ObjectivesThis study aimed to evaluate the relationship between menopausal hormone therapy (MHT) and the development of major ocular diseases, including cataract, glaucoma, and retinal disorders.MethodsThis retrospective cohort study used data from the Korean National Health Insurance Service database (2005–2015) comprising 23,333 women diagnosed with menopause, International Classification of Diseases, 10th Revision code N95. Participants were categorized into MHT and non-MHT groups. Incidence rate ratios (IRRs) of ophthalmologic diseases were analyzed, with subgroup analyses by age at menopause, time to MHT initiation, and duration of therapy.ResultsA total of 18,228 women were included. The MHT group had a significantly lower incidence of glaucoma than the non-MHT group (IRR 0.921, 95% confidence interval [CI] [0.869, 0.975]). The protective effect was most evident in women who experienced menopause at 40–49 years (IRR 0.851, 95% CI [0.762, 0.951]). Initiating MHT within 1 year of menopause was linked to a reduced glaucoma risk (IRR 0.896, 95% CI [0.844, 0.951]), while delayed initiation increased the risk (IRR 1.161, 95% CI [1.024, 1.316]). MHT use for ≥ 365 days was associated with lower risks of glaucoma (IRR 0.888, 95% CI [0.816, 0.967]) and retinal disorders (IRR 0.886, 95% CI [0.789, 0.995]) compared to shorter use.ConclusionsMHT use is associated with reduced glaucoma risk in postmenopausal women, especially those aged 40–49 years. These findings highlight the potential ocular benefits of MHT and the importance of early initiation in younger menopausal women.

ObjectivesThis prospective multi-center pilot study evaluated the safety, efficacy, and quality of life (QoL) outcomes associated with the use of a transvaginal mesh kit utilizing partially absorbable mesh (PAM) in Korean women with pelvic organ prolapse (POP).MethodsThirty patients with symptomatic POP stage II or higher underwent surgical repair using the SERATOM® PA mesh between March 2013 and February 2015. The primary endpoint was the objective surgical success rate, assessed by POP-Q stage and the need for repeat surgery within six months postoperatively. Secondary endpoints included QoL assessment using validated questionnaires (King’s Health Questionnaire, PFDI-20, PFIQ-7, and PISQ-12) and monitoring of complications.ResultsThe mean participant age was 65.6 years, with 97% being postmenopausal. Preoperative POP-Q staging revealed that most patients (87%) had stage III or IV prolapse. The average surgical time was 96.4 minutes, and hospital stay averaged 4.9 days. No intraoperative or postoperative complications were reported. Of the 24 patients who completed follow-up, 23 achieved POP-Q stage 0 at six months, with the remaining patient at stage I but asymptomatic, requiring no further intervention. No cases of healing abnormalities or reoperations were noted. Significant improvements in pelvic floor dysfunction symptoms and sexual function were observed, as evidenced by marked improvements in PFDI-20, PFIQ-7, and PISQ-12 scores at six months postoperatively.ConclusionsThe use of PAM in transvaginal POP surgery demonstrated high efficacy, excellent safety outcomes, and significant improvement in QoL, suggesting it is a viable surgical option for advanced POP in this patient population.

This corrects the article on p. 3 in vol. 31, PMID: 40347161.

Diminished ovarian reserve (DOR) occurs unintentionally during treatment or spontaneously. Despite its significant clinical manifestations, such as infertility and early menopause, and its high prevalence, most studies on DOR have focused on premature ovarian insufficiency, and reviews specifically addressing DOR remain scarce. This narrative review aims to provide insight into the diverse etiologies of DOR while discussing promising therapeutic approaches. Iatrogenic DOR can occur during chemotherapy, pelvic radiation, and ovarian surgery. Spontaneous DOR may result from ovarian tumors as well as idiopathic or genetic causes. DOR also inevitably occurs during ovarian fragment transplantation. Stem cell transplantation, in vitro activation, and platelet-rich plasma injection have shown some positive results as therapeutic approaches to DOR; however, more high-quality studies are needed to establish their broader applications in clinical practice.

