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Rossella E. Nappi, Angelo Cagnacci, Costantino Di Carlo, Alessandro D. Genazzani, Paola Villa, Tommaso Simoncini Targeting vasomotor symptoms with the new drug fezolinetant – an expert overview GynecoloGical endocrinoloGy2025, Vol. 41, no. 1, 2526560
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Abstract
Menopause is an inevitable event in the life of women who live long enough to reach this milestone. theexperience of menopause varies amongst individuals. Menopause has a negative impact on women’s lifeand is associated with symptoms including vasomotor symptoms (vMS), such as hot flushes and nightsweats, sleep disturbances and low mood. vMS are bothersome and may have a long duration. Menopausehormone therapy (MHt) is recommended in women with symptoms; however, its use is limited. the recentapproval of fezolinetant offers a new therapeutic option for women who suffer from vMS and are unsuitableor averse to MHt. Fezolinetant is a precision drug as it targets the pathological mechanism of vMS showingsome effect also on sleep disturbances. Given how variable the experience of menopause is, it is importantto offer individualized treatment options to women who suffer from menopause-related symptoms and letthem be part of the shared decision making.
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Franco Guidozzi, Deanna Guidozzi, Yolande Guidozzi
Neuro-anatomy and neuro-physiology of happiness in ageing women
European Gynecology and Obstetrics. 2024; 7(1):43-47
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Abstract
Emotional lability is common after the menopause leading to significant unhappiness and deterioration in wellbeing of ageing women. Happiness results from the complex interplay of multiple endogenous and exogenous correlates which release “happiness hormones” and other neurotransmitters. These activate emotion centres in the brain resulting in a feeling of happiness and that of well-being. The emotional centres in the cerebral cortex and subcortical regions of the brain are connected by sophisticated limbic neural networks. This intricate network is controlled and stimulated by a number of neurotransmitters which are responsible for the integration, interpretation, formulation and the response to these correlates resulting in the perception of happiness. These neurotransmitters include oxytocin, dopamine, serotonin, endorphins, the “so-called happiness hormones” as well as gonadal hormones, gamma-aminobutyric acid, endocannabinoids and epinephrine which are the primary role players. The secretion of these hormones and neurotransmitters reflects interplay and/or interaction of one’s environment, relationships, diet, exercise regime, and even one’s gut microbes and the establishment of the sensation of happiness and well-being. Genetic makeup accounts for only 30-40% of one’s happiness. This review article describes the interplay between the neuroanatomy, the complex interlacing neural network and the neurotransmitters which are impacted by external factors.
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Christian Battipaglia, Anna Szeliga, Veronica Setti, Gregory Bala, Peter Chedraui, Alessandro D. Genazzani, Blazej Meczekalski
Neuroendocrinological Aspects of a Tailored Hormonal Contraception
Endocrines 2025, 6(3), 37
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Abstract
Emotional lability is common after the menopause leading to significant unhappiness and deterioration in wellbeing of ageing women. Happiness results from the complex interplay of multiple endogenous and exogenous correlates which release “happiness hormones” and other neurotransmitters. These activate emotion centres in the brain resulting in a feeling of happiness and that of well-being. The emotional centres in the cerebral cortex and subcortical regions of the brain are connected by sophisticated limbic neural networks. This intricate network is controlled and stimulated by a number of neurotransmitters which are responsible for the integration, interpretation, formulation and the response to these correlates resulting in the perception of happiness. These neurotransmitters include oxytocin, dopamine, serotonin, endorphins, the “so-called happiness hormones” as well as gonadal hormones, gamma-aminobutyric acid, endocannabinoids and epinephrine which are the primary role players. The secretion of these hormones and neurotransmitters reflects interplay and/or interaction of one’s environment, relationships, diet, exercise regime, and even one’s gut microbes and the establishment of the sensation of happiness and well-being. Genetic makeup accounts for only 30-40% of one’s happiness. This review article describes the interplay between the neuroanatomy, the complex interlacing neural network and the neurotransmitters which are impacted by external factors.
