| 1. |
- Jernström, Helena, et al.
(författare)
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A prospective study of different types of hormone replacement therapy use and the risk of subsequent breast cancer: the women's health in the Lund area (WHILA) study (Sweden)
- 2003
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Ingår i: Cancer Causes and Control. - 1573-7225. ; 14:7, s. 673-680
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Reports suggest that combined estrogen plus progestin hormone replacement therapy (HRT) confers a higher breast cancer risk than estrogen alone. We aimed to establish whether breast cancer risk depends on the type of HRT formula. Methods: The cohort consisted of 6586 women, aged 50 - 64 years, from the Lund area, Sweden, with no reported breast cancer upon inclusion. We obtained information such as HRT use through a questionnaire between December 1995 and February 2000. New breast cancers were identified through the South Swedish tumor registry. Results: Between inclusion and December 2001, 101 women developed breast cancer. Only ever use of the continuous combined estrogen plus progestin ( CCEP) formula differed between cases and controls (45.2% versus 23.5%; p = 0.000001). Compared with never users, exclusive CCEP users had the highest age-adjusted hazard ratio HR 3.3 (95% CI: 1.9 - 5.6; p < 0.001), followed by users of CCEP in addition to other HRT formulas HR 2.8 (95% CI: 1.4 - 5.5; p = 0.003). No significant increase was seen in women who exclusively used other HRT formulas. Conclusion: Women who used CCEP had over three times the risk of developing breast cancer compared with never users and twice the risk compared with users of other types of HRT.
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| 2. |
- Khatibi Esfanjani, Ali, et al.
(författare)
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Could androgens protect middle-aged women from cardiovascular events? A population-based study of Swedish women: The Women's Health in the Lund Area (WHILA) Study
- 2007
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Ingår i: Climacteric. - : Informa UK Limited. - 1369-7137 .- 1473-0804. ; 10:5, s. 386-392
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this analysis was to delineate perceived associations between androgens and cardiovascular events in perimenopausal women. Design A cross-sectional, population-based study of 6440 perimenopausal women aged 50-59 years, living in Southern Sweden. In all, 461 (7.1%) women were premenopausal (PM), 3328 (51.7%) postmenopausal without hormone therapy (HT) (PMO) and 2651 (41.2%) postmenopausal with HT (PMT). For further comparisons, 104 women (1.6%) who reported cardiovascular disease (CVD) were studied in detail; 49 had had a myocardial infarction, 49 a stroke and six women both events. For each woman with CVD, two matched controls were selected (n = 208). Results In the matched controlled series, androstenedione levels were lower (p < 0.005) in cases. Cases with hormone therapy had also lower testosterone levels than matched controls (p = 0.05). In the total cohort, by using multiple logistic regression analyses, testosterone was positively associated with low density lipoprotem cholesterol (p < 0.001) and high density lipoprotein cholesterol (HDL-C) (p < 0.001) in all women, but negatively associated with levels of triglycerides in both the PMO (p < 0.001) and PMT (p < 0.001) groups. Androstenedione levels were positively associated with HDL-C (p < 0.05) and negatively with triglycerides (p < 0.05) in the PM group. Conclusion Women with cardiovascular disease had lower serum androgen levels, particularly women using hormone replacement therapy, even when controlled for lipids and other potential risk factors.
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| 3. |
- Khatibi Esfanjani, Ali, et al.
(författare)
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Does hormone therapy increase allergic reactions and upper gastrointestinal problems?; Results from a population-based study of Swedish woman. The women's health in the Lund area (WHILA) study.
- 2004
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Ingår i: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 48:4, s. 438-445
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To delineate the use of various drugs particularly pertaining to allergy and upper gastrointestinal problems in relation to hormone status in middle aged women. Methods: An analysis from a population-based study on women born between 1935 and 1945 and lived in the Lund area southern Sweden. Of 10766 women, 6917 provided complete data sets; in turn 5673 were assessed for the use of medication in this study. Among the cohort, 9% of women were premenopausal (PM), 54% were postmenopausal without hormone replacement therapy (PM0) and 37% were current hormone replacement therapy users (PMT). Results: There were 7 (1.3%) women in PM, 11 (0.4%) in PMO and 21 (1.0%) in PMT group who used loratadine regularly. There was a significant difference between the PM and PMO groups and also between the PMO and PMT groups in the use of loratadine (P < 0.05). Among 21 loratadine users in PMT group 4 (19%) used transdermal patches and 17 (81%) used oral HRT. The result for omeprazole use was as follows: 4 (0.8%) of PM group, 39 (1.3%) of PMO group and 42 (2.0%) of PMT group. The use of omeprazole was significantly higher in the PMT group than in the PM (P = 0.05) and PMO group (P < 0.05). There was no relation between the use of omeprazole and smoking or alcohol consumption. Conclusions: Use of hormone replacement therapy seems to be related to a higher frequency of omeprazole and loratadine use, which implies that hormone replacement therapy, may be associated with more upper gastrointestinal symptoms as well as allergy. (C) 2003 Published by Elsevier Ireland Ltd.
