Elinzanetant, a dual neurokinin-1/-3 receptor antagonist, is approved for the treatment of moderate-to-severe vasomotor symptoms. The double-blind, randomized, placebo-controlled Phase III OASIS-1-4 studies evaluated elinzanetant's efficacy and safety in diverse populations of women, including those with vasomotor symptoms associated with natural or surgical menopause (OASIS-1, -2, and -3) and caused by endocrine therapy for breast cancer (OASIS-4). Results were similar across all trials for the respective primary and key secondary endpoints (included in the statistical testing hierarchy). Significant reductions vs. placebo in the frequency of vasomotor symptoms appeared from as early as week 1 in OASIS-1 and -2 (analyzed descriptively in OASIS-3 and -4), and at week 4 in OASIS-1, -2, and -4 (analyzed descriptively in OASIS-3). By week 12, all studies showed significant reductions vs. placebo, with benefits maintained for up to 50 weeks. In OASIS-1 and -2, the severity of vasomotor symptoms significantly decreased vs. placebo at weeks 4 and 12 (analyzed descriptively in OASIS-3 and -4). Elinzanetant treatment improved sleep disturbance, assessed by the Patient-Reported Outcomes Measurement Information System Sleep Disturbance Short Form 8b total T-score, and menopause-related quality of life, measured as total score on the Menopause-specific Quality of Life questionnaire, across all four trials as early as week 1. Significant reductions vs. placebo were seen at week 12 in OASIS-1, -2, and -4 (key secondary endpoints; analyzed descriptively in OASIS-3 as a secondary endpoint). Elinzanetant was generally well tolerated with consistent efficacy across all OASIS trials in diverse populations of women experiencing vasomotor symptoms.

Anal incontinence is a multifactorial condition arising from complex anatomical, neurological, and physiological interactions. Although its true prevalence is likely underestimated due to social stigma, anal incontinence affects approximately 2-21% of women, with prevalence increasing after menopause and further rising with advancing age. Menopause plays a key role through hypoestrogenism-related changes in pelvic floor musculature, connective tissue integrity, and sphincter function. Additional contributors include aging, lifestyle factors, and comorbid gastrointestinal or neurological disorders, while surgical and other iatrogenic factors may precipitate or worsen symptoms. Despite its clinical relevance, anal incontinence remains underreported, and many physicians caring for menopausal women may be unfamiliar with its evaluation and management. This review synthesizes current evidence on the pathophysiology, risk factors, diagnostic approach, assessment tools and management strategies for anal incontinence, aiming to support menopause physicians in early identification, comprehensive assessment, and optimal management of this underrecognized yet highly impactful condition.

This study evaluated the effects of digital interventions on executive function in middle-aged and older adults with stroke and explored the dose-response relationship between intervention dose and executive function improvement. We systematically searched PubMed, Web of Science, Embase, and the Cochrane Library to identify relevant studies. Effect sizes were calculated using Hedges' g, and a three-level random-effects model was fitted using the metafor package in R. Potential dose-response associations and moderator variables were further examined. Nine studies from five countries were included, involving 396 people with stroke aged 56-73 years. The three-level meta-analysis showed that digital interventions had a small but statistically significant effect on overall executive function (Hedges' g = 0.25, 95% confidence interval [0.02, 0.49]). However, no statistically significant effects were observed for working memory (Hedges' g = 0.23, 95% confidence interval [-0.23, 0.49]), inhibitory control (Hedges' g = 0.44, 95% confidence interval [-0.24, 1.12]), or cognitive flexibility (Hedges' g = 0.24, 95% confidence interval [-0.50, 0.98]). Exploratory dose-response analysis suggested that, within the range of the included studies, higher predicted effects on executive function were observed around 945 min of total intervention duration and around 15 intervention sessions. Moderator analysis suggested that computer-based cognitive interventions showed a relatively larger observed effect estimate for executive function (Hedges' g = 0.65, 95% confidence interval [0.48, 0.82]). Based on low-certainty evidence, digital interventions may produce small improvements in executive function among middle-aged and older adults with stroke, with effects potentially influenced by intervention characteristics. These findings should be interpreted cautiously and require confirmation in future high-quality randomized controlled trials.

Whether combined training (aerobic plus resistance training) improves glucose and lipid metabolism in middle-aged and older adults and provides additional benefits over aerobic or resistance training alone for glucose and lipid metabolism remains unclear. This study conducted a systematic review and three-level meta-analysis of randomized controlled trials (RCTs) to examine the effects of combined training on glucose and lipid metabolism compared with control conditions, aerobic training, or resistance training. PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to February 2026. A total of 21 RCTs involving 1853 participants aged ≥45 years were included, and three-level meta-analysis and subgroup analyses were performed. Compared with control conditions, combined training significantly improved HbA1c (Hedges' g = -0.44, p < 0.01), HOMA-IR (Hedges' g = -0.59, p = 0.01), and glucose (Hedges' g = -0.81, p = 0.03). Evidence for insulin and lipid outcomes was inconclusive because these analyses were underpowered and the prediction intervals were wide. Current evidence does not establish a clear additional benefit of combined training over aerobic training. Compared with resistance training, combined training produced a small additional improvement in HbA1c, although this finding should be interpreted cautiously because of limited statistical power and potential differences in total exercise volume. Subgroup analyses suggested greater improvements in HOMA-IR among overweight and obese individuals. HbA1c showed the most robust findings, with moderate-certainty evidence, whereas the certainty of evidence for other outcomes ranged from low to very low. Overall, combined training was associated mainly with improvements in glycemic outcomes, but current evidence does not support a consistent advantage over single-modality exercise (e.g., aerobic training alone or resistance training alone) in middle-aged and older adults.

Breast cancer, the most frequently diagnosed malignancy in women both in the United States and globally, represents a significant public health burden. While screening constitutes the cornerstone of early detection, enhanced surveillance, and preventive measures-including risk-reducing medication and lifestyle modification-are underutilized. The well-woman visit remains a pivotal opportunity for preventive care and individualized risk assessment. Assessment should begin with "genetics": evaluation for a potential germline pathogenic variant in a breast cancer susceptibility gene. If prior genetic testing was conducted, results should be reviewed to determine the need for updated testing based on current clinical guidelines or changes in personal or family history. Negative genetic testing requires contextual interpretation within the broader family history. In the absence of a known causal variant, estimated short- and long-term risks can then be quantified using validated risk prediction models that incorporate traditional risk factors such as age, family history, reproductive history, breast density, and hormonal exposure. Despite the availability of effective tools, genetic testing and formal risk evaluation remain underutilized, especially among socioeconomically disadvantaged populations, contributing to significant outcome disparities. As such, clinicians should implement a standardized, technology-supported framework for risk assessment routinely, in all patients. Such an approach promotes early identification of higher-risk individuals and supports more targeted prevention, enhanced surveillance, and personalized management of breast health. This paper focuses on formal and informal processes for breast cancer risk assessment and the management of women at moderately increased risk.