prescribing-information","title":"VEOZAH (fezolinetant) tablets, prescribing information","authors":[],"publisher":"Astellas Pharma US","year":2026,"type":"regulator_label","url":"https://www.astellas.com/content/dam/astellas-com/global/en/documents/veozah_uspi.pdf","doi":null,"accessed":"2026-11-06","population":"Adults with moderate to severe vasomotor symptoms due to menopause","key_finding":"Boxed warning for hepatotoxicity (added 12/2024). Liver tests before starting, then monthly for the first 3 months and at 6 and 9 months; do not start if aminotransferase or total bilirubin is 2 or more times the upper limit of normal. Contraindicated with known cirrhosis, severe renal impairment or end-stage renal disease, and CYP1A2 inhibitors. Dose: one 45 mg tablet daily.","funding_conflict":"Manufacturer-issued label (FDA-approved text)","verified":true,"notes":"Label revised 02/2026. Doses are for reference only; pages never give individual dosing advice.","cited_by":["/symptoms/hot-flashes/","/symptoms/night-sweats/","/tools/does-it-work-checker/","/tools/treatment-questions/","/treatments/nonhormonal/elinzanetant/","/treatments/nonhormonal/fezolinetant/","/treatments/nonhormonal/"]},{"id":"lynkuet-approval-bayer-2025","title":"Bayer's Lynkuet (elinzanetant) approved in the U.S. for treatment of moderate to severe vasomotor symptoms due to menopause","authors":[],"publisher":"Bayer","year":2025,"type":"brand_funded","url":"https://www.bayer.com/media/en-us/bayers-lynkuet-elinzanetant-approved-in-the-us-for-treatment-of-moderate-to-severe-vasomotor-symptoms-due-to-menopause/","doi":null,"accessed":"2026-11-06","population":"Menopausal women with moderate to severe hot flashes (OASIS 1-3 trials)","key_finding":"The FDA approved elinzanetant (Lynkuet), a dual NK1 and NK3 receptor antagonist, on October 24, 2025. Efficacy came from 12 weeks of OASIS 1 and 2 in 796 women; safety from OASIS 1-3 in 1,420 women, including 627 followed for up to 52 weeks in OASIS 3.","funding_conflict":"Manufacturer press release. Replace with the FDA label for efficacy and safety figures.","verified":true,"cited_by":["/tools/does-it-work-checker/","/treatments/nonhormonal/elinzanetant/","/treatments/nonhormonal/"]},{"id":"nams-2022-hormone-therapy","title":"The 2022 hormone therapy position statement of The North American Menopause Society","authors":["The 2022 Hormone Therapy Position Statement Advisory Panel"],"publisher":"Menopause (The North American Menopause Society, now The Menopause Society)","year":2022,"type":"position_statement","url":"https://menopause.org/wp-content/uploads/professional/nams-2022-hormone-therapy-position-statement.pdf","doi":"10.1097/GME.0000000000002028","accessed":"2026-11-06","population":"Peri- and postmenopausal women","key_finding":"Hormone therapy is the most effective treatment for vasomotor symptoms and genitourinary syndrome of menopause, and prevents bone loss and fracture. For women under 60 or within 10 years of menopause without contraindications, the benefit-risk ratio is favorable; starting more than 10 years after menopause or after 60 is less favorable because of greater absolute risks of coronary heart disease, stroke, venous thromboembolism and dementia.","funding_conflict":"Funded by donations to the NAMS Education & Research Fund; the statement reports no commercial support. Individual panel disclosures not yet reviewed.","verified":true,"cited_by":["/care/","/care/menopause-books/","/compare/","/does-it-work/acupuncture/","/does-it-work/cannabis-cbd/","/does-it-work/cooling-products/","/does-it-work/hormone-balance-supplements/","/does-it-work/paced-breathing/","/does-it-work/soy-isoflavones/","/does-it-work/yoga/","/groups/early-menopause/","/groups/premature-ovarian-insufficiency/","/groups/surgical-menopause/","/menopause/how-long-symptoms-last/","/menopause/","/perimenopause/questions-for-your-doctor/","/postmenopause/bone-health/","/symptoms/anxiety/","/symptoms/brain-fog/","/symptoms/fatigue/","/symptoms/hot-flashes/","/symptoms/insomnia/","/symptoms/joint-pain/","/symptoms/low-libido/","/symptoms/night-sweats/","/symptoms/waking-at-3am/","/tools/does-it-work-checker/","/tools/treatment-questions/","/treatments/hormone-therapy/estrogen/","/treatments/hormone-therapy/","/treatments/hormone-therapy/is-it-right-for-me/","/treatments/hormone-therapy/timing/","/treatments/"]},{"id":"nams-2023-nonhormone-therapy","title":"The 2023 nonhormone therapy position statement of The North American Menopause Society","authors":["Shufelt CL","Brown V","Carpenter JS","Chism LA","Faubion SS","Joffe H","Kling JM","Soares CN","Thurston RC"],"publisher":"Menopause (The North American Menopause Society, now The Menopause Society)","year":2023,"type":"position_statement","url":"https://pubmed.ncbi.nlm.nih.gov/37252752/","doi":"10.1097/GME.0000000000002200","accessed":"2026-11-06","population":"Women with menopause-associated vasomotor symptoms","key_finding":"Recommended for hot flashes: CBT, clinical hypnosis, SSRIs/SNRIs, gabapentin, fezolinetant (Level I); oxybutynin (Levels I-II); weight loss and stellate ganglion block (Levels II-III). Not recommended: paced respiration (Level I); supplements and herbal remedies (Levels I-II); cooling techniques, avoiding triggers, exercise, yoga, mindfulness, relaxation, soy foods and extracts, equol, cannabinoids and acupuncture (Level II); clonidine and chiropractic (Levels I-III); dietary modification and pregabalin (Level III).","funding_conflict":null,"verified":true,"notes":"Panel disclosures not yet reviewed. \"Not recommended\" here means the panel did not recommend the therapy for hot flashes; some reviewers read it as \"not first-line\" (research plan). Present that nuance on each page.","cited_by":["/care/sleepwear-for-night-sweats/","/compare/","/does-it-work/acupuncture/","/does-it-work/ashwagandha/","/does-it-work/black-cohosh/","/does-it-work/cannabis-cbd/","/does-it-work/cooling-products/","/does-it-work/diet/","/does-it-work/hormone-balance-supplements/","/does-it-work/","/does-it-work/magnesium/","/does-it-work/paced-breathing/","/does-it-work/soy-isoflavones/","/does-it-work/yoga/","/groups/breast-cancer-survivors/","/groups/","/groups/surgical-menopause/","/symptoms/anxiety/","/symptoms/body-odor/","/symptoms/brain-fog/","/symptoms/depression/","/symptoms/hot-flashes/","/symptoms/insomnia/","/symptoms/irritability/","/symptoms/night-sweats/","/symptoms/panic-attacks/","/symptoms/waking-at-3am/","/symptoms/weight-gain/","/tools/does-it-work-checker/","/tools/treatment-questions/","/treatments/","/treatments/nonhormonal/cbt-and-hypnosis/","/treatments/nonhormonal/elinzanetant/","/treatments/nonhormonal/fezolinetant/","/treatments/nonhormonal/gabapentin/","/treatments/nonhormonal/","/treatments/nonhormonal/oxybutynin/","/treatments/nonhormonal/ssris-snris/"]},{"id":"menopause-society-fda-comment-2025","title":"The Menopause Society Comments on the FDA Announcement on Hormone Therapy","authors":[],"publisher":"The Menopause Society","year":2025,"type":"position_statement","url":"https://menopause.org/press-releases/the-menopause-society-comments-on-the-fda-announcement-on-hormone-therapy","doi":null,"accessed":"2026-11-06","population":"Women considering hormone therapy","key_finding":"The Society agrees with removing the boxed warning from low-dose vaginal estrogen, but says systemic estrogen still carries potential risks for some individuals that should be reviewed in detail; risks are low for younger, healthy women starting closer to menopause and greater when started later.","funding_conflict":null,"verified":true,"cited_by":["/treatments/hormone-therapy/boxed-warning/","/treatments/hormone-therapy/","/treatments/hormone-therapy/vaginal-estrogen/"]},{"id":"ims-statement-boxed-warning-2025","title":"IMS Statement: US HHS Revises Black Box Warning for Menopause Hormone Therapy","authors":[],"publisher":"International Menopause Society","year":2025,"type":"position_statement","url":"https://www.imsociety.org/2025/11/13/ims-statement-us-hhs-revises-black-box-warning-for-menopause-hormone-therapy/","doi":null,"accessed":"2026-11-06","population":"Women considering menopause hormone therapy","key_finding":"The IMS supports removing the boxed warning from vaginal estrogen products but does not support removing all warnings from systemic MHT, which can increase cardiovascular risk, breast cancer and dementia in some populations, particularly women who start later or already have these conditions.","funding_conflict":null,"verified":true,"cited_by":["/treatments/hormone-therapy/boxed-warning/","/treatments/hormone-therapy/","/treatments/hormone-therapy/vaginal-estrogen/"]},{"id":"straw-10-2012","title":"Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging","authors":["Harlow SD","Gass M","Hall JE","Lobo R","Maki P","et al."],"publisher":"Fertility and Sterility (published jointly in several journals)","year":2012,"type":"guideline","url":"https://www.fertstert.org/article/S0015-0282(12)00187-2/abstract","doi":null,"accessed":"2026-11-06","population":"Midlife women (cohort data from five countries)","key_finding":"Early menopausal transition is a persistent difference of 7 days or more in the length of consecutive cycles (recurring within 10 cycles). Late transition is 60 days or more without a period, and lasts on average 1 to 3 years. \"Perimenopause\" begins at the early transition and ends 12 months after the final menstrual period.","funding_conflict":null,"verified":true,"notes":"Consensus staging system for research and clinical use. Bleeding criteria do not apply after hysterectomy or with hormonal contraception (route these to tailored guidance in the stage tool).","cited_by":["/does-it-work/hormone-balance-supplements/","/menopause/diagnosis/","/menopause/how-long-symptoms-last/","/menopause/","/perimenopause/age/","/perimenopause/blood-tests/","/perimenopause/early-signs/","/perimenopause/heavy-periods/","/perimenopause/how-long/","/perimenopause/in-your-30s/","/perimenopause/","/perimenopause/irregular-periods/","/perimenopause/pregnancy/","/perimenopause/stages/","/perimenopause/vs-menopause/","/postmenopause/","/tools/12-month-counter/","/tools/stage-guide/"]},{"id":"nice-ng23","title":"Menopause: identification and management (NG23)","authors":[],"publisher":"National Institute for Health and Care Excellence (UK)","year":2026,"type":"guideline","url":"https://www.nice.org.uk/guidance/ng23","doi":null,"accessed":"2026-11-06","population":"Women, trans men and non-binary people registered female at birth with menopause-associated symptoms (UK)","key_finding":"UK guideline on identifying perimenopause and menopause, managing symptoms in people aged 40 and over, the effects of HRT on specific health outcomes, premature ovarian insufficiency under 40, and starting, stopping and reviewing HRT. Last reviewed 15 April 2026, when advice on vaginal bleeding while taking systemic HRT was amended.","funding_conflict":null,"verified":true,"notes":"Overview page only. Open the specific recommendation before citing it.","cited_by":["/care/","/care/sleepwear-for-night-sweats/","/does-it-work/exercise/","/groups/","/groups/premature-ovarian-insufficiency/","/perimenopause/blood-tests/","/perimenopause/in-your-30s/","/postmenopause/bleeding/","/postmenopause/bone-health/","/tools/stage-guide/"]},{"id":"nice-ng23-recommendations","title":"Menopause: identification and management (NG23), Recommendations","authors":[],"publisher":"National Institute for Health and Care Excellence (UK)","year":2026,"type":"guideline","url":"https://www.nice.org.uk/guidance/ng23/chapter/Recommendations","doi":null,"accessed":"2026-11-06","population":"Women, trans men and non-binary people registered female at birth with menopause-associated symptoms (UK)","key_finding":"1.2.2: besides changes in the menstrual cycle, symptoms may include vasomotor symptoms (hot flushes and sweats), genitourinary symptoms (for example vaginal dryness), effects on mood (for example depressive symptoms), musculoskeletal symptoms (for example joint and muscle pain) and sexual difficulties (for example low sexual desire), varying from minor to severe and over short or long periods. 1.3.1: in otherwise healthy people aged 45 or over, identify perimenopause without laboratory tests if vasomotor symptoms have recently started with any change in the menstrual cycle; menopause after 12 months without a period when not using hormonal contraception. 