ObjectivesHealthcare professionals are poorly educated about menopausal disorders. To address this issue, we launched an online Menopause Instructor Course, which is certified by the Japanese Society of Psychosomatic Obstetrics and Gynecology (JSPOG).MethodsCourses covering general remarks, hormone replacement therapy (HRT), non-HRT treatments, mental health, decision-making, and healthcare support were held in 2023 and 2024. Cognitive behavioral therapy was included in 2024. JSPOG-member healthcare professionals who completed all on-demand lectures and passed a post-test received certification as Menopause Instructors. In 2024, a questionnaire survey assessed participant feedback and compared Obstetricians and Gynecologists (OB/GYNs) to other healthcare professionals.ResultsA total of 198 and 143 professionals were certified in 2023 and 2024, respectively, with most of them being OB/GYNs. Certified Menopause Instructors were located across Japan. A survey conducted in 2024 showed that 93.7% of respondents were satisfied with the course. OB/GYNs found general remarks, HRT, and non-HRT treatments to be significantly easier. The overall self-assessed understanding was high (8.04 ± 1.01), with OB/GYNs scoring significantly higher than other healthcare professionals (8.29 ± 0.95 vs. 7.87 ± 1.02, P < 0.05).ConclusionsThe course successfully increased the number of trained professionals in menopause in Japan. Enhancing the course content to better serve OB/GYNs and other healthcare professionals is essential.

Estrogens are steroid hormones that are involved in regulating the growth, development, and functioning of the human reproductive system as well as in controlling the neuroendocrine, skeletal, adipogenesis, and cardiovascular systems. Estrogen is released into the bloodstream in two different states: as a free hormone or in association with proteins such as sex hormone-binding globulin or albumin. Unbound estrogen, which is not bound to proteins, can freely pass through cell membranes without any regulatory constraints. The microbiome is a distinct microbial population that inhabits a well-defined environment characterized by specific physio-chemical properties. It engages in a symbiotic relationship with the host, assisting in internal equilibrium regulation and immune reaction modulation. Over the years, several research investigations have underscored the importance of the microbiome in promoting wellness and preventing illnesses. An alteration in the microbiome, also known as dysbiosis, can disrupt bodily processes and contribute to the onset of ailments such as cardiovascular disorders, cancers, and respiratory conditions. The microbiome plays a crucial role in maintaining human health. Several elements affect the balance of the intestinal microecological system such as dietary habits, medication usage, pathogens, and endocrine factors. Recent research has indicated a disparity between genders in the prevalence of certain diseases associated with the microbiome, with sex hormones playing a crucial role in affecting specific health conditions.

ObjectivesThis study aimed to achieve expert consensus on menopause management in the Asia-Pacific region, taking into account patient diversity, the latest evidence, and current treatment options.MethodsA focused literature search was performed to identify clinical practice statements on menopause management. Menopause experts were nominated by members of the Asia-Pacific Menopause Federation (APMF) society. A modified Delphi methodology, involving iterative rounds of anonymous surveys, was employed until consensus was reached for each statement. Consensus was defined as ≥ 70% of experts voting ‘agree’ or ‘strongly agree’ for a given clinical practice statement.ResultsA total of 39 participants from 14 different APMF member societies were involved. Eighty-five clinical practice statements reached a consensus. Based on the clinical practice statements, an algorithm was created as a tool to guide clinicians on menopause management. APMF experts agreed that, in addition to vasomotor symptoms, Asian women experiencing somatic or psychological symptoms may also benefit from treatment with menopausal hormone therapy (MHT). MHT should also be considered for the prevention of osteoporosis in asymptomatic peri- and postmenopausal women.ConclusionsThis APMF consensus statement supersedes the previous one published in 2008. It provides guidance to gynecologists, endocrinologists, family physicians, and other healthcare professionals in delivering optimal care to menopausal women in the ethnically and culturally diverse Asia-Pacific region.