Perimenopause

Integrated acupuncture-pharmacotherapy for perimenopausal insomnia: a systematic review and meta-analysis.

Yang B, Jiang S, Teng Y, Wang Y, Zhang J, Gao C · Frontiers in neurology · 2025

Insomnia is a prevalent symptom among perimenopausal women, mainly attributed to estrogen-progesterone imbalance and neuropsychiatric factors, significantly impacting their quality of life. This article seeks to systematically evaluate the efficacy of integrated acupuncture-pharmacotherapy (AP) in treating perimenopausal insomnia (PMI), offering new insights for the management of insomnia in women. Searches were conducted in 8 databases: PubMed, Web of Science (WOS), Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine Disc (CBM), Wanfang Academic Journal Full-text Database (Wanfang), and Chongqing VIP Database (CQVIP). Database searches extended through August 1, 2024. Endnote 20 was used to build the database and screen for eligible randomized controlled trials (RCTs). The efficacy of AP for PMI were demonstrated by assessing 3 primary outcome measures (Effective rate, Hamilton Anxiety Scale [HAMA], Traditional Chinese Medicine Syndromes [

The risk of depression in the menopausal stages: A systematic review and meta-analysis.

Badawy Y, Spector A, Li Z, Desai R · Journal of affective disorders · 2024 · n=16061

For many women, menopause transition can be a period of emotional and physical changes, with different menopausal stages associated with varied risk for depressive symptoms and diagnosis. This review aimed to conduct a systematic review and meta-analyses to provide an estimate for the risk of developing a) clinical depression and b) depressive symptoms at different menopausal stages. We searched Medline, PsycInfo, Embase and Web of Science from inception to July 2023. Seventeen prospective cohort studies with a total of 16061 women were included in the review, and risk of bias was assessed using the Quality in Prognosis Studies tool (QUIPS). Seven papers with a total of 9141 participants were included in meta-analyses, using random effects models and pooled odds ratios (OR) calculated for depressive symptoms and diagnoses. Perimenopausal women were found to be at a significantly higher risk for depressive symptoms and diagnoses, compared to premenopausal women (OR = 1.40; 9

Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis.

Lu CB, Liu PF, Zhou YS, Meng FC, Qiao TY, Yang XJ · Neural plasticity · 2020

Musculoskeletal pain (MSP) is one of the most severe complaints in women undergoing menopause. The prevalence of MSP varied when taking the menopausal state and age factor into consideration. This study investigated the prevalence of MSP in perimenopausal women and its association with menopausal state. The MEDLINE, Embase, Web of Science, and PubMed databases were searched from inception to July 2020, and 16 studies were retrieved for the current meta-analysis. The primary outcome measure was the MSP Odds Ratio (OR). The estimated overall prevalence of MSP among perimenopausal women was 71% (4144 out of 5836, 95% confidence interval (CI): 64%-78%). Perimenopausal women demonstrated a higher risk for MSP than premenopausal ones (OR: 1.63, 95% CI: 1.35-1.96, P = 0.008, I 2 = 59.7%), but similar to that in postmenopausal ones (OR: 1.07, 95% CI: 0.95-1.20, P = 0.316, I 2 = 13.4%). The postmenopausal women were at a higher risk of moderate/severe MSP than the premenopausal ones (OR: 1.45,

Complementary therapies for management of menopausal symptoms: a systematic review to inform the update of the International Menopause Society recommendations on women's midlife health.

Maunder A, Mardon AK, Rao V, Torkel S, Metri NJ, Liu J · Climacteric : the journal of the International Menopause Society · 2026

Menopausal hormone therapy is standard treatment, but some women use complementary therapies. This review examines complementary therapies for menopause to inform International Menopause Society (IMS) recommendations. A systematic search of six databases (January 2022-December 2024) identified randomized controlled trials (RCTs) and systematic reviews on complementary therapies for menopause. Outcomes included menopausal, vasomotor, genitourinary, cardiometabolic, sleep symptoms, bone health and safety. The study quality and certainty of evidence were evaluated using Cochrane Risk of Bias (RoB2), A MeaSurement Tool to Assess Systematic Reviews (AMSTAR 2) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). From 3187 citations, 158 studies were included: one overview, 36 meta-analyses, seven systematic reviews and 114 RCTs. While promising evidence was found for acupuncture, Chinese herbal medicine (CHM), herbs, nutrients, mind-body/touch therapies for a va

Does exercising during peri- or early post-menopause prevent bone and muscle loss: A systematic review.