1.3.4: do not use AMH, inhibin A or B, oestradiol, antral follicle count or ovarian volume to identify perimenopause or menopause at 45 or over.","funding_conflict":null,"verified":true,"notes":"Published 12 November 2015, last updated 15 April 2026. UK guidance; check US guidance before applying to US readers.","cited_by":["/care/find-a-menopause-specialist/","/care/when-your-doctor-dismisses-you/","/compare/","/groups/early-menopause/","/groups/premature-ovarian-insufficiency/","/menopause/diagnosis/","/menopause/how-long-symptoms-last/","/menopause/","/perimenopause/age/","/perimenopause/blood-tests/","/perimenopause/contraception/","/perimenopause/early-signs/","/perimenopause/in-your-30s/","/perimenopause/","/perimenopause/irregular-periods/","/perimenopause/pregnancy/","/perimenopause/questions-for-your-doctor/","/perimenopause/vs-menopause/","/perimenopause/when-to-see-a-doctor/","/postmenopause/heart-health/","/postmenopause/","/symptoms/anxiety/","/symptoms/bladder-urgency/","/symptoms/brain-fog/","/symptoms/depression/","/symptoms/fatigue/","/symptoms/heart-palpitations/","/symptoms/hot-flashes/","/symptoms/","/symptoms/insomnia/","/symptoms/irritability/","/symptoms/joint-pain/","/symptoms/low-libido/","/symptoms/memory-problems/","/symptoms/migraines/","/symptoms/night-sweats/","/symptoms/panic-attacks/","/symptoms/recurrent-utis/","/symptoms/waking-at-3am/","/symptoms/weight-gain/","/tools/12-month-counter/","/tools/stage-guide/","/tools/symptom-tracker/","/tools/symptoms-checklist/","/tools/treatment-questions/","/treatments/hormone-therapy/bioidentical-vs-compounded/","/treatments/hormone-therapy/blood-clot-risk/","/treatments/hormone-therapy/breast-cancer-risk/","/treatments/hormone-therapy/estrogen/","/treatments/hormone-therapy/is-it-right-for-me/","/treatments/hormone-therapy/patch-vs-pill/","/treatments/hormone-therapy/pellets/","/treatments/hormone-therapy/progesterone/","/treatments/hormone-therapy/side-effects/","/treatments/hormone-therapy/starting-and-stopping/","/treatments/hormone-therapy/testosterone/","/treatments/hormone-therapy/timing/","/treatments/hormone-therapy/types/","/treatments/nonhormonal/cbt-and-hypnosis/"]},{"id":"jmir-online-menopause-information-2025","title":"Understanding Experiences of and Unmet Needs in Online Searches for Menopause Information: An Exploratory Survey","authors":["Funnell EL","McConnell F","Martin-Key NA","Qian L","Babbitt K","et al."],"publisher":"JMIR Formative Research","year":2025,"type":"other","url":"https://formative.jmir.org/2025/1/e75335","doi":null,"accessed":"2026-11-06","population":"627 UK respondents (early perimenopause 171, late perimenopause 125, postmenopause 262, surgical menopause 69)","key_finding":"92.7% had used the internet for menopause information. The most searched topics were symptoms (82.4%), treatment options (76.1%) and self-help (54.7%). Participants reported gaps in complete symptom lists, information for medical or surgical menopause, outdated content and lack of source transparency.","funding_conflict":null,"verified":true,"notes":"Cross-sectional online survey, UK-wide (the research plan did not say UK). Use for site planning, not for medical claims.","cited_by":["/care/when-your-doctor-dismisses-you/","/compare/","/groups/","/groups/surgical-menopause/"]},{"id":"public-citizen-mht-warnings-2025","title":"Removing Safety Warnings for Menopausal Hormone Therapy Undermines FDA's Credibility, Encourages Inappropriate Off-Label Use","authors":["Zeldes N"],"publisher":"Public Citizen Health Research Group","year":2025,"type":"other","url":"https://www.citizen.org/news/removing-safety-warnings-for-menopausal-hormone-therapy-undermines-fdas-credibility-encourages-inappropriate-off-label-use/","doi":null,"accessed":"2026-11-06","population":"Not applicable (advocacy statement)","key_finding":"Public Citizen argues the treatments have documented cardiovascular, cognitive and cancer risks, that the change was made without an independent advisory committee, that officials promoted unapproved uses such as preventing heart disease, and notes the U.S. Preventive Services Task Force recommends against hormone therapy to prevent chronic conditions.","funding_conflict":null,"verified":true,"cited_by":[]},{"id":"public-citizen-mht-labels-2026","title":"Outrage of the Month: Labeling Changes to Menopausal Hormone Therapy Products","authors":[],"publisher":"Public Citizen Health Research Group","year":2026,"type":"other","url":"https://www.citizen.org/article/outrage-of-the-month-labeling-changes-to-menopausal-hormone-therapy-products/","doi":null,"accessed":"2026-11-06","population":"Not applicable (advocacy commentary)","key_finding":"For systemic estrogen-alone products in the February 2026 changes the endometrial cancer boxed warning was retained; for the other product categories the boxed warning was removed entirely. Public Citizen argues the decision was based on opinion rather than new safety data.","funding_conflict":null,"verified":true,"cited_by":[]},{"id":"nhs-heart-palpitations","title":"Heart palpitations","authors":[],"publisher":"NHS (nhs.uk)","year":2026,"type":"patient_information","url":"https://www.nhs.uk/conditions/heart-palpitations/","doi":null,"accessed":"2026-11-06","population":"General public (UK)","key_finding":"Call 999 or go to A&E if palpitations do not go away or come with chest pain, shortness of breath, or feeling faint or fainting. If those symptoms have stopped, ask for an urgent GP appointment or call 111.","funding_conflict":null,"verified":true,"cited_by":["/compare/","/symptoms/anxiety/","/symptoms/heart-palpitations/","/symptoms/incontinence/","/symptoms/panic-attacks/","/tools/12-month-counter/","/tools/does-it-work-checker/","/tools/stage-guide/","/tools/symptom-tracker/","/tools/symptoms-checklist/","/tools/treatment-questions/"]},{"id":"nhs-postmenopausal-bleeding","title":"Postmenopausal bleeding","authors":[],"publisher":"NHS (nhs.uk)","year":2026,"type":"patient_information","url":"https://www.nhs.uk/conditions/post-menopausal-bleeding/","doi":null,"accessed":"2026-11-06","population":"General public (UK)","key_finding":"Any bleeding from the vagina after menopause should be checked by a GP, even a small amount or a single episode. It is not usually serious, but it can be a sign of cancer.","funding_conflict":null,"verified":true,"cited_by":["/care/moisturizers-and-lubricants/","/compare/","/menopause/diagnosis/","/menopause/","/perimenopause/vs-menopause/","/perimenopause/when-to-see-a-doctor/","/postmenopause/bleeding/","/postmenopause/","/postmenopause/life-after-menopause/","/symptoms/painful-sex/","/symptoms/vaginal-dryness/","/tools/12-month-counter/","/tools/does-it-work-checker/","/tools/stage-guide/","/tools/symptom-tracker/","/tools/symptoms-checklist/","/tools/treatment-questions/","/treatments/hormone-therapy/vaginal-estrogen/"]},{"id":"nhs-heavy-periods","title":"Heavy periods","authors":[],"publisher":"NHS (nhs.uk)","year":2026,"type":"patient_information","url":"https://www.nhs.uk/conditions/heavy-periods/","doi":null,"accessed":"2026-11-06","population":"General public (UK)","key_finding":"See a GP if heavy periods affect your life or have lasted some time, if you have severe pain during periods, bleed between periods or after sex, or have heavy periods with other symptoms such as pain when peeing, pooing or having sex.","funding_conflict":null,"verified":true,"notes":"The page gives no emergency threshold for heavy bleeding (see unverified-claims.md).","cited_by":["/perimenopause/early-signs/","/perimenopause/heavy-periods/","/perimenopause/irregular-periods/","/perimenopause/when-to-see-a-doctor/","/tools/12-month-counter/"]},{"id":"lifeline-988","title":"988 Suicide & Crisis Lifeline","authors":[],"publisher":"988 Lifeline","year":2026,"type":"patient_information","url":"https://988lifeline.org/","doi":null,"accessed":"2026-11-06","population":"General public (US)","key_finding":"Call, text or chat 988 for free, confidential support, 24/7/365.","funding_conflict":null,"verified":true,"cited_by":["/groups/early-menopause/","/groups/premature-ovarian-insufficiency/","/symptoms/anxiety/","/symptoms/depression/","/symptoms/panic-attacks/","/tools/12-month-counter/","/tools/does-it-work-checker/","/tools/stage-guide/","/tools/symptom-tracker/","/tools/symptoms-checklist/","/tools/treatment-questions/"]},{"id":"samaritans-contact","title":"Contact Samaritans","authors":[],"publisher":"Samaritans","year":2026,"type":"patient_information","url":"https://www.samaritans.org/how-we-can-help/contact-samaritan/","doi":null,"accessed":"2026-11-06","population":"General public (UK and Ireland)","key_finding":"Call 116 123 free from any phone, any time, day or night; the number does not appear on phone bills.","funding_conflict":null,"verified":true,"cited_by":["/groups/early-menopause/","/groups/premature-ovarian-insufficiency/","/symptoms/anxiety/","/symptoms/depression/","/symptoms/panic-attacks/","/tools/12-month-counter/","/tools/stage-guide/","/tools/treatment-questions/"]},{"id":"nams-2020-gsm","title":"The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society","authors":[],"publisher":"Menopause: The Journal of The Menopause Society","year":2020,"type":"position_statement","url":"https://pubmed.ncbi.nlm.nih.gov/32852449/","doi":"10.1097/GME.0000000000001609","accessed":"2026-11-06","population":"Menopausal women experiencing genitourinary symptoms","key_finding":"First-line non-hormonal management for vaginal dryness and dyspareunia consists of regular vaginal moisturisers and personal lubricants during intercourse. For persistent moderate-to-severe symptoms, low-dose vaginal estrogen is highly effective and generally safe.","funding_conflict":null,"verified":true,"cited_by":["/care/moisturizers-and-lubricants/","/care/pelvic-floor-exercises/","/groups/breast-cancer-survivors/","/menopause/how-long-symptoms-last/","/postmenopause/bleeding/","/postmenopause/","/symptoms/bladder-urgency/","/symptoms/incontinence/","/symptoms/painful-sex/","/symptoms/recurrent-utis/","/symptoms/vaginal-dryness/","/tools/does-it-work-checker/","/tools/treatment-questions/","/treatments/hormone-therapy/vaginal-estrogen/"]},{"id":"acog-clinical-consensus-gsm","title":"Treatment of Symptoms of the Genitourinary Syndrome of Menopause: Clinical Consensus No. 2","authors":[],"publisher":"American College of Obstetricians and Gynecologists","year":2021,"type":"guideline","url":"https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2021/12/treatment-of-symptoms-of-the-genitourinary-syndrome-of-menopause","doi":null,"accessed":"2026-11-06","population":"Women with genitourinary syndrome of menopause","key_finding":"Over-the-counter vaginal moisturisers used several times per week provide continuous tissue hydration, whereas lubricants reduce friction specifically during sexual activity. Both are recommended as first-line therapy before or alongside prescription options.","funding_conflict":null,"verified":true,"cited_by":["/care/moisturizers-and-lubricants/","/groups/breast-cancer-survivors/","/menopause/how-long-symptoms-last/","/postmenopause/","/symptoms/painful-sex/","/symptoms/recurrent-utis/","/symptoms/vaginal-dryness/","/tools/does-it-work-checker/","/treatments/hormone-therapy/vaginal-estrogen/"]},{"id":"cochrane-vaginal-moisturizers","title":"Non-hormonal interventions for genitourinary syndrome of menopause","authors":[],"publisher":"Cochrane Database of Systematic Reviews","year":2021,"type":"systematic_review","url":"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014761/full","doi":"10.1002/14651858.CD014761","accessed":"2026-11-06","population":"Postmenopausal women with vaginal atrophy","key_finding":"Non-hormonal moisturisers (including polycarbophil and hyaluronic acid) improve vaginal dryness and comfort compared to baseline, though low-dose vaginal estrogen provides superior mucosal maturation and tissue elasticity.","funding_conflict":null,"verified":true,"cited_by":["/care/moisturizers-and-lubricants/","/symptoms/painful-sex/","/symptoms/recurrent-utis/","/symptoms/vaginal-dryness/","/tools/does-it-work-checker/","/treatments/hormone-therapy/vaginal-estrogen/"]},{"id":"nice-ng123-urinary-incontinence","title":"Urinary incontinence and pelvic organ prolapse in women: management (NG123)","authors":[],"publisher":"National Institute for Health and Care Excellence","year":2019,"type":"guideline","url":"https://www.nice.org.uk/guidance/ng123","doi":null,"accessed":"2026-11-06","population":"Women with stress, urge, or mixed urinary incontinence","key_finding":"Offer a trial of supervised pelvic floor muscle training of at least 3 months duration as first-line treatment to women with stress or mixed urinary incontinence. Pelvic floor muscle training should comprise at least 8 contractions performed 3 times per day.","funding_conflict":null,"verified":true,"cited_by":["/care/pelvic-floor-exercises/","/symptoms/bladder-urgency/","/symptoms/incontinence/","/tools/does-it-work-checker/","/tools/treatment-questions/"]},{"id":"cochrane-pfmt-incontinence","title":"Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women","authors":[],"publisher":"Cochrane Database of Systematic Reviews","year":2018,"type":"systematic_review","url":"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005654.pub4/full","doi":"10.1002/14651858.CD005654.pub4","accessed":"2026-11-06","population":"Adult women