Racial disparities in menopausal hormone therapy acceptance: a pilot study

Pershad, Anita; Morris, Joshua; Pace, Diane Todd; Khanna, Pallavi

doi:10.1097/gme.0000000000002061

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…However, including oestrogen or an oestrogenic compound, MHT is also associated with risks of serious health conditions including breast, ovarian and endometrial cancer, stroke and venous thromboembolism, etc.. Additionally, MHT related health risks are proportional to the duration of use. It should be used in before the average menopause age, not all age groups [ 21 , 22 ]; and racial differences should be taken into account [ 23 , 24 ]. Although the development of transdermal or vaginal drug delivery has greatly reduced the side effects, the acceptance of menopausal suffers is still low [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

The 100 top-cited articles in menopausal syndrome: a bibliometric analysis

Jin,

Tian,

Kang

et al. 2024

Reprod Health

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Background Significant scientific research has been conducted concerning menopausal syndrome(MPS), yet few bibliometric analyses have been performed. Our aim was to recognise the 100 most highly cited published articles on MPS and to analytically evaluate their key features. Methods To identify the 100 most frequently cited articles, a search was conducted on Web of Science using the term 'menopausal syndrome'. Articles that matched the predetermined criteria were scrutinised to obtain the following data: citation ranking, year of publication, publishing journal, journal impact factor, country of origin, academic institution, authors, study type, and keywords. Results The publication period is from January 1, 2000, to August 31, 2022. The maximum number of citations was 406 and in 2012. The median citations per year was 39.70. Most of the articles focused on treatment and complications. These articles were published in 36 different journals, with the Journal of MENOPAUSE having published the greatest number (14%). Forty-eight articles (48%) were from the United States, with the University of Pittsburgh being the leading institute (9%). Joann E. Manson was the most frequent first author (n = 6). Observational studies were the most frequently conducted research type (n = 53), followed by experimental studies (n = 33). Keyword analysis identified classic research topics, including genitourinary syndrome of menopause, bone mineral density (BMD), and anti-mullerian hormone (AMH) loci. Conclusion Using bibliometrics, we conducted an analysis to identify the inadequacies, traditional focal points, and potential prospects in the study of MPS across current scientific areas. Treatment and complications are at the core of MPS research, whereas prediction and biomarkers have less literature of high quality. There is a necessity for innovative analytical metrics to measure the real effect of these papers with a high level of citation on clinical application.

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Section: Discussionmentioning

confidence: 99%

The 100 top-cited articles in menopausal syndrome: a bibliometric analysis

Jin,

Tian,

Kang

et al. 2024

Reprod Health

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“…A pilot study involving 113 participants showed that 49% of White individuals accepted HT compared with only 24% of Black individuals, despite having similar clinical criteria. 28 In support of this finding, a SWAN analysis found that White individuals were approximately twice as likely to receive HT as African American individuals. 29 Some studies have also indicated that HT may not be as effective in Black women with a recent SWAN study showing that HT improved self-reported quality of life in White women in comparison with complementary alternative medicine or no treatment, whereas the opposite finding was observed in Black participants.…”

Section: Racementioning

confidence: 91%

Fezolinetant treatment of moderate-to-severe vasomotor symptoms due to menopause: effect of intrinsic and extrinsic factors in two phase 3 studies (SKYLIGHT 1 and 2)

Santoro,

Nappi,

Neal-Perry

et al. 2024

Menopause

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Objective This study aimed to assess the efficacy of the neurokinin 3 receptor antagonist, fezolinetant, according to several intrinsic (individual related) and extrinsic (external influence) factors that may influence the frequency and severity of moderate-to-severe vasomotor symptoms (VMS) using pooled 12-week data from SKYLIGHT 1 and 2. Methods SKYLIGHT 1 and 2 were two phase 3, randomized, double-blind studies conducted from July 2019 to August 2021 (SKYLIGHT 1) or April 2021 (SKYLIGHT 2). Participants were initially randomized to receive daily doses of placebo, fezolinetant 30 mg, or fezolinetant 45 mg. After 12 weeks, placebo participants were rerandomized to receive fezolinetant 30 mg or 45 mg, whereas those receiving fezolinetant continued on the same dose. Change in VMS frequency from baseline to week 12 was used to assess efficacy according to several intrinsic and extrinsic factors. Overall efficacy and safety were also investigated. Results Overall, 1,022 individuals were included. Fezolinetant was efficacious in reducing VMS frequency across all intrinsic and extrinsic factors. Efficacy was most notable for participants who self-identify as Black (least squares mean difference for fezolinetant 45 mg versus placebo, −3.67; 95% CI, −5.32 to −2.01), current smokers (−3.48; −5.19 to −1.77), and current alcohol users (−3.48; −4.42 to −2.54). Overall efficacy was −2.51 (95% CI, −3.20 to −1.82) for fezolinetant 45 mg versus placebo. Similar findings were observed for the fezolinetant 30 mg dose. Comparable incidences of treatment-emergent adverse events were observed for placebo (132 of 342 individuals [38.6%]), fezolinetant 30 mg (132 of 340 individuals [38.8%]), and fezolinetant 45 mg (135 of 340 individuals [39.7%]). Conclusions None of the intrinsic and extrinsic factors analyzed substantially reduced the efficacy response to fezolinetant in SKYLIGHT 1 and 2. These data provide additional confidence for using fezolinetant in a diverse population of individuals with VMS.

