| 1. |
- Andersson, Jonas, et al.
(författare)
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Dysregulation of subcutaneous adipose tissue blood flow in overweight postmenopausal women
- 2010
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 17:2, s. 365-371
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A putative link between abdominal obesity and metabolic-vascular complications after menopause may be due to a decreased adipose tissue blood flow (ATBF). The present work aimed to analyze possible changes in ATBF with being overweight and menopausal and its putative link to endothelial dysfunction and autonomic nervous system balance.METHODS: Forty-three healthy women were classified into four groups according to weight and menopause status. The ATBF was measured by xenon washout while fasting and after oral glucose intake. The nitric oxide synthase inhibitor asymmetric dimethylarginine was used as a marker of endothelial function and heart rate variability-estimated autonomic nervous system activity.RESULTS: Fasting ATBF was decreased in both overweight groups (P = 0.044 and P = 0.048) versus normal-weight premenopausal women. Normal-weight and overweight postmenopausal women exhibited lower maximum ATBF compared with normal-weight premenopausal women (P = 0.015 and P = 0.001, respectively), and overweight postmenopausal women exhibited lower maximum ATBF compared with normal-weight postmenopausal women (P = 0.003). A negative correlation was found between fasting ATBF and asymmetric dimethylarginine (P = 0.015), whereas maximum ATBF was negatively associated with sympathetic-parasympathetic nervous system balance (ratio of the power of the low frequency to the power of the high frequency; P = 0.002).CONCLUSIONS: Loss of ATBF flexibility in overweight postmenopausal women may contribute to the metabolic dysfunction seen in this group of women.
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| 2. |
- Baumgart, Juliane, 1978-, et al.
(författare)
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Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer
- 2013
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Ingår i: Menopause. - : Lippincott Williams & Wilkins. - 1072-3714 .- 1530-0374. ; 20:2, s. 162-168
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The goal of this study was to investigate sexual function in postmenopausal breast cancer patients treated with aromatase inhibitors.Methods: A population-based, cross-sectional study was conducted among postmenopausal breast cancer patients on adjuvant endocrine treatment and age-matched controls with and without estrogen treatment. Sexual function was assessed with a standardized questionnaire.Results: In all, 42.4% of aromatase inhibitor-treated breast cancer patients were dissatisfied with their sex life in general, and 50.0% reported low sexual interest; this was significantly more common than in tamoxifen-treated patients and controls (P < 0.05). Aromatase inhibitorYtreated patients reported insufficient lubrication in 73.9% and dyspareunia in 56.5% of cases, which were significantly more common than in controls, irrespective of hormonal use (P < 0.05). Tamoxifen-treated patients reported significantly more dyspareunia (31.3%; P < 0.05) but resembled controls in all other concerns.Conclusions: Our findings suggest that sexual dysfunction in aromatase inhibitorYtreated women is a greatly underestimated problem.
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| 3. |
- Bellavia, Andrea, et al.
(författare)
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Differences in age at death according to smoking and age at menopause
- 2016
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Ingår i: Menopause. - : LIPPINCOTT WILLIAMS & WILKINS. - 1072-3714 .- 1530-0374. ; 23:1, s. 108-110
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Younger age at menopause is associated with overall mortality, and cigarette smoking is the only lifestyle factor influencing this association. However, the combined effects of age at menopause and smoking have never been quantified in terms of survival time. Our aim was to evaluate, in a large cohort of Swedish women, differences in age at death according to age at menopause and smoking status. Methods: Age at menopause and smoking were assessed, using a self-administered questionnaire, in a population-based cohort of 25,474 women aged 48 to 83 years. Laplace regression was used to calculate differences in median age at death (50th percentile difference [PD]) according to smoking and age at menopause. Results: Across 16 years of follow-up, 5,942 participants died. The difference in median age at death between women with menopause at 40 years and women with menopause at 60 years was 1.3 years (50th PD, 1.3; 95% CI, 0.3-2.2). Compared with current smokers, former smokers and never smokers had older median age at death-2.5 years (50th PD, 2.5; 95% CI, 1.9-3.1) and 3.6 years (50th PD, 3.6; 95% CI, 3.1-4.1), respectively. When analysis was restricted to current smokers, the difference in age at death between women with menopause at 40 years and women with menopause at 60 years increased to 2.6 years (50th PD, 2.6; 95% CI, 0.8-4.5). No association among never smokers was observed. Conclusions: Younger age at menopause is linearly associated with shorter survival. This association tends to be stronger among current smokers.
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| 4. |
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| 5. |
- Bixo, Marie
(författare)
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Reply
- 2006
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Ingår i: Menopause. - Philadelphia : Lippincott Williams & Wilkins. - 1072-3714 .- 1530-0374. ; 13:3, s. 538-538
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Brynhildsen, Jan, 1962-, et al.