with stress, urgency, or mixed incontinence","key_finding":"Pelvic floor muscle training is significantly more effective than no treatment or placebo for resolving urinary incontinence, with women in PFMT groups being 8 times more likely to report complete resolution of symptoms.","funding_conflict":null,"verified":true,"cited_by":["/care/pelvic-floor-exercises/","/symptoms/incontinence/","/tools/does-it-work-checker/"]},{"id":"gunter-menopause-manifesto","title":"The Menopause Manifesto: Own Your Health with Facts and Feminism","authors":["Jen Gunter"],"publisher":"Citadel Press","year":2021,"type":"other","url":"https://www.citadelpress.com/books/the-menopause-manifesto/","doi":null,"accessed":"2026-11-06","population":"Women in perimenopause and menopause","key_finding":"A board-certified gynaecologist details the biological mechanisms of reproductive aging, reviews clinical evidence for hormone therapy and non-hormonal options, and debunks predatory unproven wellness supplements.","funding_conflict":null,"verified":true,"cited_by":["/care/menopause-books/","/does-it-work/black-cohosh/","/does-it-work/hormone-balance-supplements/"]},{"id":"haver-new-menopause","title":"The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts","authors":["Mary Claire Haver"],"publisher":"Rodale Books","year":2024,"type":"other","url":"https://www.rodalebooks.com/new-menopause","doi":null,"accessed":"2026-11-06","population":"Women navigating perimenopause and menopause","key_finding":"An OB/GYN-authored guide presenting an extensive catalog of perimenopausal symptoms, communication frameworks for medical consultations, and current clinical guidelines on hormone therapy.","funding_conflict":null,"verified":true,"cited_by":["/care/menopause-books/"]},{"id":"sims-next-level","title":"Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond","authors":["Stacy Sims","Selene Yeager"],"publisher":"Rodale Books","year":2022,"type":"other","url":"https://www.rodalebooks.com/next-level","doi":null,"accessed":"2026-11-06","population":"Active and athletic women in peri- and postmenopause","key_finding":"Outlines tailored exercise physiology recommendations emphasizing progressive heavy resistance training, high-intensity intervals, and adequate protein distribution to counter age-related sarcopenia and bone mineral density loss.","funding_conflict":null,"verified":true,"cited_by":["/care/menopause-books/","/does-it-work/exercise/","/symptoms/weight-gain/"]},{"id":"liftmor-trial-bone-density","title":"High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis","authors":[],"publisher":"Journal of Bone and Mineral Research","year":2018,"type":"rct","url":"https://pubmed.ncbi.nlm.nih.gov/28975661/","doi":"10.1002/jbmr.3284","accessed":"2026-11-06","population":"Postmenopausal women with osteopenia or osteoporosis","key_finding":"Eight months of twice-weekly, 30-minute supervised high-intensity resistance and impact training (HiRIT) significantly improved lumbar spine and femoral neck bone mineral density, muscle strength, and functional performance compared to home-based low-intensity exercise.","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/exercise/","/postmenopause/bone-health/","/postmenopause/","/symptoms/joint-pain/","/symptoms/weight-gain/","/tools/does-it-work-checker/"]},{"id":"acog-vms-sleep-mood-cpg-2026","title":"ACOG Clinical Practice Guideline: Management of Menopause-Related Vasomotor, Sleep, and Mood Symptoms","authors":[],"publisher":"American College of Obstetricians & Gynecologists' Committee on Clinical Practice Guidelines-Gynecology","year":2026,"type":"guideline","url":"https://pubmed.ncbi.nlm.nih.gov/42878500/","doi":"10.1097/AOG.0000000000006428","accessed":"2026-11-06","population":"Perimenopausal and postmenopausal individuals assigned female sex at birth, with vasomotor, sleep, and mood symptoms related to spontaneous or induced menopause (age 40 or older)","key_finding":"Evidence-based recommendations, graded by strength and evidence quality using a modified GRADE framework, on pharmacologic and nonpharmacologic interventions for menopause-related vasomotor, sleep, and mood symptoms.","funding_conflict":null,"verified":true,"notes":"Indexed abstract gives purpose, target population and methods only, with no specific recommendation text. Cite only the guideline's existence/scope from this entry; do not attribute a specific recommendation to it without reading the full guideline (Obstet Gynecol. 2026 Nov 1;148(5):e345-e369).","cited_by":[]},{"id":"korn-bernstein-migraine-menopause-2026","title":"Migraine across the menopausal transition and beyond: A narrative review","authors":["Korn TF","Bernstein C"],"publisher":"Headache","year":2026,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/41934093/","doi":"10.1111/head.70071","accessed":"2026-11-06","population":"Perimenopausal and postmenopausal women with migraine","key_finding":"Unstable estradiol and progesterone during perimenopause can worsen migraine frequency. Migraine without aura often improves after menopause; migraine with aura tends to persist and independently raises ischemic stroke risk. Oral estrogen, especially at higher doses, may worsen migraine and raise vascular risk, particularly with aura; low-dose transdermal estrogen (the route recommended by the North American Menopause Society) appears safer and better tolerated. Continuous progestogen may reduce withdrawal-related attacks versus cyclic regimens.","funding_conflict":null,"verified":true,"notes":"Narrative review, not a systematic review or trial, so typed 'other'.","cited_by":["/symptoms/headaches/","/symptoms/migraines/"]},{"id":"stute-nonhormonal-transition-2026","title":"Managing the transition without hormones","authors":["Stute P","Pavicic E","Richina SF","Thurston RC"],"publisher":"Climacteric","year":2026,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/42905129/","doi":"10.1080/13697137.2026.2742071","accessed":"2026-11-06","population":"Perimenopausal and postmenopausal women seeking or requiring non-hormonal management","key_finding":"Reviews evidence-based non-hormonal strategies for vasomotor symptoms, sleep disturbance and fatigue, psychological and cognitive concerns, musculoskeletal complaints, and sexual, vulvovaginal and urinary issues, including cognitive behavioral therapy, neurokinin receptor antagonists, selected antidepressants, pelvic floor therapy, and individualized lifestyle interventions. Proposes a structured, symptom-oriented decision framework; treatment should be chosen through shared decision-making and reassessed after a defined interval.","funding_conflict":null,"verified":true,"notes":"Narrative review, not a systematic review or trial, so typed 'other'.","cited_by":["/symptoms/fatigue/","/symptoms/headaches/","/symptoms/memory-problems/","/symptoms/waking-at-3am/"]},{"id":"neda-stepan-vms-mood-systematic-review-2026","title":"Vasomotor Symptoms and Their Association with Depressive and Anxiety Symptoms in Peri- and Postmenopausal Women: A Systematic Review of Observational Studies","authors":["Neda-Stepan O","Enatescu VR","Giurgi-Oncu C","Bernad ES","Neamtu R","Bernad BC","Kadas AV","Bredicean C"],"publisher":"Medicina (Kaunas)","year":2026,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/42654471/","doi":"10.3390/medicina62081574","accessed":"2026-11-06","population":"Peri- and postmenopausal women; 12 observational studies, about 9,900 women across 7 countries","key_finding":"Greater vasomotor symptom (VMS) burden was consistently associated with higher odds of depressive symptoms, with adjusted odds ratios ranging from 1.67 to 2.99 across studies reporting adjusted estimates. Evidence for anxiety was directionally similar but considerably weaker and less certain. Certainty of evidence was rated low for depression and very low for anxiety; the predominance of cross-sectional designs, heterogeneous instruments, and largely unaddressed confounding mean these associations cannot be read as cause and effect.","funding_conflict":null,"verified":true,"cited_by":["/symptoms/depression/","/symptoms/fatigue/","/symptoms/irritability/","/symptoms/panic-attacks/"]},{"id":"maki-jaff-brain-fog-2024","title":"Menopause and brain fog: how to counsel and treat midlife women","authors":["Maki PM","Jaff NG"],"publisher":"Menopause","year":2024,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/38888619/","doi":"10.1097/GME.0000000000002382","accessed":"2026-11-06","population":"Midlife women reporting menopause-related subjective cognitive difficulties (\"brain fog\")","key_finding":"Longitudinal studies find small but reliable declines in objective memory performance as women transition into perimenopause, not explained by age alone; performance remains within normal limits for all but a very small number of women. Women's experience of brain fog extends beyond memory, reflecting effects on a broader range of cognitive abilities.","funding_conflict":null,"verified":true,"notes":"This is a short editorial/commentary (PubMed publication type: Journal Article only, no Review, Systematic Review or Guideline tag), not a primary study. Weight it accordingly, the same as a small study or preprint.","cited_by":["/symptoms/memory-problems/"]},{"id":"swan-vms-duration-avis-2015","title":"Duration of menopausal vasomotor symptoms over the menopause transition","authors":["Avis NE","Crawford SL","Greendale G","Bromberger JT","Everson-Rose SA","Gold EB","Hess R","Joffe H","Kravitz HM","Tepper PG","Thurston RC"],"publisher":"JAMA Internal Medicine","year":2015,"type":"cohort","url":"https://pubmed.ncbi.nlm.nih.gov/25686030/","doi":"10.1001/jamainternmed.2014.8063","accessed":"2026-11-06","population":"SWAN (Study of Women's Health Across the Nation): 3,302 multiracial/multiethnic US women at 7 sites, Feb 1996-Apr 2013, median 13 visits; 1,449 women with frequent VMS analyzed","key_finding":"Median total duration of frequent vasomotor symptoms (hot flashes or night sweats, 6 or more days in the prior 2 weeks) was 7.4 years. Among 881 women with an observable final menstrual period (FMP), median persistence after the FMP was 4.5 years. Women premenopausal or early-perimenopausal when frequent VMS first began had the longest duration (median over 11.8 years) and longest post-FMP persistence (median 9.4 years); those postmenopausal at VMS onset had the shortest (median 3.4 years). African American women had the longest median duration (10.1 years) of any racial or ethnic group studied. Younger age, lower education, greater perceived stress and symptom sensitivity, and higher depressive and anxiety symptoms at first VMS report were linked to longer duration.","funding_conflict":null,"verified":true,"cited_by":["/menopause/how-long-symptoms-last/","/perimenopause/how-long/","/postmenopause/life-after-menopause/","/tools/symptom-tracker/"]},{"id":"appiah-menopause-age-trends-2021","title":"Trends in Age at Natural Menopause and Reproductive Life Span Among US Women, 1959-2018","authors":["Appiah D","Nwabuo CC","Ebong IA","Wellons MF","Winters SJ"],"publisher":"JAMA","year":2021,"type":"cohort","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC8025101/","doi":"10.1001/jama.2021.0278","accessed":"2026-11-06","population":"US women aged 40-74 with natural menopause, NHANES/NHES surveys 1959-1962 through 2015-2018 (analytic sample of 7,773)","key_finding":"Mean age at natural menopause rose from 48.4 to 49.9 years between 1959-1962 and 2015-2018 (p<.001 for trend); mean reproductive life span rose from 35.0 to 37.1 years; mean age at menarche fell from 13.5 to 12.7 years. Early menopause (natural menopause at age 40-45) was reported by 11.8% of women in 2015-2018. Black and Hispanic race-ethnicity, poverty, smoking, and hormone therapy use were associated with earlier menopause and shorter reproductive span in adjusted models; higher education and oral contraceptive use were associated with longer spans.","funding_conflict":null,"verified":true,"notes":"NCBI's indexed abstract for this JAMA research letter is a one-line teaser only, with no numbers, and the publisher blocks full-text retrieval through the E-utilities API. The specific figures above come from the Blog/SEO session's own read of the full text, not from anything independently pulled via API here. Independently confirmed here: title, authors, journal, year, DOI, PMCID, and that this is a real NHANES-based research letter.","cited_by":["/groups/early-menopause/","/menopause/age/","/perimenopause/age/","/tools/12-month-counter/"]},{"id":"acog-compounded-bioidentical-2023","title":"Compounded Bioidentical Menopausal Hormone Therapy: ACOG Clinical Consensus No. 6","authors":[],"publisher":"American College of Obstetricians and Gynecologists' Committee on Clinical Consensus-Gynecology","year":2023,"type":"guideline","url":"https://pubmed.ncbi.nlm.nih.gov/37856860/","doi":"10.1097/AOG.0000000000005395","accessed":"2026-11-06","population":"Patients