Whitman PW, Alexander CJ, Kaluta L, Burt LA, Gabel L · Bone · 2025

The highest rate of bone and muscle loss occurs during the menopause transition. Yet, most clinical exercise trials have excluded peri- and early post-menopausal female participants. This systematic review aimed to determine (1) the effects of exercise on bone and muscle health during the menopause transition; and (2) which types of exercise are most effective for preventing bone and muscle mass loss during the menopause transition. Articles were retrieved from five electronic databases (MEDLINE, Embase, CENTRAL, CINAHL, and SPORTDiscus). Inclusion criteria included: (1) randomized controlled trial (RCT); (2) 45-to 60-year-old and peri- or early post-menopausal females; (3) reported bone mineral density (BMD) or lean mass. Six studies met inclusion criteria; two evaluated peri-menopausal and four investigated early post-menopausal female participants. All studies had low quality of evidence, and high risk of bias. Strength training, endurance training, and Tai Chi did not improve are

Women's experiences and expectations during the menopause transition: a systematic qualitative narrative review.

Wood K, McCarthy S, Pitt H, Randle M, Thomas SL · Health promotion international · 2025

There is an increased research focus on the menopause transition. However, this literature is still largely focused on quantitatively surveying women about their menopause symptoms, with less qualitative focus on women's lived experiences of menopause. This includes the impact of menopause on women's daily lives, how they seek information and support, and their perceptions of societal attitudes towards menopause. This article presents a narrative review of qualitative studies (2014-24) conducted with women aged 45-60 years that focused on the lived experience of menopause. Four themes were constructed from 12 papers using reflexive thematic analysis. Menopause was considered a natural and normal part of the ageing process, with many positives, including new beginnings and elevating women's status as elders in their communities. However, some women found menopause challenging in the context of other factors occurring in midlife. This included a lack of access to information about their

FIGO best practice recommendations for the mental health of women at menopausal age.

Khadilkar S, Divakar H, Benedetto C, Genazzani A, Ramos D, Argale E · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026

Mental health during the menopausal transition requires focused attention to ensure supportive experiences for women. This review presents the International Federation of Gynecology and Obstetrics (FIGO) recommendations and summarizes the evidence, addressing 13 key questions framed by members of the FIGO Committee on Women at Menopausal Age. Although the literature on mental health during menopause is extensive, a gap exists in consolidated best practice recommendations. The FIGO committee members assessed the evidence quality and recommendation strength using a 5-point Likert scale. Over 70% of the experts agreed with a strong recommendation level (score of 5) for eight questions, while five questions were agreed with high and moderate recommendations. Symptoms of anxiety and depression are prevalent during the perimenopause. Menopause-related mental health issues are often overlooked in low- and middle-income countries. Mental health issues impact quality of life, necessitating psyc

Directive clinique n(o) 422g : Ménopause et ostéoporose.

Khan AA, Alrob HA, Ali DS, Dandurand K, Wolfman W, Fortier M · Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2022

Proposer des stratégies pour améliorer les soins aux femmes en périménopause ou ménopausées d'après les plus récentes données probantes publiées. Femmes en périménopause ou ménopausées. BéNéFICES, RISQUES ET COûTS: La population cible bénéficiera des plus récentes données scientifiques publiées que leur communiqueront les fournisseurs de soins de santé. Aucun coût ni préjudice ne sont associés à cette information, car les femmes seront libres de choisir parmi les différentes options thérapeutiques offertes pour la prise en charge des symptômes et morbidités associés à la ménopause, y compris l'abstention thérapeutique. DONNéES PROBANTES: Les auteurs ont interrogé les bases de données PubMed, Medline et Cochrane Library pour extraire des articles publiés entre 2002 et 2020 en utilisant des term

Directive clinique n(o) 422b : Ménopause et santé génito-urinaire.

Johnston S, Bouchard C, Fortier M, Wolfman W · Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2021

Proposer des stratégies fondées sur les plus récentes données publiées pour améliorer les soins aux femmes ménopausées ou en périménopause. Les femmes ménopausées ou en périménopause. BéNéFICES, RISQUES ET COûTS: La population cible bénéficiera des plus récentes données scientifiques publiées communiquées par leurs fournisseurs de soins de santé. Aucun coût ni préjudice ne sont associés à cette information, car les femmes seront libres de choisir parmi les différentes options thérapeutiques, y compris le statu quo, pour la prise en charge des symptômes et morbidités associés à la ménopause. DONNéES PROBANTES: Les auteurs ont interrogé les bases de données PubMed, MEDLINE et Cochrane Library pour extraire des articles publiés entre 2002 et 2020 en utilisant des termes MeSH spécifiques &#xe

A Standardized Asparagus Racemosus Root Extract Improves Hormonal Balance and Menstrual Health and Reduces Vasomotor Symptoms in Perimenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Study.

