Women transitioning through menopause are often affected by vasomotor symptoms (VMS), bone loss, metabolic dysfunction, and increased cardiovascular risk. Although menopausal hormone therapy remains the most effective treatment for menopause, nonhormonal strategies are essential for women with contraindications, personal preference, or a history of hormone-sensitive cancers. This narrative review evaluates evidence-based integrative approaches to menopause care, including lifestyle interventions, mind-body therapies, nutritional strategies, botanicals, and complementary modalities. Cognitive behavioral therapy and clinical hypnosis have been shown to significantly reduce vasomotor symptom distress and are recommended as nonhormonal options. Although mindfulness-based interventions may improve sleep and quality of life (QOL), they are not recommended for the relief of VMS. Regular physical activity and dietary optimization are foundational for bone health and improving metabolic risk factors. Acupuncture may provide subjective improvements in overall symptom burden and QOL for some individuals. Despite the common use of phytoestrogens and various botanical therapies, high-quality evidence supporting their efficacy for VMS remains inconsistent. Consequently, these modalities are not advised for routine symptom management, particularly given their lack of standardization and potential safety concerns. Integrative approaches should be incorporated as part of an individualized, patient-centered care plan. Further research is needed to clarify effectiveness, safety, and optimal integration of these treatment approaches into clinical practice.

This Narrative Review provides a practical, symptom-based framework for the management of menopause in patients with cancer, emphasizing risk stratification and collaboration with oncology. Current evidence and guideline recommendations were synthesized from randomized trials, observational studies, systematic reviews, and major society position statements, with findings organized by symptom domain and stratified by cancer type and hormone sensitivity to support clinical decision making. Menopausal symptoms are common and often severe in patients undergoing cancer treatment, particularly in those with treatment-induced menopause, and management requires balancing symptom relief with oncologic safety. Nonhormonal therapies are first-line treatment across cancer types, with strong evidence supporting selective serotonin and norepinephrine reuptake inhibitors, gabapentin, and lifestyle interventions for vasomotor symptoms. Vaginal estrogen is effective for genitourinary syndrome of menopause, is appropriate in most gynecologic cancers, and may be considered in select breast cancer survivors after shared decision making. Systemic hormone therapy remains contraindicated in hormone receptor-positive breast cancer but may be considered in carefully selected patients with non-hormone-dependent malignancies or low-risk gynecologic cancers. Nonhormonal considerations-including thrombotic risk, hepatic function, drug-drug interactions, and cardiometabolic health-are critical to safe management. A symptom-based, risk-stratified approach enables gynecologists to manage menopause in patients with cancer through collaboration with oncology, supporting individualized care and improved quality of life.

Gastroschisis, a common congenital defect of the abdominal wall, is characterized by varying degrees of visceral herniation of the bowel and may include the stomach, liver, or bladder through a paraumbilical defect. Gastroschisis arises from a complex interplay of early embryonic morphogenetic disruption, vascular compromise, and environmental influences. Though the exact initiating events have yet to be determined, the weight of current evidence supports a model in which defective right-sided body wall formation is compounded by vascular and environmental factors that lead to a paraumbilical full-thickness defect with extruded, uncovered viscera. This Clinical Expert Series provides an overview of embryology, pathophysiology, categorization of complexity, prenatal diagnosis, antenatal monitoring, postnatal surgery, and potential options for fetal intervention for gastroschisis.

Carrier screening is used to determine reproductive risk for autosomal recessive or X-linked conditions, and its clinical implementation varies widely. We evaluated recurring clinical patterns observed at an independent, university-affiliated, high-volume maternal-fetal medicine center in Los Angeles receiving referrals from diverse practice settings. In our view, carrier screening is far too frequently performed later than ideal, which narrows timelines for partner testing, prenatal diagnosis, and decision making and increases patient distress. Carrier screening practices differ by referring clinician, resulting in inequities in detecting genetic risk. Within a single couple, partners are often screened on discordant panels (and sometimes sequentially, maternal-first), which delays risk clarification and increases the chance of misinterpretation. Based on these observations, we believe prepregnancy carrier screening should be prioritized; otherwise, carrier screening should be performed as early as possible in pregnancy with concurrent partner testing. We also believe patients should receive counseling on the benefits and limitations of all available screening options to preserve patient autonomy.

Equitable menopause care demands systemic, clinical, and research reforms. Guided by the National Institute on Minority Health and Health Disparities framework and an intersectional lens, we emphasize how sociocultural factors, the physical/built environment, behaviors, biology, and health care systems jointly heighten menopause symptom burden-especially for marginalized groups. Priorities include addressing health literacy; developing multilingual, culturally responsive educational tools; integrating menopause curricula, bias training, and trauma-informed strategies-into clinical education; and expanding insurance coverage. Inclusive recruitment and retention strategies in menopause research, plus coordinated, interdisciplinary care, are essential to deliver personalized, culturally responsive interventions and improve midlife women's outcomes.

Assessing and treating menopause in transgender and gender diverse (TGD) individuals is of increasing interest to clinicians providing gender-affirming care. There currently exists a small body of literature that describes cardiovascular, bone health, neurocognitive, and other outcomes in the TGD population who experience loss of endogenous sex hormone production, whether through gender-affirming hormone therapy, surgical gonadectomy, or natural aging. However, the literature is currently insufficient to provide clear evidence-based guidance for the medical management of menopause in TGD individuals. As a result, clinical care largely relies on extrapolation from cisgender populations, expert opinion, clinical consensus, and shared decision-making.