The literature from October 20-23 brought a national survey snapshot of menopausal symptoms from the US government's health statistics agency, a three-year study comparing two osteoporosis drugs on muscle outcomes, a quarter-million-woman analysis of ovulation and ovarian cancer, and a survey in which European endocrinologists assessed their own PMOS(PCOS) care.
1. Half of midlife women report menopausal symptoms. Fewer than one in six report taking a prescription for them.
The CDC's National Center for Health Statistics published Data Brief No. 575, "Characteristics of Women Ages 40-60 with Menopausal Symptoms: United States, 2025," using the 2025 National Health Interview Survey, a nationally representative US household survey (Vahratian and Clayton; doi:10.15620/cdc/252478).
Who was asked: women ages 40-70 who were not currently pregnant, postpartum, or in surgical menopause were read a specific list - hot flashes, night sweats, insomnia or sleep disturbances, irregular vaginal bleeding or menstrual cycles, and vaginal dryness - and asked whether they had experienced any of these in the past 12 months. This analysis covers those ages 40-60.
The numbers: 49.4% reported symptoms - roughly 16.7 million women. Reported symptoms rose with age to 62.0% of women ages 48-51 and a peak of 67.4% at ages 52-55, then eased to 53.1% at ages 56-60. Among women with symptoms, 15.6% - about 2.6 million women - reported currently taking a prescription medication for those symptoms.
Why it matters: this gives us current, nationally representative baseline numbers: how common symptoms are at each age, and how commonly symptomatic women report using prescription medication. Just as important is what the survey cannot tell us: whether women wanted treatment, whether it was offered, or whether nonprescription approaches were serving them well. Reported prescription use is not a measure of unmet need, and the brief draws no conclusions about why the numbers look the way they do. It is a starting point for better questions, not an answer.
Full brief: https://www.cdc.gov/nchs/products/databriefs/db575.htm
2. Two bone drugs, three years, and a muscle signal worth testing
Li and colleagues followed 186 postmenopausal women with osteoporosis who were at risk for sarcopenia: 82 prescribed denosumab and 104 prescribed zoledronic acid, for three years ("Denosumab Versus Zoledronic Acid for Muscle Strength and Physical Performance in Postmenopausal Osteoporosis: A 3-Year Prospective Study," Journal of Cachexia, Sarcopenia and Muscle; doi:10.1002/jcsm.70406).
At 36 months, the denosumab group showed larger gains on functional measures: grip strength up 2.52 kg versus 0.99 kg, gait speed up 0.070 versus 0.027 m/s, and chair-stand time improved by 1.47 versus 0.63 seconds. Sarcopenia prevalence was 20.0% in the denosumab group versus 46.0% in the zoledronic acid group at three years.
Why it matters: bone and muscle age together, and bone strength and falls both contribute to fracture risk, so a drug comparison that includes strength and mobility alongside density is asking the right question. But the limits here are not footnotes. Women were not randomized; the groups may have differed in ways that explain the results, and the study was modest in size. These are associations. They do not establish that denosumab protects muscle, and they are not a basis for choosing one osteoporosis drug over another. What they do is define a hypothesis that a randomized trial could properly test, and that trial would matter.
Source abstract:
3. Counting ovulations: ovarian cancer risk in 251,476 women
Garofalo and colleagues used the UK Biobank to test a long-standing theory, that ovarian cancer risk rises with the number of lifetime ovulations, alongside DNA-repair genetics ("Understanding the role of lifetime ovulatory years and DNA repair variants on ovarian cancer risk in the United Kingdom Biobank," Cancer Epidemiology, Biomarkers and Prevention; doi:10.1158/1055-9965.EPI-26-0353). Among 251,476 women with 847 incident epithelial ovarian cancers, each additional five years of ovulation was associated with a hazard ratio of 1.15. Carrying at least one pathogenic variant in a DNA-repair gene was independently associated with an HR of 1.27, and women with both high ovulatory years and a variant had an HR of 2.00.
Why it matters: reproductive history, including age at menarche, pregnancies, contraceptive use and age at menopause, contributes to cumulative ovulatory exposure. This study puts a number on that exposure while examining inherited DNA-repair risk. Two cautions deserve equal billing. First, these are population-level associations, not personal predictions; the study cannot tell any individual woman what her own ovulatory history means for her. Second, nothing here changes screening: the US Preventive Services Task Force recommends against screening for ovarian cancer in asymptomatic women without a known high-risk hereditary cancer syndrome (Grade D). The value of the study is biological understanding, not a new action item.
Source abstract:
Screening recommendation:
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/ovarian-cancer-screening
4. What 505 European endocrinologists report about PMOS(PCOS) care
In 2023, the European Society of Endocrinology's PCOS Special Interest Group ran an electronic cross-sectional survey distributed to its members; 505 clinicians responded. Livadas, Yildiz, Escobar-Morreale and colleagues have now published a secondary, survey-informed analysis of those results ("Diagnosis and management of polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome: unmet needs and areas of clinical confidence among European endocrinologists," Journal of Endocrinological Investigation; doi:10.1007/s40618-026-03050-8).
The picture is mixed. Respondents reported considerable variation in how chronic ovulatory dysfunction is defined, how hirsutism is assessed, how androgen excess is measured, and how ovarian morphology is interpreted. One quarter of respondents reported access to liquid chromatography-tandem mass spectrometry for steroid measurement, the reference method for testosterone. Uncertainty persisted about the choice and duration of combined oral contraceptive therapy and the best pharmacological approach to chronic anovulation. On the other hand, respondents commonly assessed metabolic risk, prioritized lifestyle intervention, recognized the psychological burden of the condition, and supported multidisciplinary care, and their stated priorities increasingly matched what women with the condition report wanting.
Why it matters: even among specialists, definitions and laboratory tools vary widely, and access to reference-standard hormone measurement is limited. Separately, the field has since formally renamed PCOS to PMOS - a multistep global consensus process, published in The Lancet, reflecting the condition's whole-body, metabolic nature. This survey predates the rename, so it says nothing about how the new name is being adopted; what it shows is the underlying diagnostic variability that any shared name must contend with. When the specialists themselves describe that variability, standardization belongs on the agenda. The survey is a snapshot of self-reported practice from one professional society's membership, not an audit of all care.
Survey abstract:
Naming consensus:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext
Endocrine Society announcement:
https://www.endocrine.org/news-and-advocacy/news-room/2026/pcos-name-change
If you are new here: I tell the story behind the PMOS name, and what it means for care, in Episode 1 of the Body Clock Podcast.
YouTube: https://youtu.be/LQ51omo0sCQ
Spotify: https://open.spotify.com/episode/4Ex7xnVSPopZv4asbOgCUf
Apple: https://podcasts.apple.com/us/podcast/renaming-pcos-meet-pmos-ep001-body-clock-podcast/id6818844081
Until the next one,
Dr. Herman Weiss
Medical Disclaimer
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