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Austin P. Johnson, Thanh-Giang T. Vu, Judy Simon, Ginny L. Ryan.
Special considerations in assisted reproductive technology for patients with obesity
Fertil Steril 2025;124:212–8
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Abstract
Obesity rates are increasing, and patients with obesity may disproportionately seek fertility preservation and fertility treatment because of a higher risk of related disease. At the same time, in vitro fertilization centers across the United States are increasingly setting body mass index (BMI) cutoffs above which treatment will not be provided. Patients experience these limits as another example of stigma in healthcare as well as an access challenge, exacerbating the distress of infertility. A healthy lifestyle in the long term should be the focus rather than an arbitrary BMI, which is a flawed measure of health. Tailoring in vitro fertilization treatment to patients with larger bodies, including patient-specific medication dosing, approach to oocyte retrieval, and anesthesia support for optimal safety, has demonstrated equal success and complication rates to patients who fall under typical BMI cutoffs. Many infertility treatment programs can and should access the resources needed to safely and effectively treat patients across the full range of BMIs.
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Vitor engracia Valenti , andré dos santos chagas , Peter Chedraui , ingrid soares de souza ,andrey alves Porto , isabel cristina esposito sorpreso , Jose Maria soares Júnior , JulianaZangirolami-Raimundo , David M. Garner, Rodrigo Daminello Raimundo
Effect of combined aerobic exercise and resistance training on postmenopausalwomen with type 2 diabetes: a systematic review and meta-analysis
Gynecological Endocrinology 2025, Vol. 41, no. 1, 2450338
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Abstract
Background: there is no strong evidence demonstrating whether or not aerobic exercise in conjunctionwith resistance exercise improves metabolic diabetes markers in postmenopausal women.Objective: to evaluate the effect of aerobic exercise and resistance training on metabolic markers inpostmenopausal women with type 2 diabetes mellitus (t2DM) by means of a systematic review and meta-analysis.Methods: the searches were completed using eMBase, MeDliNe/PubMed, scopus and Web of sciencedatabases. this study included non-blinded, single or double-blinded randomized control trials andpostmenopausal women diagnosed with t2DM. the imposed intervention was aerobic exercise plus anytraining protocol to strengthen muscle groups for resistance intervention. the outcomes of interest werethe blood glucose levels, insulin secretion, homeostasis model assessment-insulin resistance index (hOMa-iR)and glycated hemoglobin (hba1c). Risk of Bias tools and GRaDe were obligatory.Results: three studies were included (83 participants). exercise intervention ranged between two to fourdays per week. compared to the control group, in the group submitted to aerobic exercise + resistancetraining, no significant change was noted for hba1c (subtotal = mean difference − 0.35 [95% ci: −0.85,0.15], p = .17, and heterogeneity = 0%) (GRaDe: very low), nevertheless, hOMa-iR index was significantlyimproved (subtotal = mean difference −0.52 [95% ci: −0.99, −0.05], p = .03, and heterogeneity = 0%) (GRaDe:very low).Conclusion: Despite the very low certainty found in the quality of evidences, our analysis showed thataerobic exercise along with strength exercise seems to improve some metabolic diabetes markers inpostmenopausal women with t2DM. there is a need for further studies to support our preliminary findings.
