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Medscape
17 minutes ago
- Medscape
Early Menopause Blues: Not Just About Hormones
TOPLINE: Among women with premature ovarian insufficiency, 29.9% experienced depressive symptoms, with younger age at diagnosis, severe menopausal symptoms, and lack of emotional support being key risk factors. Oestradiol levels and the use of hormone therapy were not significantly associated with the risk for depression, underscoring the role of psychosocial factors. METHODOLOGY: Researchers in the Netherlands conducted an exploratory cross-sectional study of 345 women with premature ovarian insufficiency (median age at diagnosis, 32 years) to identify factors associated with the development of depression in this population. The diagnostic criteria for premature ovarian insufficiency included oligo/amenorrhoea for at least 4 months and an elevated follicle-stimulating hormone level (> 25 IU/L) on two occasions at least 4 weeks apart. Validated questionnaires were used to measure the severity of depressive symptoms, frequency and severity of menopausal symptoms, impact of infertility on various aspects of life, and level of emotional support. Clinical evaluations included recording vital signs and BMI; running a blood panel for lipids and thyroid function; and measuring luteinising hormone, follicle‐stimulating hormone, oestradiol, and progesterone levels. TAKEAWAY: Among the 345 patients, 29.9% reported depressive symptoms and 70.1% did not. Although 42.3% of women were using oestrogen plus progestogen therapy at baseline, no significant difference in depressive symptoms was observed between those receiving and not receiving it (P = .89); oestradiol levels and the receipt of hormone therapy were not associated with depressive symptoms in this study. Severe menopausal symptoms (odds ratio [OR], 1.13; P < .001), lower emotional support (OR, 0.86; P < .001), and younger age at diagnosis (OR, 0.95; P = .01) were each associated with higher odds of depressive symptoms, whereas genetic aetiology was associated with lower odds (OR, 0.10; P = .04). Among women experiencing fertility-related grief, a lower quality of life related to fertility issues was also associated with depressive symptoms. IN PRACTICE: "Our findings underline the need for comprehensive assessment and management of menopausal symptoms, including psychosocial and sexual well-being, in women with POI [premature ovarian insufficiency]. Addressing the psychological impact of POI, including the loss of fertility, is probably crucial in preventing or mitigating depressive symptoms," the authors wrote. SOURCE: This study was led by Charissa van Zwol-Janssens, MD, Division of Reproductive Endocrinology and Infertility, Erasmus MC, Rotterdam, the Netherlands. It was published online on July 15, 2025, in Menopause. LIMITATIONS: The observational design of the study prevented causal inferences between the identified risk factors and depression. The evaluation of symptoms at only one timepoint precluded examining trends over time or identifying at ‐ risk individuals. Moreover, enrolling participants from a single centre may have affected the generalisability of the results. DISCLOSURES: This study did not receive any funding. Some authors reported receiving research grants and fees for consultancy or presentations from various organisations, including pharmaceutical and healthcare companies. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
17 minutes ago
- Medscape
Post-Cerclage Cervical Length as Predictor of Preterm Birth
TOPLINE: Post-cerclage cervical length (CL) was a significant predictor of spontaneous preterm birth (sPTB; < 34 weeks of gestation) in women who underwent cervical cerclage, predominantly outperforming pre-cerclage CL. METHODOLOGY: Researchers in the UK conducted a retrospective cohort study at four preterm birth prevention clinics between January 2008 and March 2021 to assess the predictive value of CL measurements, both before and after cervical cerclage, for sPTB (< 34 weeks of gestation). They included 331 women who underwent cervical cerclage and had both pre- and post-cerclage CL measured per the standardised protocol using transvaginal ultrasound as recommended by the Cervical Length Education and Review program. The primary outcome was sPTB (< 34 weeks of gestation), assessed using multivariable logistic regression modelling (adjusting for pre- and post-cerclage CL, gestational age at cerclage, and direction of the CL change) and receiver operating characteristic (ROC) curves. TAKEAWAY: Both pre-cerclage CL (area under the ROC curve [AUC], 0.635; 95% CI, 0.559-0.712) and post-cerclage CL (AUC, 0.677; 95% CI, 0.604-0.751) were predictors of sPTB. Adjusted models incorporating gestational age at cerclage demonstrated that both