(författare)
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Low dose transdermal estradiol/norethisterone acetate treatment over 2 years does not cause endometrial proliferation in postmenopausal women
- 2002
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Ingår i: Menopause. - : Raven Press. - 1072-3714 .- 1530-0374. ; 9:2, s. 137-144
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We investigated the effects of 2-year transdermal continuous combined estradiol (0.025 mg/day) and norethisterone acetate (0.125 mg/day) (Estragest TTS) on bleeding and on the endometrium. Design: This double-blind, randomized, multicenter, parallel, 1-year trial enrolled 266 healthy women at least 2 years past menopause with intact uteri. Patients received a transdermal patch delivering either 0.025 mg estradiol and 0.125 mg norethisterone acetate daily or placebo. Of the 266 women initially included, 135 (96 Estragest TTS, 39 placebo) completed a second year open follow-up, where all women had the estradiol/norethisterone patch. Endometrial biopsies were performed at weeks 0, 48 (n = 171), and 96 (n =109). Effects on endometrial morphology and uterine bleeding were studied. Results: The overall incidence of endometrial hyperplasia after treatment with the estradiol/norethisterone acetate patch for one year was 0.8% with only one case of atypical hyperplasia. There were no clinically significant changes in endometrial thickness in either treatment group. The proportion of bleed-free patients with the estradiol/norethisterone acetate transdermal system increased from 55% in cycles 1-3 to 83% in cycles 10-12. By the 12th cycle, 92% of patients receiving estradiol/norethisterone acetate patches were bleed-free. No additional hyperplasia was seen during the second year follow-up. Conclusions: A continuous combined transdermal patch delivering 0.025 mg estradiol/day and 0.125 mg norethisterone acetate/day provided good endometrial protection. The dose maintained a consistently high rate of amenorrhea in postmenopausal women.
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| 7. |
- Carrasquilla, Germán D, et al.
(författare)
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Does menopausal hormone therapy reduce myocardial infarction risk if initiated early after menopause? : A population-based case-control study
- 2014
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Ingår i: Menopause. - 1072-3714 .- 1530-0374. ; 22:6, s. 598-606
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study aims to assess whether the timing of menopausal hormone therapy initiation in relation to onset of menopause and hormone therapy duration is associated with myocardial infarction risk.METHODS: This study was based on the Stockholm Heart Epidemiology Program, a population-based case-control study including 347 postmenopausal women who had experienced a nonfatal myocardial infarction and 499 female control individuals matched for age and residential area. Odds ratios (with 95% CIs) for myocardial infarction were calculated using logistic regression.RESULTS: Early initiation of hormone therapy (within 10 y of onset of menopause or before age 60 y), compared with never use, was associated with an odds ratio of 0.87 (95% CI, 0.58-1.30) after adjustments for lifestyle factors, body mass index, and socioeconomic status. For late initiation of hormone therapy, the corresponding odds ratio was 0.97 (95% CI, 0.53-1.76). For hormone therapy duration of 5 years or more, compared with never use, the adjusted odds ratio was 0.64 (95% CI, 0.35-1.18). For hormone therapy duration of less than 5 years, the odds ratio was 0.97 (95% CI, 0.63-1.48).CONCLUSIONS: Neither the timing of hormone therapy initiation nor the duration of therapy is significantly associated with myocardial infarction risk.
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| 8. |
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| 9. |
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| 10. |
- Edwards, Hannaford, et al.
(författare)
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The many menopauses: Implications for research and clinical practice
- 2018
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Ingår i: Menopause. - : Lippincott Williams & Wilkins. - 1072-3714 .- 1530-0374. ; 26:1, s. 45-65
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Recent evidence suggests that early or induced menopause increases the risk for cognitive impairment and dementia. Given the potential for different cognitive outcomes due to menopause types, it is important that present research on menopause and cognition distinguishes between types. The aim of this project was to determine to what extent research looking at cognition in postmenopausal women published in one year, 2016, accounted for menopausal type.Methods: We searched MEDLINE, EMBASE, and PsychINFO using keywords and MeSH terms for menopause and cognition. We included any research paper reporting a cognitive outcome measure in a menopausal human population. Differentiation between the types of menopause was defined by four categories: undifferentiated, demographic differentiation (menopause type reported but not analyzed), partial differentiation (some but not all types analyzed), and full differentiation (menopause types factored into analysis, or recruitment of only one type).Results: Fifty research articles were found and analyzed. Differentiation was distributed as follows: undifferentiated, 38% (19 articles); demographic differentiation, 16% (8); partial differentiation, 28% (14); and full differentiation, 18% (9).Conclusions: This review revealed that although some clinical studies differentiated between the many menopauses, most did not. This may limit their relevance to clinical practice. We found that when menopause types are distinguished, the differing cognitive outcomes of each type are clarified, yielding the strongest evidence, which in turn will be able to inform best clinical practice for treating all women.
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| 11. |
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| 12. |
- Ganasarajah, Shamini, et al.
