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\"This exhibition marks the first full museum overview of the work produced by On Kawara after 1963. It has been organized in close collaboration with the artist, who proposed most of the sections that comprise the final structure of the show...\"--Introduction, page 19.

Abstract This Position Statement has been endorsed by the International Menopause Society, The Endocrine Society, The European Menopause and Andropause Society, The International Society for Sexual Medicine, The International Society for the Study of Women's Sexual Health, The North American Menopause Society, The Federacion Latinoamericana de Sociedades de Climaterio y Menopausia, The Royal College of Obstetricians and Gynecologists, The International Society of Endocrinology, The Endocrine Society of Australia, and The Royal Australian and New Zealand College of Obstetricians and Gynecologists.* The only evidence-based indication for testosterone for women is for HSDD. There are insufficient data for using testosterone for any other symptom/condition or for disease prevention.

Key PointsSexual Dysfunction in WomenSexual dysfunction in women is common and is associated with impaired well-being and quality of life.Many women with sexual dysfunction will not seek care unless prompted by their health care provider. However, there are no evidence-based screening recommendations for sexual dysfunction as part of routine care.Sexual well-being is determined by a complex interplay of biologic, psychological, and sociocultural factors. Therefore, an assessment of sexual dysfunction involves a comprehensive review of the patient’s general health and psychosocial circumstances and a history of the patient’s use of prescription and nonprescription medications and other drugs.Management pathways for sexual dysfunction include lifestyle modification, counseling and psychosexual therapies, physical therapy, and pharmacologic therapy.

Diminished ovarian reserve (DOR) is common in women with infertility and is associated with poorer in vitro fertilization (IVF) outcomes. Testosterone is widely used off-label in this patient group, although evidence for its efficacy and safety is limited. To address this, we conducted a triple-blind, placebo-controlled, randomized clinical trial evaluating whether transdermal testosterone gel prior to IVF improves clinical pregnancy rates in women with DOR. Females aged 18-43 with infertility and DOR according to the Bologna criteria were recruited at 10 fertility clinics in Europe between April 2015 and November 2022. Of 316 assessed for eligibility, 290 were enrolled and randomized. Two were excluded from the primary analysis as their treatment coincided with the onset of the COVID-19 pandemic, and they did not start ovarian stimulation, leaving 288 participants. Participants were randomized to 5.5 mg of transdermal testosterone or matching placebo once daily for ~9 weeks prior to ovarian stimulation. All participants received ovarian stimulation in a long GnRH-agonist cycle with 300IU/day of highly purified human menopausal gonadotropin; fresh embryo transfer was performed if an embryo was available. The primary outcome was clinical pregnancy rate following fresh embryo transfer, defined as an intrauterine gestational sac with an embryo demonstrating cardiac activity at ≥7 weeks’ gestation. Of the 288 participants, 134 were randomized to testosterone and 154 to placebo. Clinical pregnancy rates did not differ significantly, occurring in 21 women (15.7%) in the testosterone group and 23 (14.9%) in the placebo group (risk ratio (RR), 1.05; 95% confidence interval (CI) 0.61 to 1.81, p = 0.86). The study was terminated for futility at the prespecified interim analysis based on a conditional power calculation once 70% of the target sample size were randomized. In this study, transdermal testosterone did not improve clinical pregnancy rates compared with placebo in patients with infertility and DOR. Trial Registration: ClinicalTrials.gov: NCT02418572, EudraCT: 2014-001835-35 Efficacy of transdermal testosterone gel in treatment for female infertility remained unknown. Authors conducted randomized clinical trial to show transdermal testosterone did not improve clinical pregnancy rates.

Background The pronounced changes in reproductive hormones, such as oestradiol and progesterone, that occur during the menopause transition can contribute to increased risk of eating disorder onset or exacerbate a pre-existing eating disorder. Despite this heightened risk, there is a lack of available education and support that takes into consideration the unique challenges of experiencing an eating disorder during the menopause transition. This research aimed to qualitatively explore the perspectives of people with a lived experience of an eating disorder during the menopause transition, and to co-design a support option that addressed their unmet needs. Methods A Double Diamond co-design process was followed involving four phases: discover, define, develop, and deliver. Seventeen women in Australia with a lived experience of an eating disorder during the menopause transition participated in online workshops across the four phases to identify their unmet health educational needs in experiencing an eating disorder during this transition, develop potential solutions and ultimately deliver a prototype solution in the final phase. All online workshops were recorded, transcribed verbatim and analysed using qualitative thematic analysis. The findings from the previous phase informed the next leading to the prototype creation. Results Qualitative thematic analysis identified six major themes across the four phases; lack of awareness of the intersection of menopause and eating disorders, lack of education, limited and stigmatising services, learning from lived experience, resource impact and resource development. Conclusions Findings from this study provided preliminary acceptability of a novel online resource to address the unmet educational needs of people experiencing an eating disorder during the menopause transition. Overall positive feedback on the potential for the resource to improve knowledge and empower treatment-seeking was provided by women with lived experience. Plain English summary Menopause is the end of reproductive functioning usually marked by the permanent ending of menstrual periods. In the few years leading up to menopause, known as the menopause transition, there can be an increased risk of eating disorder onset or exacerbation of a pre-existing eating disorder. However, there is a lack of available education and support that takes into consideration the unique challenges of experiencing an eating disorder during the menopause transition. As such, this study designed and developed an online educational resource together with and specifically for people experiencing an eating disorder during the menopause transition through a comprehensive series of online workshops. We found that the women in our study were unaware and confused regarding the intersection of eating disorders and menopause. They provided positive feedback on the online educational resource at the end of the study which they reported improved their knowledge and made them feel more confident to seek further support from health professionals.

