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Objective: To compare the influence on lipid metabolism of two discontinuous, sequentially combined hormone replacement therapy (HRT) regimens. Study design: In an open, randomized study in 60 women, a full lipid profile including Lp(a) and liver function tests were assessed in a fasting state at the end of treatment cycles 6 and 12. Group A was treated with 2 mg oestradiol valerate (days 1-21)...
As part of a case-control study of vulvar cancer, we examined the role of reproductive history, menstrual history, exogenous estrogen use and body mass in the etiology of this disease. A total of 330 women with vulvar squamous cell cancer (259 in situ, 81 invasive), aged 18 79 years, who were diagnosed with this tumor during 1980-1990 were interviewed. Their responses were compared to those of 1010...
Objective: To study progestin administration at less than monthly intervals in postmenopausal women given continuous estrogen replacement. Methods: Eighty postmenopausal women received 0.625 mg/day of conjugated equine estrogens for 48 weeks. Using a double-masked design, the subjects were randomized to medroxyprogesterone acetate 10 mg/day for 14 days every 28 or 84 days, or the same dosage for...
Background: Estrogen replacement therapy reduces the risk of coronary heart disease in postmenopausal women, and estrogen treatment modulates endothelium-dependent vasodilation in ovariectomized, atherosclerotic monkeys. Estradiol-17 also induces relaxation in isolated rabbit coronary arteries as well as cerebral basilar arteries. The estrogen concentrations required to induce such relaxation are...
In order to analyse both sexual desire after menopause and its response to treatment with tibolone, a randomized placebo/tibolone trial has been designed with 28 postmenopausal patients. They were asked to answer a questionnaire designed by us to obtain quantitative measurements to describe changes in sexual desire. After selection, the patients were randomly assigned to two groups as follows: 14...
The effects of menopause and hormone replacement therapy (HRT) on the epidermis are largely unknown. The aim of this study was to model and measure the influence of estrogen-transdermal HRT on subtle physiological changes taking place in the epidermis during the perimenopause. Skin capacitance and transepidermal water loss were measured both on normal-looking skin and at the site of a plastic occlusion...
This study examines the symptoms after a natural menopause recalled by women aged 50-89 years. We determined the frequency and clustering of symptoms, the effect of age on symptoms, and the relation of symptoms to the use of estrogen therapy in a cross-sectional, community-based study of 589 Caucasian, middle- to upper-middle-class women from Rancho Bernardo, California. At the time of menopause,...
Postmenopausal women were randomly given either oral calcium (500 mg/day, control group, n = 12) or a combination of estradiol valerate (EV, 2 mg/day for 21 days) with cyproterone acetate (CPA, 1 mg/day in the last 10 days of the treatment cycle, n = 19). EV+CPA reduced (P < 0.01) postmenopausal complaints, inducing regular withdrawal bleeds, with no hysteroscopic or hystologic evidence of endometrial...
Objective: To investigate whether creatinine clearance (Ccr) at menopause is related to bone mass later in life. Methods: Ccr was measured within 5 years after natural menopause in two groups af normal women. Bone mineral content (BMC) of the distal forearm, lumbar spine, and proximal femur were measured by photon absorptiometry and dual energy X-ray absorptiometry in these women 6 years (n = 47)...
Menopausal hot flashes are thought to be a disorder of thermoregulation initiated centrally within the medial preoptic area of the hypothalamus. These heat-loss mechanisms appear to be activated in the presence of normal core body temperature. Previous studies have demonstrated that thermal stimuli have the potential to alter sleep stages. We performed 24-h ambulatory recordings of hot flashes and...
To examine potential confounders and dose-response data for the association between smoking and menopause, we used both a cross-sectional and case-controlled approach. In total, 10 606 middle-aged women residing in eastern Massachusetts were surveyed about their age at menopause and smoking history; 344 women (cases) with natural menopause prior to age 47 and 344 age-matched women (controls) who...
Objective: To determine the effects of estrogen deprivation and estrogen replacement on coronary artery atherosclerosis. Design: Randomized trials using female cynomolgus monkeys as subjects. Setting: Comparative Medicine Clinical Research Center of an academic medical center. Patients: Premenopausal and postmenopausal female cynomolgus monkeys fed diets comparable in fat and cholesterol to those...
The extent of menopausal and postmenopausal hormone use in Denmark, Finland, Norway, and Sweden during 1981-1992 was studied by means of drug sales figures and associations between hormone use, education, employment and occupational status, by questionnaire surveys in each of the respective countries in the 1980s-90s. According to sales figures, hormone use has been different in each of the countries...
Objective: To determine the changes in cardiovascular risk factors and psychological and physical symptoms that occur during the perimenopause. Design: Cohort study of 541 healthy middle-aged premenopausal women followed up through the menopause. Setting: General community. Participants: After a baseline evaluation taken at study entry, 152 women ceased menstruating for 3 months (not due to surgery)...
Two-hundred and fourteen (214) menopausal women with moderate to severe vasomotor symptoms, aged 40-65 years, were randomised. After a 4-week treatment-free period, each woman received a continuous regimen of Menorest 50 twice weekly or Premarin 0.625 mg daily, for 12 weeks. Didrogesterone 10 mg was also given to all women for 12 days of every 28-day cycle. The objectives were to compare the...
Objective: Only two medications, estrogen and injectable salmon calcitonin, are currently approved by the FDA for the treatment of osteoporosis. Oral etidronate has been investigated but not approved for osteoporosis therapy. We compared the three available anti-resorptive medications in untreated osteoporotic women. Design: A non-randomized, open label trial. After baseline biochemistry and bone...
Objectives. We attempted to determine whether continuous and cyclic medroxyprogesterone acetate modulates the effects of estrogen on dilation of atherosclerotic coronary arteries in surgically postmenopausal female monkeys. Background. Estrogen replacement in postmenopausal women preserves normal dilator responses of atherosclerotic coronary arteries. The effects of progestins on coronary artery...
This study examines the relationship between menopausal estrogen and estrogen-progestin replacement therapy and risk of breast cancer, focusing on whether associations differ according to whether the tumors are in situ or invasive. Data are from a prospective study conducted 1980-1989 on 49017 selected participants in the Breast Cancer Detection Demonstration Project, a five-year screening program...
In the medical evaluation of older female patients with sexual problems, you need to assess the woman's psychological state, as well as her physical condition. An important question to ask is whether her level of sexual activity is satisfactory to her. Women's early sexual experiences, in some cases including childhood sexual abuse, impact greatly on their sexuality in later life. When sexual problems...
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