Yadav P, Yadav S, Vedururu SS, Kumari G · Journal of the American Nutrition Association · 2025

Perimenopausal women often experience dysmenorrhea, menstrual cramps, hormonal imbalances and vasomotor symptoms (VMS), significantly affecting their quality of life. In Ayurveda, Asparagus racemosus (Shatavari) root extract has been used for female reproductive health. This study evaluated the safety and efficacy of CL22205, a standardized A. racemosus root extract, in managing perimenopausal symptoms. This randomized, double-blind, placebo-controlled trial was conducted on 50 perimenopausal women (age: 40-50 years) experiencing mild to moderate climacteric symptoms. Participants received either CL22205 (200 mg/day) or placebo over a period of 120 consecutive days. Primary outcome measure was Menopausal Rating Scale (MRS) scores. Secondary measures assessed Hot Flash Weekly Weighted Score (HFWWS), Menstrual Symptom Questionnaire (MSQ), ovarian follicular number using ultrasonography, serum Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Anti-Müllerian

Acupoint catgut embedding regulates community structure of intestinal flora in central obesity during perimenopause.

Jin Y, Huang Y, Zhu J, Liao D, Zeng S, Jin X · Women & health · 2024

Acupoint catgut embedding (ACE) is a safe and effective method for treating obesity. However, how it modulates intestinal flora and adiponectin remains unclear. We employed 16s rRNA sequencing technology to investigate ACE induced changes in intestinal flora and its association with adiponectin in subjects who received real (n = 41) and Sham (n = 41) stimulation. After treatment, the ACE group's body weight, BMI, WC, HC, WHtR, and WHR were significantly lower than those of the Control group (p < .01), there was statistically significant differences in ADPN between the two groups (p < .01). ACE reduces the species abundance and increased the diversity and differences of the gut microbiota in perimenopausal patients with central obesity. Most notably, there was an increase in Kosakonia and Klebsiella after ACE treatment in the patients. Significant negatively correlations were found between body weight/waist circumference and

Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial.

Zhao FY, Zheng Z, Fu QQ, Conduit R, Xu H, Wang HR · Frontiers in public health · 2023 · n=41

Whilst acupuncture is widely used for treating psychosomatic diseases, there is little high-quality evidence supporting its application in comorbid perimenopausal depression (PMD) and insomnia (PMI) which are common complaints during climacteric. This feasibility, patient-assessor-blinded, randomized, sham-controlled clinical trial addresses this gap by investigating the efficacy and safety of acupuncture on depressed mood and poor sleep in women with comorbid PMD and PMI. Seventy eligible participants were randomly assigned to either real-acupuncture (RA) or sham-acupuncture (SA) groups. Either RA or SA treatment were delivered in 17 sessions over 8 weeks. The primary outcomes for mood and sleep were changes on 17-items Hamilton Depression Rating Scale (HAM-D17) and Pittsburgh Sleep Quality Index (PSQI) scores, from baseline to 16-week follow-up. Secondary outcome measures involved anxiety symptoms, perimenopausal symptoms, quality of life, participants' experience of and satisfactio

Impact of Exercise on Perimenopausal Syndrome: A Systematic Review of Randomized Controlled Trials.

Philip AE, Singh H, Nanjundiah SY, Samudrala PC, Theunissen W, Robinson J · Cureus · 2025

Exercise has been contemplated as a natural means to alleviate the symptoms of perimenopause. The need for this study arises from the lack of data regarding the impact of exercise on the perimenopausal population. The primary objective of this systematic review of randomized controlled trials was to evaluate the impact of exercise in improving various symptoms of perimenopause, including hot flushes, insomnia, paresthesia, myalgia, arthralgia, palpitations, fatigue, headache, depression, vaginal dryness, and irritability in perimenopausal women. An extensive literature review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, examining the impact of exercise on relieving perimenopausal syndrome. The assessment was based on the readings of the Blatt-Kupperman Index (KI), a scale in which 11 symptoms of perimenopause are rated from 0 (absence of symptom) to 3 (severe). Based on the studies, there was a considerable redu

Menopause and suicide: A systematic review.