pre-cerclage CL (odds ratio [OR], 0.964; P = .018) and post-cerclage CL (OR, 0.940; P < .001) were significant predictors of sPTB. In a comparative model analysis, the effect of post-cerclage CL on sPTB was greater than that of pre-cerclage CL (OR, 0.943; P < .001 vs OR, 0.974; P = .058). Overall, sPTB was reported in 11.9% of women with history-indicated cerclage vs 24.3% of those with ultrasound-indicated cerclage and 36.8% of those with emergency cerclage (P = .003). IN PRACTICE: "Clinicians performing cervical cerclage should aim to maximize total CL when inserting cerclage and continue to monitor CL after cerclage insertion," the authors wrote. SOURCE: This study was led by K. E. Mountain and S. Ng, March of Dimes Prematurity Research Centre at The Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, England. It was published online on July 09, 2025, in Ultrasound in Obstetrics & Gynecology. LIMITATIONS: This study included only women who underwent cervical cerclage, limiting the use of pre-cerclage CL thresholds for decision-making guidance. Metrics related to the cerclage position within the cervical canal were not assessed. Additionally, the intervals between pre- and post-cerclage scans and cervical cerclage were not standardised. DISCLOSURES: This study was supported by the National Institute for Health and Care Research Imperial Biomedical Research Centre, London, and Tommy's Charity, London, UK. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
17 minutes ago
- Medscape
Frequent Walking Tied to Lower CVD Risk in Seniors Above 80
TOPLINE: In older adults initially free of cardiovascular disease (CVD), each additional 10 moderate-to-vigorous physical activity walking events was associated with a reduced risk for CVD. In those aged 80 years or older, frequent light physical activity walking bouts also provided significant protection. METHODOLOGY: Moderate-to-vigorous physical activity (three or more metabolic equivalents) has been known to reduce the risk for CVD in older adults; however, the influence of different activity patterns and age-related differences remain unclear. Researchers analysed data from a Swedish cohort study and included 423 participants aged either 66 years or 80 years or older (67.4% women) without any CVD. Thigh-worn accelerometers were used to measure physical activity such as steps per day, sit-to-stand transitions, daily time in light and moderate-to-vigorous physical activity, and walking events. Walking events were identified as continuous walking bouts (excluding standing), with less than 100 steps per minute being classified as light and 100 or more steps per minute being classified as moderate-to-vigorous physical activity. The primary outcome was the incidence of both fatal and non-fatal CVD events, tracked over a mean follow-up duration of 5.6 years. TAKEAWAY: The participants took an average of 9276 steps per day and engaged in 35.5 minutes of moderate-to-vigorous physical activity per day; 30% of participants experienced at least one CVD event during the follow-up period. Overall, each additional 10 moderate-to-vigorous physical activity walking events was associated with a 10% reduced risk for CVD (adjusted hazard ratio, 0.90; P = .019). Among participants aged 80 years or older, the risk for CVD reduced by 39% for each additional 100 light physical activity walking events and by 13% for each additional 10 moderate-to-vigorous physical activity walking events (P < .05 for both). No clear associations between physical activity patterns and the risk for CVD were observed among younger-old adults (66 years). IN PRACTICE: "Our findings suggest that the daily frequency of PA [physical activity] events, alongside adherence to international MVPA [moderate-to-vigorous PA] recommendations (≥ 150-300 minutes per week), may offer added benefits in mitigating CVD risk," the authors wrote. SOURCE: This study was led by Caroline Lager, PhD student, Karolinska Institutet, Stockholm, Sweden. It was published online on July 12, 2025, in the European Journal of Preventive Cardiology. LIMITATIONS: Accelerometers may not have provided accurate measures of activities such as cycling, resistance training, or water-based exercises. Intensity levels of activities may have been misclassified. Data on physical activity may have been incomplete as the accelerometers were worn only during waking hours. DISCLOSURES: This study received support from the Swedish Research Council, the Swedish Ministry of Health and Social Affairs, and participating county councils and municipalities. Additional support was provided by The Mälardalen area doctoral school in health care science and the Strategic Research Area Health Care Science at Karolinska Institutet. The authors declared having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