considering or using compounded bioidentical menopausal hormone therapy","key_finding":"Compounding pharmacies market 'bioidentical hormone' preparations as natural, safer, and more effective than FDA-approved menopausal hormone therapy, but evidence to support those safety and effectiveness claims is lacking. ACOG recommends against routinely prescribing compounded bioidentical MHT when FDA-approved formulations exist; clinicians should counsel patients who request it anyway on the lack of FDA approval and the risks specific to compounding (no standardized testing for purity, potency, or sterility). High-quality randomized controlled trials comparing compounded with FDA-approved MHT are still needed.","funding_conflict":null,"verified":true,"cited_by":["/compare/winona-review/","/evidence/products-we-wont-recommend/","/treatments/hormone-therapy/bioidentical-vs-compounded/","/treatments/hormone-therapy/pellets/"]},{"id":"kamp-menopause-hair-disorders-2022","title":"Menopause, skin and common dermatoses. Part 1: hair disorders","authors":["Kamp E","Ashraf M","Musbahi E","DeGiovanni C"],"publisher":"Clinical and Experimental Dermatology","year":2022,"type":"other","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10092469/","doi":"10.1111/ced.15327","accessed":"2026-11-06","population":"Peri- and postmenopausal women with hair changes","key_finding":"Literature review. A reduction in anagen (growth-phase) hairs is seen in postmenopausal women, more apparent frontally than occipitally. Female pattern hair loss (FPHL): frontovertical thinning with a preserved frontal hairline; most patients have normal androgen levels; testosterone/prolactin testing is warranted only if other signs of androgen excess (hirsutism, severe acne, irregular menses) are present. There is insufficient evidence to support the role of HRT in FPHL; first-line treatment is topical minoxidil (2% solution 1-2 times/day, or 5% foam once daily). Frontal fibrosing alopecia is also associated with the perimenopausal state. Facial hirsutism is seen in about 50% of postmenopausal women, usually with normal androgen levels.","funding_conflict":null,"verified":true,"notes":"Confirmed against the full open-access text (PMC), not just the abstract, since the specific treatment/prevalence figures aren't in the abstract.","cited_by":["/symptoms/facial-hair/","/symptoms/hair-thinning/"]},{"id":"viscomi-menopausal-skin-hrt-2025","title":"Managing Menopausal Skin Changes: A Narrative Review of Skin Quality Changes, Their Aesthetic Impact, and the Actual Role of Hormone Replacement Therapy in Improvement","authors":["Viscomi B","Muniz M","Sattler S"],"publisher":"Journal of Cosmetic Dermatology","year":2025,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/40847905/","doi":"10.1111/jocd.70393","accessed":"2026-11-06","population":"Menopausal and perimenopausal women with skin concerns","key_finding":"Declining estrogen contributes to decreased collagen production, reduced elasticity, and moisture loss, causing dryness and wrinkling. Most studies report positive associations between HRT and improved menopausal skin aging, but findings are inconsistent, and clinical guidelines do not support HRT use solely for estrogen-deficient skin, due to a lack of robust skin-specific clinical trials. Few aesthetics studies stratify by menopausal or HRT status.","funding_conflict":null,"verified":true,"cited_by":["/symptoms/dry-itchy-skin/"]},{"id":"hubbard-breast-pain-assessment-2020","title":"Breast pain: assessment, management, and referral criteria","authors":["Hubbard TJE","Sharma A","Ferguson DJ"],"publisher":"British Journal of General Practice","year":2020,"type":"other","url":"https://bjgp.org/content/70/697/419","doi":"10.3399/bjgp20X712133","accessed":"2026-11-06","population":"Women presenting with breast pain (mastalgia) in primary care","key_finding":"Mastalgia affects up to 70% of women in their lifetime. Cyclical pain (two-thirds of true mastalgia) is hormone-related, worsening in the week before menses and relieved at onset; non-cyclical (one-third) includes cysts, pregnancy, trauma, and mastitis/abscess (erythema, swelling, focal pain). Extra-mammary chest-wall pain (e.g. costochondritis) is now the commonest type referred to breast clinics, treated with NSAIDs. Per NICE: breast pain alone is not a criterion for urgent cancer referral (positive predictive value under 3%); routine referral is considered if cyclical pain affects quality of life or sleep for more than 3 months and is unresponsive to first-line care. A well-fitting bra can fully resolve symptoms per multiple studies. Topical NSAIDs (diclofenac/piroxicam) are first-line treatment. Evening primrose oil, vitamin E, pyridoxine, and diuretics have no proven efficacy and are not recommended by NICE.","funding_conflict":null,"verified":true,"notes":"PMC and Europe PMC both flag this article as not open access, and automated fetches of the publisher page were blocked (plain HTTP fetch returned only the page header). Confirmed by reading the full article text in a real browser session instead.","cited_by":["/symptoms/breast-tenderness/"]},{"id":"heitkemper-chang-ibs-hormones-2009","title":"Do Fluctuations in Ovarian Hormones Affect Gastrointestinal Symptoms in Women With Irritable Bowel Syndrome?","authors":["Heitkemper MM","Chang L"],"publisher":"Gender Medicine","year":2009,"type":"other","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC3322543/","doi":"10.1016/j.genm.2009.03.004","accessed":"2026-11-06","population":"Women with and without IBS, across the menstrual cycle and perimenopause","key_finding":"Literature review (18 papers, Jan 1980-Sep 2008) on increased GI symptoms (bowel discomfort, abdominal pain, bloating, altered bowel patterns) reported during the premenstrual/menstrual phase and the perimenopause period, in women with and without IBS. Proposes declining or low ovarian hormone levels (estrogen/progesterone withdrawal) as one possible mechanism, directly or indirectly, but explicitly states the review 'highlights the need for confirmatory preclinical and clinical studies' — the mechanism is not established, only an association.","funding_conflict":null,"verified":true,"cited_by":["/symptoms/bloating/","/symptoms/digestive-changes/"]},{"id":"khalifey-hrt-cardiovascular-2026","title":"The impact of hormone replacement therapy on cardiovascular health in postmenopausal women: a narrative review","authors":["Khalifey HT","Mahereen R","Adwan R","Chahine R","Kaidali M","Mirza SF","Tullah SN","Shaikh S","Hammad S","Sukkarieh HH"],"publisher":"Frontiers in Reproductive Health","year":2026,"type":"other","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12872825/","doi":"10.3389/frph.2026.1745210","accessed":"2026-11-06","population":"Postmenopausal women, cardiovascular disease risk and HRT","key_finding":"The menopause transition is accompanied by substantially increased cardiovascular disease (CVD) risk; vasomotor symptoms correlate with increased cardiovascular risk. CV risk intensifies after age 50, with the proportion of women at intermediate-to-high CV risk nearly doubling between ages 51 and 55. 'Timing hypothesis': HRT started within 10 years of menopause onset or before age 60 may confer cardiovascular benefit; later initiation may increase risk. The modern approach emphasizes individualized selection, lower-dose regimens, and transdermal delivery. Significant uncertainties persist due to trial heterogeneity and underrepresentation of diverse populations.","funding_conflict":null,"verified":true,"cited_by":["/postmenopause/heart-health/","/symptoms/hot-flashes/","/treatments/hormone-therapy/timing/"]},{"id":"ftc-health-products-compliance-guidance-2022","title":"Health Products Compliance Guidance","authors":[],"publisher":"Federal Trade Commission","year":2022,"type":"regulator_statement","url":"https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance","doi":null,"accessed":"2026-11-06","population":"Marketers of dietary supplements and health-related products (US)","key_finding":"FTC staff guidance (replacing the 1998 dietary supplements advertising guide) requires health/safety claims about dietary supplements and other health-related products to be truthful, not misleading, and backed by competent and reliable scientific evidence before the ad runs — advertisers must have adequate substantiation for every objective claim made, expressly or by implication. This is guidance only, without the force of law, but reflects FTC Act Section 5/12 enforcement principles drawn from over 200 settled or adjudicated cases since 1998.","funding_conflict":null,"verified":true,"cited_by":["/evidence/products-we-wont-recommend/"]},{"id":"menopause-society-choosing-practitioner","title":"Choosing a Healthcare Practitioner","authors":[],"publisher":"The Menopause Society","year":2026,"type":"patient_information","url":"https://menopause.org/patient-education/choosing-a-healthcare-practitioner","doi":null,"accessed":"2026-11-06","population":"Women seeking a menopause-knowledgeable healthcare provider","key_finding":"The Menopause Society Certified Practitioner (MSCP) credential is awarded to licensed healthcare professionals who pass a competency examination demonstrating expertise in midlife women's health; valid for 3 years, renewable by re-examination or continuing education credits. The Society maintains a searchable 'Find a Menopause Clinician' database including MDs, DOs, nurse practitioners, PAs, nurse midwives, pharmacists, nurses, physical therapists, social workers, and PhDs who provide care for women from perimenopause onward.","funding_conflict":null,"verified":true,"cited_by":["/care/find-a-menopause-specialist/"]},{"id":"lethaby-cochrane-phytoestrogens-2013","title":"Phytoestrogens for menopausal vasomotor symptoms","authors":["Lethaby A","Marjoribanks J","Kronenberg F","Roberts H","Eden J","Brown J"],"publisher":"Cochrane Database of Systematic Reviews","year":2013,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/24323914/","doi":"10.1002/14651858.CD001395.pub4","accessed":"2026-11-06","population":"Perimenopausal and postmenopausal women with vasomotor symptoms; 43 RCTs, 4,364 participants (breast cancer history excluded)","key_finding":"Pooled meta-analysis of 5 trials of Promensil (a red clover extract) found no significant difference vs. placebo in hot flush frequency (mean difference -0.93, 95% CI -1.95 to 0.10). Authors' conclusion: no conclusive evidence shows phytoestrogen supplements effectively reduce the frequency or severity of hot flushes and night sweats, though high-genistein extracts (over 30mg/day) in 4 unpooled trials showed more consistent reduction and should be further investigated. A strong placebo effect was noted (1-59% reduction with placebo). No evidence of estrogenic stimulation of the endometrium or vagina, or other adverse effects, up to 2 years.","funding_conflict":"Lethaby disclosed advising the author of one unpublished included study (Bicca 2004), on which she is a co-author; Eden is an author of two included studies (Knight 1999, 2001) — both disclosed in the review.","verified":true,"cited_by":["/does-it-work/red-clover/","/does-it-work/soy-isoflavones/"]},{"id":"kazemi-evening-primrose-oil-2021","title":"The Effect of Evening Primrose Oil Capsule on Hot Flashes and Night Sweats in Postmenopausal Women: A Single-Blind Randomized Controlled Trial","authors":["Kazemi F","Masoumi SZ","Shayan A","Oshvandi K"],"publisher":"Journal of Menopausal Medicine","year":2021,"type":"rct","url":"https://pubmed.ncbi.nlm.nih.gov/33942584/","doi":"10.6118/jmm.20033","accessed":"2026-11-06","population":"Postmenopausal women, Hamadan health centers, single-blind RCT (evening primrose oil 1000mg capsule twice daily vs. placebo, 8 weeks)","key_finding":"No statistically significant difference in hot flash duration, frequency, or severity vs. placebo (P>0.05). Night sweats frequency and severity were significantly lower in the intervention group (P<0.05).","funding_conflict":null,"verified":true,"notes":"Single-blind, single small trial — not strong enough alone to establish a night-sweats-specific benefit, but worth noting the hot-flash/night-sweat distinction rather than treating EPO as uniformly ineffective.","cited_by":["/does-it-work/evening-primrose-oil/"]},{"id":"uspstf-vitamin-d-calcium-fractures-2018","title":"Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: Preventive Medication","authors":[],"publisher":"US Preventive Services Task Force","year":2018,"type":"guideline","url":"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-d-calcium-or-combined-supplementation-for-the-primary-prevention-of-fractures-in-adults-preventive-medication","doi":null,"accessed":"2026-11-06","population":"Community-dwelling postmenopausal women, men, and premenopausal women (US)","key_finding":"USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1000mg or less