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“…SWAN found that vasomotor symptoms were more prevalent in African-American and Hispanic women, while vaginal dryness was most prevalent in Hispanic women 6 . Another analysis of the SWAN study found that lowincome women reported greater severity and frequency of menopausal symptoms compared to White women and women with higher income; however, these findings should be interpreted with caution, as they can be influenced by factors such as access to healthcare and use of hormone therapy, which varies based on demographic characteristics 7,8 . Other studies have sought to describe specific symptoms and their relationship to race and ethnicity, but none of them examined all symptoms across the Menopause Rating Scale (MRS) [9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

The Impact of Race, Ethnicity, and Socioeconomic Status on the Severity of Menopause Symptoms: A Study of 68,864 Women

Kochersberger,

Coakley,

Millheiser

et al. 2023

Preprint

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ObjectiveTo evaluate how race, ethnicity, and socioeconomic status (SES) affect the severity of menopause symptoms in a large, diverse sample of women.MethodsFor this cross-sectional study conducted between March 24, 2019, and January 13, 2023, a total of 68,864 women were enrolled from the Evernow online telehealth platform. Participants underwent a clinical intake survey, which encompassed demographic information, detailed medical questionnaires, and a modified Menopause Rating Scale (MRS). The modified scale was adapted for ease of use online and is available in the supplementary material along with the full intake. Symptom severity was evaluated using a multivariate binomial generalized linear model, accounting for factors such as race, ethnicity, age, BMI, smoking status, bilateral oophorectomy status, and SES. Odds ratios and confidence intervals were calculated based on the linear regression coefficients.ResultsOf the participants, 67,867 (98.6%) were included in the analysis after excluding outliers and those with unknown oophorectomy status. The majority of respondents identified as White (77.4%), followed by Hispanic (9.0%), Black (6.7%), two or more races/ethnicities (4.4%), Asian (1.2%), Indigenous/First Nations (0.8%), Middle Eastern (0.3%), and South Asian (0.2%). Notably, individuals identifying as Black, Hispanic, Indigenous/First Nations, Middle Eastern, or with two or more races/ethnicities reported higher levels of symptom severity compared to their White counterparts. Conversely, Asian and South Asian participants reported lower symptom severity. Even after incorporating SES into the linear model, racial and ethnic groups with lower SES (Black, Hispanic, Indigenous, and multiple ethnicities) exhibited slight shifts in odds ratios, while maintaining high statistical significance.ConclusionsOur study suggests that the relationship between race and ethnicity and the severity of menopause symptoms is not solely explained by differences in SES but is itself an independent factor. Understanding and addressing social, cultural, and economic factors is crucial to reduce disparities in menopausal symptoms.

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Racial disparities in menopausal hormone therapy acceptance: a pilot study

Abstract: The presence of racial disparity in acceptance of these treatment modalities can inform clinicians about patient factors affecting treatment choice for menopausal symptoms and opportunities to explore racial differences in quality of care.

Cited by 9 publications

References 9 publications

The 100 top-cited articles in menopausal syndrome: a bibliometric analysis

The 100 top-cited articles in menopausal syndrome: a bibliometric analysis

Fezolinetant treatment of moderate-to-severe vasomotor symptoms due to menopause: effect of intrinsic and extrinsic factors in two phase 3 studies (SKYLIGHT 1 and 2)

The Impact of Race, Ethnicity, and Socioeconomic Status on the Severity of Menopause Symptoms: A Study of 68,864 Women

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