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| 4. |
- Li, Cairu, et al.
(författare)
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Effects of norethisterone acetate addition to estradiol in long term HRT
- 2000
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Ingår i: Maturitas. - 1873-4111. ; 36:2, s. 139-152
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate the efficacy and tolerability of hormone replacement therapy (HRT) among postmenopausal women living in the Lund area of Southern Sweden and to analyze treatment effects in different types or routes of HRT administration, as well as to compare with unopposed estrogen therapy. METHOD: in an ongoing, large population-based, prospective cohort study, this interim analysis included 3900 women. Of them, 693 postmenopausal women were eligible in the present analyses as they continued to use one of the four commercial HRT products for at least 2-3 years, i.e. continuous oral estradiol (E(2)) 2 mg+norethisterone acetate (NETA) 1 mg (CON-O), sequential oral estradiol 2 mg + norethisterone acetate 1 mg (CYC-O), sequential transdermal estradiol 50 microg + norethisterone acetate 250 microg (CYC-TRANS) and estradiol monotherapy. These women completed one generic questionnaire and one specific 'hormonal' questionnaire, as well as a personal interview pertaining to socio-demographics, detailed status of HRT use, and therapeutic efficacy and untoward side-effects by HRT. RESULTS: comparing the three combined E(2)+NETA groups with E(2) monotherapy, the beneficial effects on sexual desire and emotional well-being were significantly less in the combined groups than in E(2) monotherapy group. There was no significant difference regarding the negative side-effects between the groups. No significant difference was found between CON-O and CYC-O groups either in positive effects or in negative side-effects. A higher prevalence of positive effects was found in CYC-TRANS group than that in CYC-O group, especially in amelioration of sleep and urinary symptoms. Higher odd ratios of negative effects by HRT, such as irregular bleeds, weight gain, food craving and skin disorders were also found in CYC-TRANS group. CONCLUSION: in long-term HRT administration, the addition of a progestogen in HRT could compromise the beneficial effects of estradiol, particularly, the effects on women's emotional well being and psychosexual functioning. Administration of NETA continuously and sequentially had similar therapeutic efficacy and tolerability. More marked positive effects, such as improving of sleep and urinary symptoms, as well as nuisance side-effects, i.e. irregular bleeds, weight gain, food craving and skin disorders were encountered by the women using sequential transdermal regimen
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| 5. |
- Li, Cairu, et al.
(författare)
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Health profile of middle-aged women: The Women's Health in the Lund Area (WHILA) study.
- 2002
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 17:5, s. 1379-1385
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Middle-aged women experience various health-related problems. The aim of this study was to evaluate the impacts of menopause status and hormone intervention on women's health. METHODS: In an ongoing, population-based study, 4943 women, born 1935 to 1945 and living in the Lund area of Southern Sweden, were included in this analysis. They completed a generic questionnaire pertaining to socio-demographic background and current health-related symptoms. Among the cohort, 9% of women were pre-menopausal (PM), 52% were post-menopausal without hormone replacement therapy (PMO) and 39% were current hormone replacement therapy users (PMT). RESULTS: Hot flushes and vaginal dryness were strongly related to menopausal status. The prevalence of somatic symptoms worsened progressively from the groups of PM to PMO to PMT. The most abundant complaints were headache and muscle-skeletal-joint problems. A total of 85% of women experienced psychological problems. Contrary to our expectation, a poorer profile of psychological health was found in the PMT group when compared with the PMO group. CONCLUSIONS: The high prevalence of symptoms in middle-aged women could be attributed to age, hormonal influence as well as personality.
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| 6. |
- Li, Cairu, et al.