of calcium for primary fracture prevention in postmenopausal women (Grade D). Evidence is insufficient (Grade I) to assess benefit or harm at higher doses in postmenopausal women, and insufficient for men or premenopausal women at any dose. The page explicitly flags that this topic is being updated, with a successor review in progress on vitamin D/calcium for falls and fractures — check for a newer statement before treating this as the final word.","funding_conflict":null,"verified":true,"notes":"Correction to a claim first proposed for this entry: the current (2018) USPSTF position, read directly on this page's 'Other Relevant USPSTF Recommendations' row, is that USPSTF RECOMMENDS AGAINST vitamin D supplementation to prevent falls in community-dwelling adults 65+ — the opposite of the for-fall-prevention claim first drafted here, which was the superseded 2012-era position. Dropped that sub-claim from key_finding rather than publish it backwards; do not cite this source for a fall-prevention recommendation.","cited_by":["/does-it-work/calcium/","/does-it-work/vitamin-d/"]},{"id":"cohen-omega3-vms-rct-2014","title":"Efficacy of Omega-3 Treatment for Vasomotor Symptoms: A Randomized Controlled Trial","authors":["Cohen LS","Joffe H","Guthrie KA","Ensrud KE","Freeman M","Carpenter JS","Learman LA","Newton KM","Reed SD","Manson JE","Sternfeld B","Caan B","Freeman EW","LaCroix AZ","Tinker LF","Booth LaForce C","Larson JC","Anderson GL"],"publisher":"Menopause (MsFLASH network trial)","year":2014,"type":"rct","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC4072122/","doi":"10.1097/GME.0b013e31829e40b8","accessed":"2026-11-06","population":"Peri- and postmenopausal women with VMS, MsFLASH network, 3x2 factorial 12-week RCT (omega-3 n=177 vs. placebo n=178, crossed with yoga/exercise/usual activity)","key_finding":"1.8g/day omega-3 (EPA 425mg + DHA 100mg + other omega-3s 90mg per capsule) for 12 weeks did not significantly reduce VMS frequency vs. placebo (relative difference of 0.3 fewer hot flashes/day, 95% CI -0.5 to 1.0, p=0.28) or VMS bother (p=0.36). No improvement in self-reported sleep or mood vs. placebo (p>0.09 for all comparisons). Confirmed against the full open-access text (PMC), not just the abstract.","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/omega-3/"]},{"id":"midi-health-own-site-2026","title":"Midi Health — pricing, insurance, and care model (own site)","authors":[],"publisher":"Midi Health","year":2026,"type":"other","url":"https://www.joinmidi.com/","doi":null,"accessed":"2026-11-06","population":"Prospective Midi Health patients (US)","key_finding":"Self-reported by Midi: live video visits with MDs/NPs produce a Care Plan (hormonal, non-hormonal, lifestyle); available in all 50 states. Self-pay: $250 first visit / $150 follow-up (excludes labs/meds). With insurance: average about $50 out-of-pocket per visit reported by Midi, deductible up to $250 (new) / $150 (follow-up), in-network with most (not all) major PPO plans. Does not accept Medicaid/Medi-Cal even self-pay; Medicare beneficiaries self-pay only, no claims submission.","funding_conflict":"Self-reported by the company being reviewed — treat as the company's own claims about its own service, not independent verification of care quality or outcomes.","verified":true,"notes":"Confirmed directly: homepage for the care-model claims, and the Midi Health help-center article 'How much will my appointment cost?' for the exact pricing/deductible figures, which match word for word.","cited_by":["/care/hrt-cost/","/compare/midi-review/","/compare/midi-vs-alloy/","/compare/midi-vs-evernow/"]},{"id":"alloy-own-site-2026","title":"Alloy — care model and pricing model (own site)","authors":[],"publisher":"Alloy","year":2026,"type":"other","url":"https://www.myalloy.com/","doi":null,"accessed":"2026-11-06","population":"Prospective Alloy customers (US)","key_finding":"Self-reported by Alloy: medical intake (5-10 min) reviewed by a board-certified, menopause-specialized physician, treatment plan within about 12 hours, free delivery, 24/7 messaging. Hormone therapy offered as pill/patch/gel/spray/cream, described as FDA-approved. Also sells skincare, sexual health, GLP-1 weight care, hair/lash/brow, and gut-health products — a broader midlife wellness catalog, not menopause-exclusive. HSA/FSA eligible. Could not confirm a specific current consult price from public pages.","funding_conflict":"Self-reported by the company being reviewed.","verified":true,"notes":"Confirmed directly on the homepage. The page also displays marketed outcome percentages (e.g. '95% of Alloy customers... symptom relief in 2 weeks or less') which are correctly excluded from this key_finding — unverifiable methodology, not independently confirmable.","cited_by":["/care/hrt-cost/","/compare/alloy-review/","/compare/alloy-vs-evernow/","/compare/midi-vs-alloy/"]},{"id":"evernow-own-site-2026","title":"Evernow — pricing and care model (own site)","authors":[],"publisher":"Evernow","year":2026,"type":"other","url":"https://www.evernow.com/","doi":null,"accessed":"2026-11-06","population":"Prospective Evernow patients (US)","key_finding":"Self-reported by Evernow: two pricing paths — one-time insurance-eligible visit, no membership required; or membership (ongoing messaging, optional insurance-eligible video visits, prescriptions, care plans) starting at $35/month. States it now accepts insurance for video visits. Care team described as specially certified in menopause/postmenopause; covers VMS, sexual health, body aches, mental health, weight, hair/skin, sleep. Sells supplements marketed to complement HRT.","funding_conflict":"Self-reported by the company being reviewed.","verified":true,"notes":"Confirmed directly on the homepage, including the $35/month membership floor and the insurance-for-video-visits claim.","cited_by":["/care/hrt-cost/","/compare/alloy-vs-evernow/","/compare/evernow-review/","/compare/midi-vs-evernow/"]},{"id":"winona-own-site-2026","title":"Winona — treatment formats and care model (own site)","authors":[],"publisher":"Winona","year":2026,"type":"other","url":"https://bywinona.com/treatments","doi":null,"accessed":"2026-11-06","population":"Prospective Winona patients (US)","key_finding":"Self-reported by Winona, from its own /treatments page: body cream, vaginal cream, and pill formats are each explicitly labeled 'Compounded' (+ 'Plant-derived'); the patch format is labeled only 'Plant-derived', with no 'Compounded' tag. No blood/saliva hormone testing required before prescribing (citing The Menopause Society/NAMS and ACOG). No insurance billing (HSA/FSA reimbursement only).","funding_conflict":"Self-reported by the company being reviewed.","verified":true,"notes":"Confirmed directly, on both /treatments and the homepage. The homepage strings 'FDA-approved / Compounded / Plant-derived' together directly under '#1 Physician-Recommended Treatment for Menopause' and above all four delivery formats, which reads as if FDA approval applies across the board — while the /treatments page itself shows only the patch lacks the 'Compounded' tag. That juxtaposition is real, not an artifact of secondary reporting, and is directly relevant to the ACOG consensus already in the registry (acog-compounded-bioidentical-2023) on compounded vs. FDA-approved bioidentical hormones. Worth a second look before any comparison page states or implies Winona's cream/pill products are FDA-approved.","cited_by":["/compare/winona-review/"]},{"id":"hims-hers-health-public-company-2026","title":"Hims & Hers Health, Inc. (NYSE: HIMS) — public company profile","authors":[],"publisher":"Public company filings/financial data aggregators (e.g. stockanalysis.com)","year":2026,"type":"other","url":"https://stockanalysis.com/stocks/hims/company","doi":null,"accessed":"2026-11-06","population":"Not applicable (corporate/public-markets fact)","key_finding":"Hims & Hers Health, Inc. trades on the NYSE under ticker HIMS; founded 2017, headquartered San Francisco; telehealth platform connecting patients with providers across specialties including erectile dysfunction, hair loss, skincare, mental health, and weight loss, alongside Hers' women's health offerings (menopause among them), using a catalog of generic, branded, and compounded prescription drugs plus OTC products. Used only to establish Hers' corporate/platform context — Hers' own site (forhers.com) blocks automated access on every page tried, so its menopause-specific pricing, insurance policy, and prescribing details could not be independently verified and are not stated anywhere on this site.","funding_conflict":null,"verified":true,"notes":"Confirmed the block is real: forhers.com returns a Cloudflare interactive challenge (HTTP 403, 'Just a moment...') to a real browser session, not just to an API-based fetch. Do not state a specific Hers price, insurance policy, or prescribing detail anywhere without reading the real page first.","cited_by":["/compare/hers-review/"]},{"id":"owada-suzuki-dizziness-menopause-2014","title":"The relationship between vasomotor symptoms and menopause-associated dizziness","authors":["Owada S","Suzuki M"],"publisher":"Acta Otolaryngol","year":2014,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/24138120/","doi":"10.3109/00016489.2013.841991","accessed":"2026-11-07","population":"85 women aged 40-59 with diagnosed menopause-related dizziness, retrospective chart review (29 with vasomotor symptoms, 38 without)","key_finding":"Recovery from menopause-related dizziness (diagnosed by neuro-otological exam, followed until improvement) was significantly slower in women with vasomotor symptoms than those without. Within the VMS group, those treated with HRT (n=7) recovered faster than those not treated (n=22), but this HRT difference was not statistically significant.","funding_conflict":null,"verified":true,"notes":"Corrected from the first-drafted entry: first author's initial is S (Owada S), not T, confirmed directly on PubMed. The finding is about recovery rate from a diagnosed dizziness episode, not a correlation between symptom severity scores — tightened the key_finding to match what the abstract actually reports.","cited_by":["/symptoms/dizziness/"]},{"id":"castillo-bustamante-vestibular-menopause-2024","title":"Balance in Transition: Unraveling the Link Between Menopause and Vertigo","authors":["Castillo-Bustamante M","Celebisoy N","Echavarria LG","Franco I","Valencia S","Gonzalez S","Garcia A"],"publisher":"Cureus","year":2024,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/38813338/","doi":"10.7759/cureus.59277","accessed":"2026-11-07","population":"Perimenopausal and postmenopausal women with vestibular/vertigo symptoms","key_finding":"Narrative review proposing estrogen's modulatory role in neurosensory function, including the vestibular system, as a plausible mechanism linking the menopausal hormonal decline to increased vertigo symptoms. Describes this as a developing research area with clinical implications for diagnosis and treatment of postmenopausal vestibular disorders.","funding_conflict":null,"verified":true,"notes":"Narrative review, not a primary study — typed 'other'. The abstract itself doesn't name vestibular migraine as a specific overlapping diagnosis; that detail (if used in the article) should be attributed to the full text, not this abstract-level entry.","cited_by":["/symptoms/dizziness/"]},{"id":"reinke-frozen-shoulder-hrt-2026","title":"A preliminary pilot study to address design issues related to research on potential association of hormone therapy and adhesive capsulitis","authors":["Reinke EK","Ford AC","Wahl E","Kennedy J","Poehlein E","Green CL","Saltzman E","Wittstein JR"],"publisher":"Climacteric","year":2026,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/41614260/","doi":"10.1080/13697137.2026.2615391","accessed":"2026-11-07","population":"1,952 postmenopausal women aged 40-60 at a single US health maintenance organization (152 on hormone therapy, 1,800 not)","key_finding":"Adhesive capsulitis (frozen shoulder) was diagnosed in 7.65% of women not on hormone therapy versus 3.95% of those on hormone therapy (odds ratio 1.99, 95% CI 0.86-4.58, p=0.10) — not statistically significant. Explicitly framed by the authors as a pilot study to establish sample-size needs for a larger prospective trial, not a conclusive finding either way.","funding_conflict":null,"verified":true,"cited_by":["/symptoms/frozen-shoulder/"]},{"id":"baharvand-burning-mouth-syndrome-2013","title":"Comparison of Burning Mouth Syndrome Prevalence and its Related Factors between Menopausal and Non-Menopausal Women","authors":["Baharvand M","Eshghpour M","Mortazavi H","Fallah Z"],"publisher":"Journal of Dental Materials and Techniques","year":2013,"type":"small_study","url":"https://jdmt.mums.ac.ir/article_2052.html","doi":"10.22038/jdmt.2013.2052","accessed":"2026-11-07","population":"450 female patients aged 30-60 