Every woman who lives past midlife will experience menopause, which, by definition, is complete cessation of ovarian function. This process might occur spontaneously (natural menopause) or be iatrogenic (secondary menopause), and can be further classified as ‘early’ if it occurs before the age of 45 years and ‘premature’ if it occurs before the age of 40 years. Globally, the mean age of natural menopause is 48.8 years, with remarkably little geographic variation. A woman’s age at menopause influences health outcomes in later life. Early menopause is associated with a reduced risk of breast cancer, but increased risks of premature osteoporosis, cardiovascular disease and premature death. The cardinal symptoms of menopause, and adverse health sequelae, are due to loss of ovarian oestrogen production. Consequently, menopausal hormone therapy (MHT) that includes oestrogen or an oestrogenic compound ameliorates menopausal symptoms, while preventing menopause-associated bone loss and cardiometabolic changes. Importantly, comprehensive care of postmenopausal women involves lifestyle optimization (attention to nutrition and physical activity, reducing alcohol consumption and not smoking) and treating other established chronic disease risk factors. This Review offers a commentary specifically on the contemporary use of MHT and novel pharmaceutical alternatives to manage menopausal symptoms.Menopause affects roughly half of the global population, yet many affected people do not receive the treatment they need. This Review discusses currently available menopausal hormonal therapies and novel pharmaceutical alternatives to manage menopausal symptoms.

The biological, psychological and social changes that occur during the menopause transition can contribute to increased risk of eating disorder onset, re-emergence or exacerbation of a pre-existing eating disorder. Owing to a substantial lack of available evidence-based information addressing the intersection of eating disorders and menopause, we co-designed a novel online resource with people with a lived experience of an eating disorder during the menopause transition and other key stakeholders. We previously demonstrated preliminary acceptability and feasibility of this resource. The aim of our study was to conduct a brief evaluation of the online resource with “real world” users. In an approximately 7-month period during 2024, with the resource being hosted on Eating Disorders Victoria’s LearnED platform, 279 people enrolled in the resource. The most common resource users were health professionals, particularly dietitians and psychologists. Of these users, almost 40% completed a brief online evaluation survey included within the resource which showed that participants were primarily seeking to understand the intersection of eating disorders and menopause as well as find services for support as their reasons for engaging with the resource. According to the evaluation results, the feedback from users was very positive - they had their learning needs met, were satisfied with the experience and would recommend the resource to others. Although more comprehensive resource evaluation should be completed in the future, our brief evaluation helps to pave the way for expansion of much needed research and resource development in the neglected field of eating disorders intersecting with menopause.

Background Testosterone therapy for women is in widespread use, primarily in the form of compounded preparations and off-label use of formulations for men. The benefits and risks of such therapy remain uncertain. This review will identify and evaluate studies that have examined the effects of testosterone therapy for women on a range of outcomes including sexual function, cardiovascular events, metabolic parameters, musculoskeletal health, wellbeing, cancer events, androgenic effects and withdrawal rates. Methods Studies meeting our pre-determined inclusion criteria will be identified through searches in Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science. Assessing a range of outcomes, we will assess the risk-of-bias of relevant studies and draw conclusions about the strength of evidence for benefits and risks of testosterone therapy for each outcome. Discussion This comprehensive systematic review with meta-analysis will provide the foundation for the development of evidence-based clinical practice guidelines that will address benefits and risks of testosterone therapy, when treatment might be appropriate or inappropriate, areas of clinical uncertainty and the basis for assessment and monitoring of patients. Systematic review registration PROSPERO registration number: CRD42018104073

DURING PREGNANCY AND POSTPARTUM, hypothyroidism is common, and its treatment with thyroxine (T4) may exacerbate the known problem of inadequate dairy intake during this period. Clear guidance would help rectify this.

Whether serum androgen levels can identify women with \"androgen insufficiency\" or \"androgen excess\" is unresolved; thus, what constitutes \"normal\" remains uncertain. We sought to determine whether androgens, including 11-oxygenated C19 steroids, vary with age, menstrual cycle, or body mass index (BMI), during the reproductive years. Cross-sectional study recruited from eastern Australian states. A total of 588 women, aged 18 to 39 years, who were not pregnant, lactating, or using systemic hormone therapy, with regular menstrual cycles and no previous diagnosis of polycystic ovarian syndrome. Sex steroids measured using liquid chromatography-tandem mass spectrometry. Testosterone and androstenedione concentrations were significantly higher during the menstrual cycle mid- and luteal phases than in the early follicular phase, with median values across the cycle of 0.34 nmol/L (range, 0.04 to 1.01) and 1.97 nmol/L (range, 0.53 to 7.89), respectively. No cyclical variations were found in dehydroepiandrosterone (DHEA; 4.91 nmol/L; range, 0.08 to 23.51), 11-ketoandrostenedione (11KA; 7.99 nmol/L; range, 0.07 to 31.67), or 11-ketotestosterone (11KT; 1.27 nmol/L; range, 0.03 to 7.61). Overweight women had lower median testosterone (P < 0.05), DHEA (P < 0.05), and 11KA (P < 0.01) levels than normal-weight women. All C19 steroids were significantly lower (P < 0.01) in those aged 35 to 39 years than in those aged 18 to 25 years. The median 11KA/androstenedione (4.3:1) and 11KT/testosterone (3.9:1) ratios did not change with age, after adjustment for BMI and cycle stage. We have demonstrated that 11KA and 11KT are stable across the menstrual cycle and make major quantitative contributions to the circulating androgen pool. All C19 androgens declined with age before menopause; hence, age-specific reference ranges are required for the interpretation of androgen levels in premenopausal women.