Hendriks O, McIntyre JC, Rose AK, Sambrook L, Reisel D, Crockett C · Women's health (London, England) · 2025

The menopausal transition is a critical phase in a woman's life marked by hormonal fluctuations that can result in a wide variety of physical and psychological symptoms. These symptoms vary in strength and their negative impacts on women's health and well-being. One of the most severe impacts of (peri)menopause is increased vulnerability to suicidality in some women, yet no systematic review has examined the holistic relationship regarding this potential link. To examine the relationship between the menopausal transition and suicidality, and identify menopause-related factors contributing to increased suicide risk. A systematic review was conducted in accordance with PRISMA guidelines. MedLine, CINAHL, PsychINFO, Web of Science and Cochrane Library were searched for studies addressing both menopause and suicidality. Studies were screened independently by two reviewers. Data extraction focused on suicidal ideation, attempts, and completed suicide among menopausal women. The quality o

Contraception in perimenopause.

Soltes BA · Menopause (New York, N.Y.) · 2025

Perimenopause is characterized by wide hormone fluctuations and irregular menstrual cycles for 5 or more years preceding menopause and lasts until 12 months of amenorrhea have been achieved. It represents a period of reproductive transition with a decline in fertility. However, unintended pregnancies do occur, with a high risk for poor outcomes and maternal complications. All women transitioning through perimenopause should be adequately counseled. There are many hormone and nonhormone contraceptive methods that are highly effective and suited to the personal and medical needs of the perimenopausal woman. Contraception should continue until menopause is confirmed.

Effects of 12-week Magnesium Supplementation on Peri-menopause Symptoms, Cognition, Sleep and Psychological Wellbeing - a Randomised, Placebo-controlled Trial

n=58 · NCT07235878 · RECRUITING · RECRUITING

Perimenopause is a transition phase into menopause, characterised by menopausal symptoms while menstrual periods are still occurring. Common symptoms of perimenopause include hot flushes, night sweats, mood swings, anxiety, sleep disturbances, fatigue, and cognitive difficulties. These symptoms can be both frequent and intense, with the potential to significantly deteriorate women's quality of life. Despite an increase in public discourse around menopause, there are still large gaps in knowledge. Previous literature has suggested a relationship between diet and menopause management. However, studies in this area are limited and women often rely on social media for advice on supplements to address menopause complaints. One supplement that has received a lot of attention with purported benefits for menopause is magnesium, primarily due to its links to energy and or/sleep, however no studies have explored psychological effects of magnesium supplementation in perimenopause. The aim of this study is to explore the effects of 12-weeks magnesium supplementation on perimenopause symptoms, cognition, sleep, and psychological well-being.

Investigating Resistance Training for Vascular Function and Quality of Life in Perimenopausal Women

n=50 · NCT07022340 · RECRUITING · RECRUITING

Women's blood vessel health gets worse after menopause, or "the change of life". Some women exercise less during menopause. Exercise can improve blood vessel health. The investigators want to know if resistance exercise, like lifting weights, can improve blood vessel health in women who are just starting menopause. The investigators also want to know if lifting weights can improve mood, sleep, and quality of life in women going through menopause. The investigators will have two groups of women for this study. One group will lift weights (do resistance exercise) twice per week, and the other group will get emails with information about menopause. The investigators will measure blood vessel health, sleep, mood, and menopause symptoms at the start and the end of this study and compare women who did and did not exercise.

Benefits of Melatonin Use in Patients With Climacterious Symptoms in the Perimenopause: Randomized, Double-blind, Placebo-controlled Clinical Trial

n=24 · NCT06192641 · COMPLETED · COMPLETED

Menopause is defined as the absence of menstruation for 12 months without a pathological cause and it is marked by physical fluctuations and biological changes that can impact women's quality of life. During the perimenopause and menopause transition period, women may experience a variety of changes, including menstrual cycle irregularity and climacteric symptoms. Treatment to relieve symptoms may include hormonal and non-hormonal options, such as behavioral therapies, medications and low-dose hormonal therapies. The objective of this study will be to evaluate the effect of melatonin in women with perimenopausal symptoms. This is a double-blind, placebo-controlled randomized clinical trial research, where perimenopausal women will be interviewed, who will answer questionnaires, and will use melatonin/placebo for a period of 30 days, before and after, they will be asked about possible changes during treatment, such as mood changes, drowsiness, dizziness, headaches or allergic reactions. It is hoped that with this study, the effect of melatonin in women on climacteric symptoms during the perimenopausal period will be understood.

Cochrane Library – Search: 'Perimenopause'

The Cochrane Library · Strength: null

The Cochrane Library provides a collection of high-quality, independent evidence to inform healthcare decision-making, including systematic reviews relevant to perimenopause. It aggregates research findings on various interventions and management strategies.

TRIP Database – Search: 'Perimenopause'

TRIP Database · Strength: null

The TRIP database is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence. It provides access to clinical guidelines, systematic reviews, and other evidence-based resources related to perimenopause.