attending dental clinics in Gorgan, Iran","key_finding":"13.8% of patients (n=62) had burning mouth syndrome (BMS). Logistic regression found educational level, menopausal status, antidepressant use, and systemic disease significantly related to BMS; menopause was associated with an odds ratio of 4.45 for BMS.","funding_conflict":null,"verified":true,"cited_by":["/symptoms/burning-mouth/"]},{"id":"gagliano-dry-eye-hormones-2014","title":"Low levels of 17-β-oestradiol, oestrone and testosterone correlate with severe evaporative dysfunctional tear syndrome in postmenopausal women: a case-control study","authors":["Gagliano C","Caruso S","Napolitano G","Malaguarnera G","Cicinelli MV","Amato R","Reibaldi M","Incarbone G","Bucolo C","Drago F","Avitabile T"],"publisher":"British Journal of Ophthalmology","year":2014,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/24390165/","doi":"10.1136/bjophthalmol-2012-302705","accessed":"2026-11-07","population":"44 postmenopausal women: 22 with severe evaporative dry eye syndrome, 22 controls","key_finding":"Serum 17-beta-oestradiol, oestrone, and total testosterone were all significantly lower in the dry-eye group than controls (p<0.05). Within the dry-eye group, all three hormones were inversely correlated with tear film osmolarity (r=-0.70, -0.88, and -0.81 respectively). Schirmer test and tear film break-up time were also significantly lower in the dry-eye group (p<0.001).","funding_conflict":null,"verified":true,"notes":"Small case-control study (n=44) — weigh accordingly.","cited_by":["/symptoms/dry-eyes/"]},{"id":"khunger-mehrotra-menopausal-acne-2019","title":"Menopausal Acne - Challenges And Solutions","authors":["Khunger N","Mehrotra K"],"publisher":"International Journal of Women's Health","year":2019,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/31754313/","doi":"10.2147/IJWH.S174292","accessed":"2026-11-07","population":"Menopausal women with acne","key_finding":"Menopausal acne has a multifactorial etiology, with a relative rise in androgens (clinical hyperandrogenism) as the major driver, also manifesting as hirsutism and androgenetic alopecia. Most menopausal women with isolated, limited acne have normal (normoandrogenic) serum levels and don't need extensive investigation, though baseline total testosterone is useful. Prolonged topical therapy is the mainstay for mild acne without virilization; combined oral contraceptives are effective but relatively contraindicated postmenopause; spironolactone is the first-choice oral anti-androgen when one is needed.","funding_conflict":null,"verified":true,"cited_by":["/symptoms/acne/"]},{"id":"orendorz-fraczkowska-hearing-balance-menopause-2020","title":"Organ of hearing and balance in peri- and postmenopausal women. Effects of hormone replacement therapy on hearing and balance in peri- and post-menopausal women: The current state of knowledge","authors":["Orendorz-Fraczkowska K","Temporale H"],"publisher":"Advances in Clinical and Experimental Medicine","year":2020,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/32589823/","doi":"10.17219/acem/121935","accessed":"2026-11-07","population":"Peri- and postmenopausal women","key_finding":"Worldwide published data on hearing loss and dizziness in perimenopausal women is inconsistent, and reports on sex hormones' effects on the ear and its aging are similarly controversial. This review concludes that hearing and balance impairment is significantly related to osteoporosis resulting from estrogen deficiency at menopause, and calls for further detailed study of HRT's effect on hearing and balance, accounting for HRT type, serum hormone levels, and osteoporosis status.","funding_conflict":null,"verified":true,"notes":"Narrative review explicitly describing the underlying evidence as inconsistent/controversial — cite as 'evidence is mixed', not as a settled mechanism.","cited_by":["/symptoms/tinnitus/"]},{"id":"liu-menopausal-symptoms-nurses-2015","title":"Factors associated with menopausal symptoms among middle-aged registered nurses in Beijing","authors":["Liu P","Yuan Y","Liu M","Wang Y","Li X","Yang M","Xi S","Ding Y","Liu JE","Xu G","Guo X","Ren Z","Bai W","Yao C"],"publisher":"Gynecological Endocrinology","year":2015,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/25310028/","doi":"10.3109/09513590.2014.971237","accessed":"2026-11-07","population":"2,100 registered nurses aged 40-55 at 20 hospitals in Beijing, China (self-administered questionnaire survey)","key_finding":"Menopausal status was the factor most strongly associated with menopausal symptoms overall (p<0.01), including hot flashes and sweating (strongest association), paresthesiae, insomnia, arthralgia/myalgia, palpitations, skin formication (crawling-skin sensation), and unsatisfactory sexual life. Psychosocial factors (recent upsetting events, pessimism) were also significantly associated with most symptoms.","funding_conflict":null,"verified":true,"cited_by":["/symptoms/tingling/"]},{"id":"gopal-ashwagandha-perimenopause-2021","title":"Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study","authors":["Gopal S","Ajgaonkar A","Kanchi P","Kaundinya A","Thakare V","Chauhan S","Langade D"],"publisher":"Journal of Obstetrics and Gynaecology Research","year":2021,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/34553463/","doi":"10.1111/jog.15030","accessed":"2026-11-07","population":"100 perimenopausal women with climacteric symptoms, India (91 completed); 8-week RCT","key_finding":"300mg ashwagandha root extract twice daily vs. placebo. Significant reduction in total Menopause Rating Scale score (p<0.0001, across psychological, somato-vegetative, and urogenital domains) and MENQoL score (p<0.0001). Significant increase in serum estradiol (p<0.0001) and decrease in FSH (p<0.0001) and LH (p<0.05) vs. placebo; no significant difference in testosterone.","funding_conflict":null,"verified":true,"notes":"No funding/conflict-of-interest statement found in the indexed abstract; all listed author affiliations are academic institutions (D Y Patil University, Vedanta Hospital, Terna Medical College, Narayana Hrudayalaya), with no industry sponsor named there.","cited_by":["/does-it-work/ashwagandha/"]},{"id":"lee-maca-menopause-systematic-review-2011","title":"Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review","authors":["Lee MS","Shin BC","Yang EJ","Lim HJ","Ernst E"],"publisher":"Maturitas","year":2011,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/21840656/","doi":"10.1016/j.maturitas.2011.07.017","accessed":"2026-11-07","population":"Healthy peri-, early-, and late-postmenopausal women across 4 included RCTs","key_finding":"All 4 included RCTs showed favorable effects on the Kupperman Menopausal Index or Greene Climacteric Score, but the reviewers conclude this is only limited evidence given the very small number of trials, small sample sizes, and methodological quality issues across them. Safety has not yet been proven. The review explicitly calls for larger, more rigorous trials before drawing firm conclusions.","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/maca/"]},{"id":"hirata-dong-quai-trial-1997","title":"Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial","authors":["Hirata JD","Swiersz LM","Zell B","Small R","Ettinger B"],"publisher":"Fertility and Sterility","year":1997,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/9418683/","doi":"10.1016/s0015-0282(97)00397-x","accessed":"2026-11-07","population":"71 postmenopausal women with hot flashes and elevated FSH (>30 mIU/mL); 24-week RCT","key_finding":"No statistically significant differences between dong quai and placebo in endometrial thickness, vaginal maturation index, number of hot flashes, or the Kupperman index. Used alone, dong quai produced no estrogen-like effect and was no more helpful than placebo for relieving menopausal symptoms.","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/dong-quai/"]},{"id":"scheffers-dhea-cochrane-2015","title":"Dehydroepiandrosterone for women in the peri- or postmenopausal phase","authors":["Scheffers CS","Armstrong S","Cantineau AEP","Farquhar C","Jordan V"],"publisher":"Cochrane Database of Systematic Reviews","year":2015,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/25879093/","doi":"10.1002/14651858.CD011066.pub2","accessed":"2026-11-07","population":"28 trials, 1,273 peri- or postmenopausal women (oral and intravaginal DHEA, vs. placebo or other active treatment)","key_finding":"No evidence DHEA improves quality of life vs. placebo (SMD 0.16, moderate-quality evidence). Associated with androgenic side effects, mainly acne (OR 3.77, moderate-quality evidence). Effect on general menopausal symptoms unclear - results were inconsistent across trials and couldn't easily be pooled. DHEA may slightly improve sexual function overall (SMD 0.31) compared with placebo, though the oral-only subgroup's effect on sexual function (SMD 0.11) was not itself significant, versus one intravaginal-DHEA study (SMD 0.42, significant alone).","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/dhea/"]},{"id":"lemos-intravaginal-dhea-meta-analysis-2026","title":"Intravaginal dehydroepiandrosterone for the treatment of vulvovaginal atrophy: a systematic review and meta-analysis","authors":["Lemos MJ","Queiroz LF","Diniz AF","Longo da Silva CM","Dos Santos PL","de Oliveira Gomide P","Ferraz JM","De Marco Novellino AM"],"publisher":"Menopause","year":2026,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/41589851/","doi":"10.1097/GME.0000000000002736","accessed":"2026-11-07","population":"5 unique RCTs (6 publications), 1,611 postmenopausal women with vulvovaginal atrophy","key_finding":"Intravaginal DHEA (prasterone/Intrarosa) significantly improved vaginal dryness (mean difference -0.23, 95% CI -0.35 to -0.11) and dyspareunia (mean difference -0.40, 95% CI -0.66 to -0.15) vs. placebo. No major safety concerns; adverse effects were mild and infrequent, with low to moderate heterogeneity across trials.","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/dhea/"]},{"id":"pu-collagen-skin-aging-metaanalysis-2023","title":"Effects of Oral Collagen for Skin Anti-Aging: A Systematic Review and Meta-Analysis","authors":["Pu SY","Huang YL","Pu CM","Kang YN","Hoang KD","Chen KH","Chen C"],"publisher":"Nutrients","year":2023,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/37432180/","doi":"10.3390/nu15092080","accessed":"2026-11-07","population":"26 RCTs, 1,721 participants, general adult population (not menopause-specific)","key_finding":"Hydrolyzed collagen supplementation significantly improved skin hydration (p<0.00001) and elasticity (p<0.00001) vs. placebo. No significant difference in effect by collagen source or measurement method on elasticity. Several biases were identified across the included RCTs, and the authors call for larger, confirmatory trials.","funding_conflict":null,"verified":true,"notes":"Not specific to menopausal women - a general-population skin study. Cite it as general evidence for collagen and skin, not as menopause-specific evidence.","cited_by":["/does-it-work/collagen/"]},{"id":"wang-probiotics-bone-health-metaanalysis-2024","title":"Effects of probiotic supplementation on bone health in postmenopausal women: a systematic review and meta-analysis","authors":["Wang F","Wei W","Liu PJ"],"publisher":"Frontiers in Endocrinology","year":2024,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/39553313/","doi":"10.3389/fendo.2024.1487998","accessed":"2026-11-07","population":"12 RCTs, 1,183 postmenopausal women","key_finding":"Probiotic supplementation significantly increased bone mineral density at the lumbar spine (SMD 0.60, 95% CI 0.14-1.05) and hip (SMD 0.74, 95% CI 0.15-1.33) versus controls, and reduced the bone-turnover markers CTX and BALP. The effect was more pronounced in women with osteopenia than those with osteoporosis. Results remained robust in sensitivity analyses; the authors still call for further RCTs to confirm and refine the findings.","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/probiotics/"]},{"id":"acquarulo-pollen-extract-vms-metaanalysis-2024","title":"The efficacy of purified pollen extract for reducing vasomotor symptoms in women: a systematic review and meta-analysis","authors":["Acquarulo EL","Hernandez EC","Kodzodziku F","Nemec EC"],"publisher":"Menopause","year":2024,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/38194609/","doi":"10.1097/GME.0000000000002301","accessed":"2026-11-07","population":"5 studies (1 RCT, 4 observational), 420 women total; search string explicitly included product/brand names (Bonafide, Femal, Estroven, Serelys)","key_finding":"Pooling all 5 studies showed significant improvement at 3 months in hot flashes, night disturbance, depression, and myalgia. When only the placebo-controlled studies were pooled, these improvements were no longer statistically significant - the authors conclude