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hao-Yi Jia, Peng-Yuan he, Jin Zhang, Meng-Jie Zhou, Xian-Ming Xu
Association between triglyceride-to-HDL-cholesterol ratio and risk ofgestational diabetes mellitus in the first trimester: a retrospectivecohort study
Gynecological Endocrinology 2025, Vol. 41, no. 1, 2528817
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Abstract
this retrospective cohort study examined the association between first-trimestertriglyceride-to-hDl cholesterol (tG/hDl-c) ratio and gestational diabetes mellitus (GDM)risk among 2,356 pregnant women from shanghai General hospital between October2019, and June 2021. Using logistic regression and restricted cubic spline models, wefound the tG/hDl-c ratio was an independent GDM predictor (OR:1.37, 95%ci:1.16-1.62,p<0.001), persisting after adjustment (aOR:1.65, 95%ci:1.27-2.13, p < 0.001). Nonlineardose-response relationships were observed (p-interaction<0.05), with strongerassociations in women >35 years (OR:1.60, 95%ci:1.12-2.28) and those with BMi≥25kg/m² (OR:1.78, 95%ci:1.25-2.54). First-trimester tG/hDl-c ratio elevation significantlyincreases GDM risk, suggesting its potential for early risk stratification and targetedprevention.
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Alaa Al Nofal, Khalid Benkhadra, Alzhraa Abbas, Marie-Joy Nduwimana, Mohammad AL-Kordi, Adel Kabbara Allababidi, Jennifer Wyckoff, Annunziata Lapolla, Larry J. Prokop, Zhen Wang, M. Hassan Murad
A Systematic Review Supporting the Clinical Practice Guidelines on the Management of Preexisting Diabetes and Pregnancy
The Journal of Clinical Endocrinology & Metabolism, 2025, 110, e2811–e2832
Abstract
Context: Women with preexisting diabetes mellitus (PDM) are at increased risk of pregnancy-related complications.
Objective: To summarize the available supporting evidence for the Endocrine Society guidelines about management of PDM in pregnancy. Data Sources: MEDLINE, EMBASE, Scopus, and other sources through February 2025.
Study Selection: Studies were selected by pairs of independent reviewers.
Data Extraction: Data were extracted by pairs of independent reviewers.
Data Synthesis: We included 17 studies. Meta-analysis showed no significant difference between hybrid closed-loop insulin pump (HCL) and standard of care regarding time in range (TIR), time above range (TAR), and time below range (TBR). HCL had better overnight TIR and TBR. For women with type 2 diabetes mellitus (T2DM), intermittent use of continuous glucose monitoring (CGM) was not associated with a significant change in the risk of large for gestational age (LGA) neonates (2 randomized controlled trials [RCTs], 102 patients). Adding metformin to insulin was associated with a lower risk of LGA (2 RCTs, 1126 patients). Three retrospective studies (1724 patients) suggested increased neonatal complications when delivery was induced before 39 weeks of gestation (particularly before 38 weeks) in women with preexisting type 1 (T1DM) and T2DM, although this evidence was subject to likely confounding. One retrospective study showed no increase in neonatal complications with periconceptional exposure to glucagon-like peptide-1 receptor agonists. We could not identify comparative studies assessing a screening question about the possibility of pregnancy or a carbohydrate restrictive diet.
Conclusion: This systematic review addresses various aspects of managing PDM in pregnancy and will support the development of the Endocrine Society guidelines.
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Mario J A Saad and Andrey Santos
The Microbiota and Evolution of Obesity
Endocrine Reviews, Volume 46: 300–316
Abstract
Obesity is a major global concern and is generally attributed to a combination of genetic and environmental factors. Several hypotheses have been proposed to explain the evolutionary origins of obesity epidemic, including thrifty and drifty genotypes, and changes in thermogenesis. Here, we put forward the hypothesis of metaflammation, which proposes that due to intense selection pressures exerted by environmental pathogens, specific genes that help develop a robust defense mechanism against infectious diseases have had evolutionary advantages and that this may contribute to obesity in modern times due to connections between the immune and energy storage systems. Indeed, incorporating the genetic variations of gut microbiota into the complex genetic framework of obesity makes it more polygenic than previously believed. Thus, uncovering the evolutionary origins of obesity requires a multifaceted approach that considers the complexity of human history, the unique genetic makeup of different populations, and the influence of gut microbiome on host genetics.
