Vegunta, Suneela

Introduction Advancements in transplant care have led to an increasing number of women with solid organ transplantation (SOT) living through peri- and postmenopause. Menopause can significantly impact quality of life, and the added burden of SOT may exacerbate symptoms. Few studies have evaluated the menopausal experience in this population, and existing data rarely use validated questionnaires. Research Question This study aimed to characterize menopausal symptoms and menopausal hormone therapy (MHT) use in peri- and postmenopausal SOT recipients using validated measures. Design A cross-sectional survey study of female patients ≥18 years who underwent SOT between 2018 and 2023 was conducted at a tertiary transplant center. A reproductive and sexual health questionnaire incorporating validated instruments, including the Menopause Rating Scale (MRS), was administered. Results Among peri- and postmenopausal SOT recipients ( n = 192), 8.9% reported use of MHT. The median MRS total score was 8.0, consistent with mild-to-moderate symptom severity overall. Symptom severity differed by menopausal status for vasomotor symptoms ( P =.03), sleep disturbances ( P = .04), depressive mood ( P = .04), and anxiety ( P <.001), with perimenopausal participants generally reporting more symptoms in these domains than postmenopausal participants. Despite these differences, overall symptom severity remained mild to moderate in both groups. Conclusion Menopausal symptoms among female SOT recipients are common but generally mild to moderate, with low utilization of MHT. The lack of increased vasomotor burden compared to prior literature may reflect under-recognition or misattribution of symptoms to transplant-related factors. Incorporating menopause-specific screening into transplant care may improve symptom recognition, quality of life, and long-term health outcomes.

Background: Telemedicine use has expanded rapidly across ambulatory care. Satisfaction with telemedicine services has been associated with social determinants of health (SDOH) such as socioeconomic status, ethnicity, and employment status. However, little is known about gender-specific patterns in patient experience. This study examined how demographic and SDOH are associated with telehealth satisfaction among women. Methods: A cross-sectional analysis was conducted using data from female patients who completed standardized post-telehealth surveys within the Mayo Clinic Health Care System between March 2020 and December 15, 2023. Logistic regression was used to evaluate the association between patient satisfaction and the following demographics and SDOH: age, race, ethnicity, marital status, Elixhauser score, mental health diagnosis, stress risk, financial risk, transportation risk, food insecurity risk, primary language, and physical activity risk. Results: Among 51,512 female patients, higher age was associated with less satisfaction with “ease of scheduling appointment” and “ease of contacting clinic,” but was associated with significantly higher satisfaction for other measures, including “care practitioners’ efforts to include” and “recommending healthcare office.” A high Elixhauser score was associated with lower satisfaction with “how well the audio and video connections worked.” Conclusion and Action Steps: A higher Elixhauser score and older age emerged as key factors associated with telehealth satisfaction among women. Targeted efforts to support patients with complex health needs and those requiring enhanced care coordination may improve satisfaction and equity in ambulatory telemedicine.