the apparent benefit in the uncontrolled studies may reflect a placebo effect. No significant adverse effects were found either way.","funding_conflict":null,"verified":true,"cited_by":["/does-it-work/relizen/"]},{"id":"radzinsky-amberen-pooled-trials-2019","title":"Succinate-Based Dietary Supplement for Menopausal Symptoms: A Pooled Analysis of Two Identical Randomized, Double-Blind, Placebo-Controlled Clinical Trials","authors":["Radzinsky VE","Uspenskaya Y","Shulman LP","Kuznetsova IV"],"publisher":"Obstetrics and Gynecology International","year":2019,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/31781230/","doi":"10.1155/2019/1572196","accessed":"2026-11-07","population":"227 women aged 42-60 (114 treatment/113 placebo), pooled from two identical 90-day RCTs of a succinate-based supplement (Amberen)","key_finding":"Significant improvement in 16 of 21 Greene Climacteric Scale symptoms (p<=0.05) and reduced anxiety (p<0.0001) vs. placebo. Significant reductions in weight, BMI, and waist/hip circumference vs. placebo. Serum estradiol increased significantly from baseline (p<0.0001) among users.","funding_conflict":"Disclosed in the paper itself: author Shulman is a paid consultant for Biogix Inc. (formerly Lunada Biomedical, Amberen's manufacturer). The other three authors were investigators in one or both of the pooled trials, not independent of the research - Kuznetsova and Radzinsky were each the main investigator in one of the two trials.","verified":true,"notes":"Graded Limited despite the randomized, double-blind, placebo-controlled design, specifically because of the disclosed financial conflict - evidence outranks commission, but a real conflict of interest still outranks an otherwise-solid design when setting the grade.","cited_by":["/does-it-work/amberen/"]},{"id":"relizen-own-site-2026","title":"Relizen (hot flash and night sweat supplement) — product page (own site)","authors":[],"publisher":"Bonafide Health, LLC","year":2026,"type":"other","url":"https://hellobonafide.com/products/relizen","doi":null,"accessed":"2026-11-07","population":"Prospective Relizen customers (US)","key_finding":"Self-reported by Bonafide: under a 'Results backed by science' heading, the page states '75% of women experienced reduced hot flash frequency' and '70% of women experienced reduced night sweats', both footnoted to reference 36. That reference (Bernsley et al., Menopause 2021;28(12):1438-1476) is explicitly described on the same page as 'based on survey data of 4,925 customers taking Relizen for at least 3 months' - a customer satisfaction survey, not a controlled trial - placed directly beside citations to three real placebo-controlled clinical trials (references 30-32) under the same science heading.","funding_conflict":"Self-reported by the company being reviewed.","verified":true,"notes":"Confirmed directly by reading the page's own footnote text. The juxtaposition of a customer survey and real RCT citations under one 'backed by science' heading, with the same superscript style, is a genuine finding worth calling out plainly, not an artifact of secondary reporting.","cited_by":["/does-it-work/relizen/"]},{"id":"aso-s-equol-hot-flash-trial-2012","title":"A natural S-equol supplement alleviates hot flushes and other menopausal symptoms in equol nonproducing postmenopausal Japanese women","authors":["Aso T","Uchiyama S","Matsumura Y","Taguchi M","Nozaki M","Takamatsu K","Ishizuka B","Kubota T","Mizunuma H","Ohta H"],"publisher":"Journal of Women's Health","year":2012,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/21992596/","doi":"10.1089/jwh.2011.2753","accessed":"2026-11-07","population":"160 equol-nonproducing postmenopausal Japanese women with at least 1 hot flush/day (77 S-equol, 83 placebo); 12-week multicenter double-blind RCT, 126 completed","key_finding":"10mg/day natural S-equol vs. placebo. Hot flush frequency decreased more with S-equol than placebo (-58.7% vs. -34.5% from baseline, p=0.009). Severity of hot flushes and neck/shoulder muscle stiffness also significantly decreased more with S-equol. No changes in clinical parameters and no serious adverse effects reported.","funding_conflict":null,"verified":true,"notes":"Added to match a citation already used in content/pages/does-it-work/equelle.md (the content session's own id for it) - verified independently via NCBI, not just taken from the content file's paraphrase. Note this trial used a different, equol-nonproducer-only Japanese population - whether its results generalize to women in general isn't established by this trial alone.","cited_by":["/does-it-work/equelle/"]},{"id":"overbeek-chemotherapy-ovarian-function-2017","title":"Chemotherapy-related late adverse effects on ovarian function in female survivors of childhood and young adult cancer: A systematic review","authors":["Overbeek A","van den Berg MH","van Leeuwen FE","Kaspers GJ","Lambalk CB","van Dulmen-den Broeder E"],"publisher":"Cancer Treatment Reviews","year":2017,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/28056411/","doi":"10.1016/j.ctrv.2016.11.006","accessed":"2026-11-07","population":"45 studies, 5,607 female survivors of childhood and young adult cancer","key_finding":"Median age at menopause was earlier in cancer survivors than in the general population. Amenorrhoea prevalence ranged from 0% to 83% depending on treatment regimen; MVPP protocols and cyclophosphamide-containing regimens for breast cancer carried the highest risk (39-80%). The strongest risk factors for ovarian dysfunction were alkylating agents (specifically procarbazine and busulfan) and older age at treatment. The authors note all included studies had methodological limitations and call for nation-wide registries to guarantee long-term follow-up of cancer survivors.","funding_conflict":null,"verified":true,"notes":"Added to match a citation already used in content/pages/groups/chemotherapy-induced-menopause.md (the content session's own id for it) - verified independently via NCBI, not just taken from the content file's paraphrase.","cited_by":["/groups/chemotherapy-induced-menopause/"]},{"id":"ahn-hysterectomy-ovarian-function-2002","title":"Effect of hysterectomy on conserved ovarian function","authors":["Ahn EH","Bai SW","Song CH","Kim JY","Jeong KA","Kim SK","Lee JS","Kwon JY","Park KH"],"publisher":"Yonsei Medical Journal","year":2002,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/11854933/","doi":"10.3349/ymj.2002.43.1.53","accessed":"2026-11-07","population":"94 women thoroughly followed of 510 reviewed, after total abdominal hysterectomy (with or without unilateral salpingo-oophorectomy) for benign disease, Korea, 1989-1992","key_finding":"Mean menopausal age (based on patient-reported symptoms) was significantly lower in TAH-treated patients than in the control group (p<0.001), with a positive correlation between younger age at operation and earlier menopausal age. The authors concluded TAH accelerated ovarian dysfunction and that TAH patients are at risk of early menopause.","funding_conflict":null,"verified":true,"notes":"Retrospective, symptom-based menopause determination (not hormone-confirmed), and only 94 of 510 originally reviewed women were followed up closely enough to include - a real limitation worth keeping in mind alongside the newer Atay et al. 2007 study, which found no significant difference.","cited_by":["/groups/hysterectomy-ovaries-retained/"]},{"id":"atay-hysterectomy-ovarian-preservation-2007","title":"Hysterectomy with preservation of both ovaries does not result in premature ovarian failure","authors":["Atay V","Ceyhan T","Baser I","Gungor S","Goktolga U","Muhcu M"],"publisher":"Journal of International Medical Research","year":2007,"type":"small_study","url":"https://pubmed.ncbi.nlm.nih.gov/17593871/","doi":"10.1177/147323000703500317","accessed":"2026-11-07","population":"29 women who had total abdominal hysterectomy with both ovaries preserved at age <=40, vs. 42 menopausal controls with no previous ovarian pathology","key_finding":"Mean age at menopause was 49.7 years (TAH group) vs. 50.1 years (control group) - not statistically significant. The authors concluded TAH without oophorectomy does not cause premature menopause, at the cost of a higher risk of developing adnexal pathology (cysts) afterward.","funding_conflict":null,"verified":true,"notes":"The abstract's own cyst-incidence figures (31% TAH vs. 44.8% control) read as inconsistent with its stated conclusion of an 'increased incidence of cysts in the TAH group' - the content session noticed this and deliberately cited only the clean, unambiguous menopause-age finding, not the cyst figures. Flagging the same caveat here: don't cite this source's cyst-incidence numbers without reading the full text to resolve the discrepancy.","cited_by":["/groups/hysterectomy-ovaries-retained/"]},{"id":"emas-endometriosis-menopause-guide-2025","title":"Endometriosis and menopausal health: An EMAS clinical guide","authors":["Erel CT","Nigdelis MP","Ozcivit Erkan IB","Goulis DG","Chedraui P","Giannini A","Kiesel L","Phillips N","Simoncini T","Armeni E","Boban J","Ceausu I","Hillard T","Lambrinoudaki I","Smetnik A","Sprem Goldstajn M","Stute P","van Dijken D","Rees M"],"publisher":"Maturitas (European Menopause and Andropause Society)","year":2025,"type":"position_statement","url":"https://pubmed.ncbi.nlm.nih.gov/40907339/","doi":"10.1016/j.maturitas.2025.108715","accessed":"2026-11-07","population":"Women with a history of endometriosis, peri- or postmenopausal","key_finding":"Endometriosis or its treatment may cause spontaneous early/premature or surgically induced menopause, and is associated with increased risk of cardiovascular disease, ovarian/breast/thyroid cancer, and osteoporosis. Continuous combined MHT may be safer than other forms (including after hysterectomy) since it may reduce the risk of recurrence or malignant transformation of residual endometriosis tissue; estrogen-only MHT should be avoided even after hysterectomy in this group. Neurokinin-3 receptor antagonists are a non-hormonal alternative for vasomotor symptoms; antiresorptive/anabolic therapy plus calcium and vitamin D for bone protection. Surgery is preferred for symptomatic postmenopausal endometriosis. Herbal preparations are advised against (uncertain efficacy, some contain estrogenic compounds).","funding_conflict":"Guideline panel of 18 authors; several disclose industry consultancy, speaker fees, or grant funding from multiple different companies (Astellas, Bayer, Gedeon Richter, Besins, and others) - typical for a specialist society guideline panel of this size, not a single-sponsor study. Several other authors declared none.","verified":true,"cited_by":["/groups/endometriosis/"]},{"id":"kapoor-vms-workplace-survey-2026","title":"Impact of vasomotor symptoms on women in the workplace: Results from a non-interventional survey in the United States","authors":["Kapoor E","Ajmera M","Shiozawa A","Chertavian E","Kim J","Renteria T","Straubing R","Mancuso S"],"publisher":"Maturitas","year":2026,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/42617245/","doi":"10.1016/j.maturitas.2026.109084","accessed":"2026-11-07","population":"1,011 US women aged 40-65, employed or stopped working/retired within the last year, with vasomotor symptoms (>=2 hot flash/night sweat episodes/day in the preceding 2 weeks for >=1 month); mean age 49.6, 72.9% White","key_finding":"Mean 7.5 hot flashes/night sweats per day. 81.3% had never received treatment. Activity impairment, absenteeism, and presenteeism were reported by 36%, 6%, and 32% respectively, all increasing with VMS severity. Almost 80% had never discussed VMS with their employer; only 18.1% felt their employer was supportive. Top coping mechanisms at work: temperature control (71.0%), layered/breathable clothing (46.0%). Top requested accommodations: changes to benefit packages (27.9%), more workplace awareness (25.7%), more flexible working arrangements (23.2%).","funding_conflict":"Disclosed: funded by/affiliated with Astellas Pharma (maker of fezolinetant/Veozah). Three authors (Ajmera, Shiozawa, Kim, Mancuso) are Astellas employees; lead author Kapoor discloses consulting fees from Astellas and several other companies (Novo Nordisk, Estetra, Fresenius Kabi, Exeltis, Dexcom, WellFound); the remaining authors are employees of a health-economics consultancy (Medicus Economics) engaged for the analysis.","verified":true,"notes":"This is workplace-impact epidemiology (self-reported survey data), not a drug-efficacy claim, but the funding conflict is disclosed anyway per house style since the funder sells a treatment for the exact symptoms being surveyed.","cited_by":["/groups/menopause-at-work/"]},{"id":"chesnokova-insurance-mht-disparity-2026","title":"Insurance Type and Menopausal Hormone Therapy Use Among US Women","authors":["Chesnokova A","Mumford SL","Schachter A","Hamm RF","Lorch S","Klebanoff M","Lindley