Maturitas
Objectives: Unopposed estrogen therapy may induce endometrial hyperplasia. To protect the endometrium, estrogen replacement therapy should be combined with a progestin in menopausal women with an intact uterus. The aim of this open non-comparative study was to evaluate the effects on bleeding control and endometrium of spacing-out the 14-day progestin therapy to every second month during transdermal...
Objective: To compare the occurrence of climacteric symptoms at two points in the cycle, identified as minE (phase of minimum estrogen effect) and MaxP (phase of maximum progesterone effect). Methods: Prospective randomized cross-over study in postmenopausal women currently on HRT comparing two opposed, sequential formulations: a regimen of 21 tablets containing estradiol valerate (EV) opposed with...
Evolutionary biologists classify theories of menopause as either: ( * 1) adaptive, suggesting that female reproductive cessation results from its selective advantage, in that the increased risk of personal reproduction late in life makes it biologically more advantageous to rechannel reproductive energy into helping existing descendents, or ( * 2) nonadaptive, indicating menopause...
The lack of uniformity in descriptive terminology applied to the cessation of human female menstruation and events related thereto has retarded scientific progress and resulted in confusion and, perhaps, therapeutic mismanagement. Inevitably, many published clinical studies do not clearly define the population being tested, and conclusions drawn are misleading or invalid. Although menopause refers...
Objectives: To compare the effects of a non-oral combination of a transdermal oestradiol patch (50 μg daily) and an intrauterine device (IUD) releasing 20 μg of levonorgestrel daily on the serum pattern of lipids and lipoproteins with an established oral regimen of a daily dose of 2 mg of oestradiol and 1 mg of noretisterone acetate. Methods: An open, randomized study comprised of 40 healthy, early...
A questionnaire study was carried out in 6000 randomly selected women in the County of Jamtland in Sweden. The response rate was 61.2%. Questions were asked about general health, height and body weight, sleep, menstruation and menopausal complaints. There were also questions about visits to doctors and the use of sleeping pills and hormone preparations. A deterioration of the night's sleep after...
Objective: To determine the incidence of breakthrough bleeding and its significance in recently postmenopausal women who take tibolone (Livial-Organon). Design: A two year comparative nonrandomised prospective study of women taking tibolone (2.5 mg) and control subjects not on medication. Setting: Teaching hospital menopause and well women clinic. Subjects: One hundred women who were recently menopausal...
Epidemiologic data on breast cancer risk in menopausal women treated with oral estrogen alone show no risk modification with conjugated estrogens 0.625 mg/day, and only a slight risk increase with long term use at generally higher doses. Contrarily to parenteral estrogens, oral estrogens produce marked hepatocellular effects. Some of these effects, for example increased sex hormone binding globulin...
The authors explored the possibility that estrogen loss associated with menopause may contribute to the development of Alzheimer's disease by using a case-control study nested within a prospective cohort study. The Leisure World Cohort includes 8,877 female residents of Leisure World Laguna Hills, a retirement community in southern California, who were first mailed a health survey in 1981. From...
The same ethical principles that apply to biomedical research in general also govern research on menopause. The principles of respect for persons, beneficence, and justice embody ethical concerns in the selection and recruitment of subjects, the process of obtaining informed consent from potential subjects, the assessment of risks and benefits, and the conduct of the research itself. An argument...
Patients with breast cancer have been denied subsequent exposure to increased levels of estrogen (endogenous or exogenous) based on the belief that exacerbation of the cancer would occur. This issue is of critical concern in postmenopausal breast cancer patients where hormone replacement therapy (HRT) was demonstrated improvement in quality of life and survival of menopausal women as a result of...
Estrogen deficiency in postmenopausal women is a major contributing factor to bone loss occurring after menopause. Although serum estradiol levels decrease conspicuously, a considerable amount of estrone still exists in women after natural menopause. Since most of the estrone is converted from androgens in adipose tissues, we attempted to seek interrelationship among serum estrone levels, fat mass...
Evolutionary aspects of menopause are considered from several perspectives. First, the programmed exhaustion of ovarian oocytes appears to be a general trait of mammals that is not as widely found in other vertebrates. Second, studies on mice suggest that the maternal age effect that accelerates the incidence of Down syndrome is due not to age per se but to dwindling ovarian oocyte pools. Because...
The aim of our controlled study was to evaluate peripheral microcirculation at the level of the nail-fold capillaries in relation to menopause status and postmenopausal hormone replacement therapy (HRT). A total of 105 postmenopausal women were randomly allocated to three different HRT groups of equal size. A fourth group of 35 similar healthy volunteers served as controls. HRT was either peroral...
Women who have used combined oral contraceptives (COC) have a reduced risk of endometrial cancer relative to that of women who have never used oral contraceptives, but it is unclear whether the size of the reduction is influenced by the progestin content of the preparation. We analyzed data from two population-based case-control studies of endometrial cancer to investigate this question. Among women...
Preliminary animal and human data suggest that estrogens may be protective against Alzheimer's disease in women. In a population-based case-control study at Group Health Cooperative of Puget Sound, Seattle, Washington, the authors compared the exposure of estrogen replacement therapy of 107 female Alzheimer's disease cases with 120 age- and sex-matched controls by using computerized pharmacy data...
Purpose: To critically review the available evidence for screening asymptomatic women for ovarian cancer with ultrasonography or the CA 125 radioimmunoassay (CA 125) or both. Data Sources: A MEDLINE search of the English-language literature and bibliographies of published studies providing estimates of ovarian cancer risk and test operating characteristics (based on observational studies and meta-analyses)...
The effects of four different treatment schedules on serum lipid concentrations were studied for 1 year in 402 postmenopausal women in the Kuopio Osteoporosis Study. The women were randomized to four treatment groups: A, Sequential combination of estradiol valerate and cyproterone acetate (Climen ); B, Vitamin D 3 , 300 IU/day; C, Climen + Vitamin D 3 ; D, placebo. In group A,...
Careful examination as well as biochemical and hormonal investigations should be performed in men suffering from vertebral crush fractures, in order to detect a destructive skeletal process (multiple myeloma, bone metastatic lesions, lympho and myeloproliferative disorders), a mineralization defect (osteomalacia) or a secondary osteoporosis: primary hyperparathyroidism, hypogonadism, hyperthyroidism,...
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)...