Abstract Introduction Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and glucagon-like peptide-1 receptor and glucose-dependent insulinotropic polypeptide dual receptor agonists (GLP-1/GIP RAs) have transformed the management of obesity and type 2 diabetes, both of which are prevalent in women of reproductive age and are closely linked to fertility concerns and adverse pregnancy outcomes [1,2]. Beyond their metabolic effects, emerging evidence suggests GLP-1 RAs and GLP-1/GIP RAs can positively influence ovulatory function, menstrual regularity, and conception, particularly in women with obesity or polycystic ovary syndrome (PCOS). However, the reproductive implications of GLP-1 RA and GLP-1/GIP RA use remain poorly understood [3]. This study seeks to address this critical gap by investigating self-reported changes in sexual activity, menstruation, and fertility among reproductive-aged women using GLP-1 RAs and GLP-1/GIP RAs within an institution. 1. Kong L, Nilsson IAK, Gissler M, Lavebratt C. Associations of Maternal Diabetes and Body Mass Index With Offspring Birth Weight and Prematurity. JAMA Pediatr. Apr 1 2019;173(4):371-378. doi:10.1001/jamapediatrics.2018.5541 2. Drummond RF, Seif KE, Reece EA. Glucagon-like peptide-1 receptor agonist use in pregnancy: a review. Am J Obstet Gynecol. Jan 2025;232(1):17-25. doi:10.1016/j.ajog.2024.08.024 3. Cesta CE, Rotem R, Bateman BT, et al. Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy. JAMA Intern Med. Feb 1 2024;184(2):144-152. doi:10.1001/jamainternmed.2023.6663 Objective The primary objectives of this study are: 1) to explore how GLP-1 RAs and GLP-1/GIP RAs may influence reproductive health, specifically sexual activity, menstrual regularity, fertility and conception; 2) to understand the prevalence and patterns of contraceptive use and failure and clinician counseling among women taking GLP-1 RAs and GLP-1/GIP RAs during their reproductive years; and 3) to assess whether reproductive outcomes differ by specific GLP-1 RA and GLP-1/GIP RAs. Methods This descriptive, cross-sectional survey study will be conducted across multiple sites of a major academic institution. Eligible participants include women aged 18-55 who are currently prescribed a GLP-1 RA or GLP-1/GIP RAs, identify as female, report heterosexual relationships, are English-speaking, and are patient portal users. Exclusion criteria include postmenopausal women, non-English speakers, and those unable to complete the survey independently. Participants will receive an electronic questionnaire through the patient’s portal. The survey will collect demographic information, reproductive health history, menstrual patterns, sexual activity, and contraceptive use. QR code included with link to the survey. Responses will be de-identified and stored for analysis. Descriptive statistics and correlation tests will be used to evaluate associations between GLP-1 RA and GLP-1/GIP RA use and reproductive outcomes. Results Data collection and analysis are ongoing. Preliminary results will describe participant demographics, frequency of self-reported changes in menstruation, fertility, and sexual activity, as well as patterns of contraceptive use and potential failure using GLP-1 RAs and GLP-1/GIP RAs. Conclusions This study will provide insight into the reproductive health experiences of women taking GLP-1 RAs and GLP-1/GIP RAs. By identifying self-reported menstrual, fertility, and sexual health changes, findings may inform future clinical counseling, contraceptive recommendations, reproductive safety guidance, and interdisciplinary research on broader physiological effects of GLP-1 RAs and GLP-1/GIP RAs. Ultimately, this work aims to bridge the current gap between metabolic therapy and women’s health reproductive health outcomes. Disclosure No.

ABSTRACT Background As survival following solid organ transplantation (SOT) improves, attention has shifted to survivorship and quality of life (QoL) outcomes. Sexual function is an important component of women's health in transplant recipients. In the general population, sexual distress affects approximately 10%–15% of midlife women. Female SOT recipients may experience additional risk for sexual dysfunction related to surgery, body image, and immunosuppression. However, sexual health in this population remains understudied. This study assessed sexual function and its impact on QoL among female SOT recipients by menopausal status. Methods A cross‐sectional study of female SOT recipients aged ≥ 18 years was conducted at a single tertiary transplant center from 2018 to 2023. Participants were within five years of kidney, liver, or pancreas transplantation. Validated questionnaires included female sexual function index (FSFI), female sexual distress scale (FSDS), menopause rating scale (MRS), linear analog scale assessment (LASA). Respondents were categorized as premenopausal or peri/postmenopausal. Sexual function, distress, and QoL were compared between groups, with exploratory analyses stratified by current sexual activity status. Results The survey response rate was approximately 30%. Among 277 respondents, peri/postmenopausal patients were less likely to be sexually active (48.9% vs 69.4%, p = 0.002). They reported lower desire, arousal, and lubrication scores, and higher sexual distress than premenopausal SOT recipients. While overall QoL was rated highly across both groups, sexual distress negatively correlated with QoL across menopausal groups. Among the entire cohort, most women (≈74%) had not been asked about sexual health by any provider in the past year. Conclusion Sexual dysfunction is common among female SOT recipients and is associated with menopausal status, with higher rates observed than those reported in the general population. These findings highlight the importance of integrating sexual health into posttransplant survivorship care.

Objective: Telemedicine addresses limitations in patient access, health care costs, and time spent by patients for health care visits. However, gender-based differences in patient satisfaction with this method are unclear. Our study aimed to evaluate gender-based differences in patient satisfaction for telemedicine (both video and telephone) and in-person health care visits. Methods: Patients were randomly selected to complete a patient satisfaction survey regarding their health care experiences after outpatient medical appointments at a large academic institution. Results: Of 476,777 total respondents, most patients were women (47.5%) and men (37.3%), with fewer patients in the categories transgender, other, or unknown/choose not to disclose (15.2%). Women and men were both satisfied with telemedicine by video or telephone (83.3% women versus 84.5% men rated their visit 5/5) and in-person visits (84.1% women versus 85.7% men rated their visit 5/5). Conclusions: Men and women were nearly equally satisfied with telemedicine and in-person visits, although both genders were slightly less satisfied with telemedicine video visits than in-person visits. The findings indicate that the ongoing integration of telemedicine into clinical practice could serve as a satisfactory alternative to in-person consultations for all patients.