S","Harness E","Williams M","Schapira MM"],"publisher":"JAMA Network Open","year":2026,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/42467433/","doi":"10.1001/jamanetworkopen.2026.23740","accessed":"2026-11-07","population":"NHANES 2013-2020 cycles; 1,666 unweighted respondents (weighted n=22,275,545), US women aged 45-64 with Medicaid or private insurance, eligible for MHT (91.4% weighted private, 8.6% Medicaid)","key_finding":"Medicaid-insured women reported a lower history of MHT use than privately insured women (10.7%, 95% CI 6.9-16.0% vs. 20.7%, 95% CI 18.1-23.5%); after adjustment, Medicaid insurance was associated with lower odds of MHT use (OR 0.50, 95% CI 0.28-0.87). Black participants had lower odds of MHT use than White participants (OR 0.68, 95% CI 0.45-0.95), but this difference was attenuated once insurance status was added to the model (adjusted OR 0.72, 95% CI 0.50-1.04) - suggesting insurance type may partly explain the racial gap.","funding_conflict":null,"verified":true,"cited_by":["/care/insurance/"]},{"id":"goodrx-estradiol-pricing-2026","title":"Estradiol prices, coupons & savings tips","authors":[],"publisher":"GoodRx","year":2026,"type":"other","url":"https://www.goodrx.com/estradiol","doi":null,"accessed":"2026-11-07","population":"N/A — US retail drug pricing data","key_finding":"As of 2026-11-07, listed US retail (non-insurance) prices for a 1-month supply of generic estradiol: once-weekly patches ranged roughly $37-$69 depending on dose (4-patch cartons); gel packets ranged much more widely, roughly $39-$545 depending on dose/quantity, with some specific strength/quantity combinations priced far higher, likely a brand/generic-substitution quirk at that exact SKU rather than a representative price. Tablet pricing was not checked.","funding_conflict":null,"verified":true,"notes":"I could not independently re-access goodrx.com myself (it returned a 403 'Access to this page has been denied' to my browser session on 2026-11-07, both for the main estradiol page and a patch-specific subpage) - this entry rests on the content session's own direct read, not my own verification. Retail pricing pages change often and are explicitly dated in the content as 'as of November 2026' rather than presented as a stable fact; re-check before relying on these figures again.","cited_by":["/care/hrt-cost/"]},{"id":"trento-postmenopausal-sexual-function-2021","title":"Sexual Function and Associated Factors in Postmenopausal Women","authors":["Trento SRSS","Madeiro A","Rufino AC"],"publisher":"Revista Brasileira de Ginecologia e Obstetricia","year":2021,"type":"other","url":"https://pubmed.ncbi.nlm.nih.gov/34461662/","doi":"10.1055/s-0041-1735128","accessed":"2026-11-07","population":"380 women aged 40-65, public health service users, Brazil, 2019; cross-sectional","key_finding":"64% (243/380) were at risk of sexual dysfunction, with lower scores in sexual desire/interest, comfort, orgasm, and satisfaction. Factors significantly associated with greater risk of sexual dysfunction: sexual complaints (adjusted OR 8.16, 95% CI 5.06-13.15), vaginal dryness (adjusted OR 3.44, 95% CI 2.22-5.32), sleep problems (adjusted OR 2.72, 95% CI 1.77-4.19), having a partner (adjusted OR 2.07, 95% CI 1.03-4.17), and depressed mood (adjusted OR 2.03, 95% CI 1.32-3.10).","funding_conflict":null,"verified":true,"cited_by":["/postmenopause/sexual-health/"]},{"id":"silva-sexual-counseling-metaanalysis-2022","title":"Educational Programs and Sexual Counselling for Postmenopausal Sexual Dysfunction: A Systematic Review and Meta-Analysis","authors":["Santos Silva IM","Paula Pinto M","Goncalves D"],"publisher":"Journal of Sexual Medicine","year":2022,"type":"systematic_review","url":"https://pubmed.ncbi.nlm.nih.gov/34758929/","doi":"10.1016/j.jsxm.2021.09.017","accessed":"2026-11-07","population":"8 studies (6 RCTs, 2 non-randomized), 619 women aged 39-75, all in menopause less than 5 years","key_finding":"Sexual counseling/education programs (4-10 sessions of 45-60 minutes, some including CBT or mindfulness) significantly improved total Female Sexual Function Index score vs. routine care (mean difference +7.14, 95% CI 3.70-10.6, p<0.0001), with significant improvement across all evaluated domains: pain, arousal, lubrication, desire, orgasm, and satisfaction.","funding_conflict":null,"verified":true,"notes":"No conflict-of-interest statement appears in the indexed abstract itself - recorded here as 'not stated', not assumed to be 'none', since the two are different things.","cited_by":["/postmenopause/sexual-health/"]},{"id":"uspstf-breast-cancer-screening-2024","title":"Breast Cancer: Screening","authors":[],"publisher":"US Preventive Services Task Force","year":2024,"type":"regulator_statement","url":"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening","doi":null,"accessed":"2026-11-07","population":"US women","key_finding":"USPSTF recommends biennial screening mammography for women aged 40-74 (Grade B). Evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75+ (Grade I), or of supplemental screening with ultrasound or MRI for women with dense breasts (Grade I).","funding_conflict":null,"verified":true,"notes":"Dated April 30, 2024 on the page itself.","cited_by":["/postmenopause/health-checklist/"]},{"id":"uspstf-osteoporosis-screening-2025","title":"Osteoporosis to Prevent Fractures: Screening","authors":[],"publisher":"US Preventive Services Task Force","year":2025,"type":"regulator_statement","url":"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening","doi":null,"accessed":"2026-11-07","population":"US women and men","key_finding":"USPSTF recommends screening for osteoporosis in women 65+ (Grade B), and in postmenopausal women younger than 65 who are at increased fracture risk per clinical risk assessment (Grade B). Evidence is insufficient to assess the balance of benefits and harms of screening in men (Grade I).","funding_conflict":null,"verified":true,"notes":"Dated January 14, 2025 on the page itself.","cited_by":["/postmenopause/health-checklist/"]},{"id":"uspstf-colorectal-cancer-screening-2021","title":"Colorectal Cancer: Screening","authors":[],"publisher":"US Preventive Services Task Force","year":2021,"type":"regulator_statement","url":"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening","doi":null,"accessed":"2026-11-07","population":"US adults at average risk for colorectal cancer","key_finding":"USPSTF recommends screening for colorectal cancer in adults aged 50-75 (Grade A) and 45-49 (Grade B). For adults 76-85, clinicians should selectively offer screening based on overall health, prior screening history, and patient preference (Grade C), since the net benefit of screening everyone in this age group is small.","funding_conflict":null,"verified":true,"notes":"Dated May 18, 2021 on the page itself.","cited_by":["/postmenopause/health-checklist/"]},{"id":"uspstf-cervical-cancer-screening-2018","title":"Cervical Cancer: Screening","authors":[],"publisher":"US Preventive Services Task Force","year":2018,"type":"regulator_statement","url":"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening","doi":null,"accessed":"2026-11-07","population":"US women","key_finding":"USPSTF recommends against cervical cancer screening in women older than 65 who have had adequate prior screening and aren't otherwise at high risk (Grade D), and against screening women who have had a hysterectomy with cervix removed and no history of a high-grade precancerous lesion (CIN 2/3) or cervical cancer (Grade D). For women 21-65, recommends screening every 3 years with cytology alone, or every 5 years with hrHPV testing alone or cotesting (Grade A).","funding_conflict":null,"verified":true,"notes":"Dated August 21, 2018, and the page displays 'This topic is being updated... Update in Progress for Cervical Cancer: Screening' as of the access date - check for a newer statement before treating this as the final word, same caveat as the other 'update in progress' USPSTF pages already in this registry.","cited_by":["/postmenopause/health-checklist/"]},{"id":"cagnacci-contraception-over-40-consensus-2025","title":"Consensus conference results on contraception in women beyond 40 years of age","authors":["Cagnacci A","Fruzzetti F","Bruni V","Gambera A","Guida M","Bonaccorsi G","Londero AP"],"publisher":"European Journal of Contraception and Reproductive Health Care","year":2025,"type":"position_statement","url":"https://pubmed.ncbi.nlm.nih.gov/40838950/","doi":"10.1080/13625187.2025.2544754","accessed":"2026-11-07","population":"Women over 40 considering hormonal contraception during perimenopause","key_finding":"Italian Society of Contraception multidisciplinary consensus panel (literature review to October 2024, statements voted at a national congress, consensus defined as >=75% agreement): 7 statements endorsed at 95-99% agreement. Cardiovascular safety is the primary factor in contraceptive selection; progestogen-only methods are considered safe for cardiovascular risk; combined hormonal contraceptives using natural estrogens or 20mcg ethynylestradiol with non-androgenic progestins are considered more advantageous for cardiovascular risk. LNG-IUD, estradiol valerate/dienogest, and the combined vaginal ring are identified as most effective for menstrual bleeding management. Hormone type and route of administration can influence sexual function, with implants and vaginal rings showing positive effects. Combined hormonal contraceptives show protective effects on bone density; progestogen-only methods are neutral.","funding_conflict":null,"verified":true,"notes":"Expert consensus/position statement, not a systematic review of trial data - reflects panel judgment on existing evidence, graded accordingly.","cited_by":["/perimenopause/contraception/"]},{"id":"greendale-swan-body-composition-2019","title":"Changes in body composition and weight during the menopause transition","authors":["Greendale GA","Sternfeld B","Huang M","Han W","Karvonen-Gutierrez C","Ruppert K","Cauley JA","Finkelstein JS","Jiang SF","Karlamangla AS"],"publisher":"JCI Insight","year":2019,"type":"cohort","url":"https://pubmed.ncbi.nlm.nih.gov/30843880/","doi":"10.1172/jci.insight.124865","accessed":"2026-11-07","population":"SWAN (Study of Women's Health Across the Nation) longitudinal cohort, DEXA-based body composition measures across the menopause transition","key_finding":"Fat and lean mass both increased before the menopause transition (MT). At MT onset, the rate of fat gain doubled and lean mass began declining; both continued until 2 years after the final menstrual period (FMP), then flattened to zero slope. Weight itself climbed linearly during premenopause with no acceleration at the start of the MT, and its trajectory became flat after the MT - the authors conclude there is no discernible change in the rate of weight gain at the start of the transition, despite the real underlying shift from lean to fat mass.","funding_conflict":null,"verified":true,"notes":"NIH-funded (National Institute on Aging, National Institute of Nursing Research, NIH Office of Research on Women's Health); no conflict of interest declared.","cited_by":["/perimenopause/year-by-year/"]},{"id":"kravitz-swan-postmenopause-depression-2022","title":"Risk of high depressive symptoms after the final menstrual period: the Study of Women's Health Across the Nation (SWAN)","authors":["Kravitz HM","Colvin AB","Avis NE","Joffe H","Chen Y","Bromberger JT"],"publisher":"Menopause","year":2022,"type":"cohort","url":"https://pubmed.ncbi.nlm.nih.gov/35796553/","doi":"10.1097/GME.0000000000001988","accessed":"2026-11-07","population":"1,551 midlife women, SWAN cohort, 1996-2017, median 19.0-year follow-up","key_finding":"Women had higher odds of a high depressive-symptom score during postmenopause than when premenopausal (OR 1.49, 95% CI 1.09-2.04); not significantly different for perimenopause vs. premenopause. Three pre-FMP depressive-symptom trajectories were identified: consistently low (47.7% of women), moderate (39.9%), and consistently high (12.4%). Compared with the consistently-low group, both the moderate (OR 2.62, 95% CI 1.89-3.66) and high (OR 6.88, 95% CI 4.72-10.02) trajectory groups had significantly higher postmenopausal depressive symptoms. Other pre-FMP factors associated with high postmenopausal depressive symptoms: childhood trauma/maltreatment, poor physical role functioning, high anxiety, sleep problems, high vasomotor symptoms, younger age, and lower social support.","funding_conflict":"All authors report NIH grant funding for this study (NIA; NCI and NIMH for some). One co-author (Joffe) additionally discloses grants from Merck and Pfizer and consulting fees from NeRRe/KaNDy, Eisai, Jazz, and Bayer - unrelated to this specific analysis but disclosed for transparency. Two co-authors (Colvin, Chen) declared no conflicts of any kind.","verified":true,"cited_by":["/perimenopause/year-by-year/"]}]}