(författare)
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Important factors for use of hormone replacement therapy: a population-based study of Swedish women. The Women's Health in Lund Area (WHILA) Study
- 2000
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Ingår i: Menopause. - 1530-0374. ; 7:4, s. 273-281
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to delineate the use of hormone replacement therapy (HRT) among women who were born between December 2, 1935, and December 1, 1945, and living in the Lund area of southern Sweden and to analyze factors that contribute to the acceptance and continuation of HRT. METHODS: All women received a generic questionnaire pertaining to demographic background, lifestyle, health behavior, and climacteric symptoms and underwent a personal interview. An interim analysis was carried out on 3,900 women. We mailed a hormone questionnaire to the women who were using HRT (n = 1,875). This hormone questionnaire covered, for example, menopausal status, complaints, and alterations in and efficacy of HRT use, as well as the reasons for discontinuing HRT use. RESULTS: A total of 1,415 (76%) women answered the hormone questionnaire. Forty-eight percent were HRT ever users, and 32% were current users. Mean duration of HRT use was 47 months. The most common incentives for HRT use were alleviation of menopausal symptoms (72%) and prevention of bone loss (50%) and/or cardiovascular disease (31%). Forty-seven percent of HRT users reported that they had changed regimens at least once. HRT users had higher education, full-time work, and a higher consumption of alcohol but less consumption of cigarettes. They reported higher frequencies of climacteric symptoms, past histories of premenstrual syndrome, use of oral contraceptives, and hysterectomy. They also had a higher consumption of healthcare resources. A total of 177 women withdrew from therapy. The most common reasons for discontinuation of HRT were weight gain, anxiety of cancer, bleeding, breast tenderness, and emotional problems. Compared with current users, past users had less positive as well as fewer negative effects of HRT. Several variables contributed to compliance, including education, full-time work, regular exercise, low frequency of persistent climacteric symptoms, and alteration of regimens. CONCLUSION: Education, working conditions, lifestyle, interest in prevention, and severity of the climacteric symptoms are determinants for both acceptance of and compliance with HRT.
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| 7. |
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| 8. |
- Lidfeldt, Jonas, et al.
(författare)
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A screening procedure detecting high-yield candidates for OGTT. The Women's Health in the Lund Area (WHILA) study: a population based study of middle-aged Swedish women
- 2001
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Ingår i: European Journal of Epidemiology. - 1573-7284. ; 17:10, s. 943-951
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to evaluate a screening procedure for detecting high-yield candidates for an OGTT, in a population of middle-aged Swedish women. A two-step screening procedure was performed in 6917 subjects. Women with a positive screening outcome, i.e. increased non-fasting capillary blood glucose, serum triglycerides, BMI, WHR, blood pressure or a family history of diabetes, pharmacological treatment of hypertension or hyperlipidaemia at the primary screening underwent a 75-g OGTT. A control group of women with negative screening outcome (n = 221) also underwent an OGTT. In 2923 women with positive screening outcome, 517 (17.7%) had NFG/IGT (normal fasting venous blood glucose <5.6 mmol/l and 2h-glucose 6.7-9.9 mmol/l), 109 (3.7%) IFG/IGT (fasting 5.6-6.0 and 2h 6.7-9.9 mmol/l) and 223 (7.6%) diabetes (fasting > or = 6.1 or 2h > or = 10.0 mmol/l). These figures were three, five and four times higher, respectively, than in the control group with negative screening outcome (p < 0.001 for all); no differences were found for IFG/NGT (fasting 5.6-6.0 and normal 2h < 6.7 mmol/l) (4.6% vs. 7.2%). For predicting impaired glucose metabolism (IFG/NGT, NFG/IGT, IFG/IGT, diabetes), the screening instrument showed an estimated sensitivity of 70%, specificity of 55%, positive predictive value of 34% and negative predictive value of 85%, based on findings in the control sample. The odds ratio for NFG/IGT increased with the numbers of risk factors from 2.8 to 7.7, for IFG/ IGT from 5.7 to 55.0 and for diabetes from 2.5 to 18.1. High B-glucose, WHR and BMI were the three most important factors associated with an increased risk for NFG/IGT, IFG/IGT and diabetes. In subjects with IFG/NGT, none of the screening variables was associated with an increased risk. In summary, the results show a population screening method focused on features of the metabolic syndrome that discloses high-yield candidates for OGTT. A high prevalence of unknown impaired glucose metabolism was found in middle-aged women with a positive screening profile.
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| 9. |
- Lidfeldt, Jonas, et al.
(författare)
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Basic lifestyle advice
- 2004
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Ingår i: Diabetes Research. - 0265-5985. ; , s. 9-9
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Tidskriftsartikel (refereegranskat)
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| 10. |
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