Menopause

A reader-driven look at the 10 most-viewed articles on Contemporary OB/GYN from the first half of 2026, spanning FDA decisions, clinical research, and emerging treatments across menopause, contraception, endometriosis, and pelvic health.

A study published in Frontiers in Public Health and led by Mount Sinai researchers found that postmenopausal women in lower-income neighborhoods experienced up to 3.8 times greater bone mineral density loss from air pollution exposure than women in wealthier areas, based on data from 9041 participants in the Women's Health Initiative.

A recap of the top-performing, most-viewed Contemporary OB/GYN stories from June 2026, including new SMFM guidance on acetaminophen in pregnancy, ACOG's break from federal vaccine recommendations, and our coverage of SLEEP 2026 in Baltimore.

A recap of the top FDA news stories covered by Contemporary OB/GYN in Q2 2026, spanning cervical cancer screening, menopause therapeutics, and antibiotic treatment for urinary tract infections.

A look ahead to the second half of 2026 for ob-gyns, including Viatris's pending FDA decision on a low-dose estrogen contraceptive patch and previews of the IDSOG, AUGS PFD Week, and The Menopause Society annual meetings.

Fiona C. Baker, PhD, explains how menopausal sleep disturbance differs from other forms of sleep disruption, citing the role of vasomotor symptoms, hormone changes, and an increased postmenopausal risk of sleep apnea in driving nighttime awakenings.

Among SWAN participants, sleep disturbance was independently associated with lower HRQoL relating to role-physical, role-emotional, and energy/fatigue, with no change in these associations over time.

In part 2 of our discussion with Fiona Baker, PhD, she details how to interpret data from the NIRVANA study, which revealed reductions in wakefulness after sleep onset in the elinzanetant group vs placebo.

Elinzanetant produced a numerically greater reduction in PSG-measured WASO vs placebo across the 12-week NIRVANA trial, with the effect more pronounced at week 4 than week 12.

A post hoc analysis of the phase 2 NIRVANA trial presented at SLEEP 2026 found that elinzanetant reduced WASO versus placebo across in-lab PSG, home-based Sleepiz One+ monitoring, and patient-reported Sleep Diary.

Presented at SLEEP 2026, NIRVANA data show a consistent elinzanetant treatment signal across three sleep measurement modalities, extending earlier OASIS trial findings on patient-reported sleep outcomes in menopausal women.

The total treatment effect of elinzanetant on sleep disturbance relative to placebo was -4.92 (95% CI, -5.73 to -4.12), indicating a clinically meaningful reduction.

Two neurokinin receptor antagonists are now available for vasomotor symptom (VMS)-related sleep disruption, with elinzanetant's (Lynkuet) NK1 and NK3 dual-receptor profile potentially offering more targeted sleep benefit than fezolinetant's (Veozah) NK3-selective mechanism—but effective management requires systematic screening for obstructive sleep apnea, restless leg syndrome, and primary insomnia before attributing sleep disruption to VMS alone

The HRT uptake meta-analysis is largely drawn from high-income country data and cannot be generalized globally, whereas the ongoing influence of WHI-era risk framing on prescribing underscores the need for individualized absolute risk assessment—supported by decision aids that do not yet adequately exist for many clinical scenarios.

A meta-analysis of 53 studies found that Black women had 53% lower odds of HRT use than White women, and that diabetes, obesity, stroke, and VTE history were each associated with lower uptake—findings that point to both racial inequities and potentially overcautious prescribing in women with cardiovascular risk factors who may benefit from individualized assessment.

Genevieve Neal-Perry, MD, PhD, highlights that phase 4 real-world data confirm that fezolinetant significantly reduces VMS bother, particularly in high-burden groups such as Black women and patients with obesity.

David Shalowitz explains why experts now recommend a dual approach for most patients with postmenopausal bleeding due to limitations in ultrasound accuracy.

At ACOG, David Shalowitz, MD, highlighted the biggest takeaways from April's updated guidance on postmenopausal bleeding.

Meaningful improvements in gynecologic care for LGBTQ patients require both environmental changes—inclusive waiting rooms, trained front desk staff, flexible scheduling—and clinical recalibration, including routine screening for contraceptive needs and menopausal symptoms regardless of gender identity or presentation.

Pelin Batur, MD, emphasizes that half of patients are unsatisfied with their sexual health and clinicians should normalize these concerns through simple, open-ended questions.

Jill Liss, MD, MSCP, FACOG, outlines aspects of hormonal and non-hormonal treatments for vasomotor symptoms.

In this discussion from ACOG's 75th Annual Meeting, Genevieve Neal-Perry, MD, PhD, explains how elinzanetant has impacted patients since it's approval in October 2025.

A study of 1206 women found that while many remain sexually active as they age, a higher number of menopausal symptoms was linked to decreased sexual satisfaction.

Contemporary OB/GYN will be on site in Washington, D.C. to cover the latest data out of the 75th Annual ACOG Clinical & Scientific Meeting.

The letter from the federal agency allows further phase 2 development for refisolone under an investigational new drug application.