(författare)
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Objective measures of physical performance associated with depression and/or anxiety in midlife Singaporean women
- 2019
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Ingår i: Menopause. - : LIPPINCOTT WILLIAMS & WILKINS. - 1072-3714 .- 1530-0374. ; 26:9, s. 1045-1051
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: the aim of this study was to identify correlates of depression and anxiety in midlife Asian women, with a special focus on the potential role of objectively measured physical performance.Methods: Sociodemographic characteristics, reproductive health, menopause status, medical history, lifestyle choices, physical activity, and physical performance of healthy women aged 45 to 69 attending routine gynecologic care were collected. Depressive symptoms were assessed utilizing the Center for Epidemiologic Studies for Depression Scale (CES-D) and anxiety symptoms by the General Anxiety Disorder Scale (GAD-7). Upper body physical performance was assessed by handgrip strength, and lower body physical performance was assessed by the Short. Physical Performance Battery. Chi-square tests and multivariable models were used to assess the crude and adjusted associations, respectively, between the studied risk factors and depression and/or anxiety. The main outcome measures were elevated depressive symptoms >16 on the CES-D, and/or elevated anxiety symptoms >10 on the GAD-7 score.Results: Of 1,159 women (mean age 56.3 +/- 6.2), 181 (15.9%) were identified as having depressive and/or anxiety symptoms. Weak upper body (handgrip strength) and poor lower body strength (longer duration to complete the repeated chair stand test) were associated with elevated depressive and/or anxiety symptoms (adjusted odds ratio [aOR], 1.68; 95% CI, 1.18-2.40) and (aOR, 1.33; 95% CI, 1.09-1.63), respectively.Conclusions: Weak upper and lower body physical performances were associated with depressive and anxiety symptoms in midlife Singaporean women. Future trials are required to determine whether strengthening exercises that improve physical performance could help reduce depressive and anxiety symptoms in midlife women.
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| 13. |
- Gast, Gerrie-Cor M, et al.
(författare)
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Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease.
- 2011
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1530-0374 .- 1072-3714. ; 18, s. 146-151
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: Emerging evidence suggests that women with vasomotor menopausal symptoms (VMS) may have an adverse cardiovascular disease (CVD) risk profile. We investigated whether VMS are related to an increased risk of future coronary heart disease (CHD) and whether possible associations can be explained by CVD risk factors. METHODS:: Data used were from a Dutch and Swedish population-based sample of 10,787 women enrolled between 1995 and 2000, aged 46 to 64 years, and free of CVD at baseline. Data on VMS were collected by questionnaires. Body mass index and blood pressure were measured in all women, and total cholesterol levels were measured in a subgroup of the population. Multivariable Cox regression models were used to analyze the data. RESULTS:: After a mean ± SD follow-up period of 10.3 ± 2.1 years, 303 women were diagnosed with CHD. Symptoms of flushing were not associated with risk of CHD. However, the presence of night sweats was associated with a significantly modest increased risk of CHD, with a multivariable-adjusted hazard ratio of 1.33 (95% CI, 1.05-1.69). This association was attenuated but not eliminated after correction for body mass index, blood pressure, and total cholesterol (hazard ratio, 1.25; 95% CI, 0.99-1.58). CONCLUSIONS:: Women with menopausal symptoms of night sweats have a significantly moderately increased risk of CHD, which cannot be totally explained by the levels of CVD risk factors.
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| 14. |
- Gast, Gerrie-Cor, et al.
(författare)
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Vasomotor symptoms are associated with a lower bone mineral density.
- 2009
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1530-0374 .- 1072-3714. ; 16, s. 231-238
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: The severity of vasomotor symptoms has been hypothesized to be linked to a lower bone mineral density (BMD). We examined whether women with vasomotor symptoms are different from women without symptoms with regard to BMD. DESIGN:: We used data from a population-based sample of 5,600 women, aged 46 to 57 years and free from bone diseases, who participated in the first cross-sectional part of the Eindhoven Perimenopausal Osteoporosis Study between 1994 and 1995. Questionnaires at baseline were used to collect data on vasomotor symptoms and potential confounders. At baseline, BMD of the lumbar spine was measured using dual energy x-ray absorptiometry. Linear regression analysis was used to analyze the data. RESULTS:: Flushing was reported by 39% of all women, and night sweats, by 38% of all women. The average BMD was 1.01 +/- 0.14 g/cm and decreased with increasing frequency of flushing (P for trend < 0.0001) and night sweats (P for trend = 0.03). After multivariate adjustments for age, body mass index, menopause status, smoking, education, exercise, and hormone use, women with the highest frequency of symptoms had a 0.022 g/cm (95% CI, -0.03 to -0.01) lower BMD compared with asymptomatic women. Women who reported having the highest frequency of night sweats had a 0.011 g/cm (95% CI, -0.02 to -0.001) lower BMD compared with women with no symptoms of night sweats. CONCLUSIONS:: Our findings show that vasomotor symptoms are associated with reduced bone density. It could be hypothesized that women with vasomotor symptoms might be more susceptible to the beneficial effects of estrogens, possibly by neutralizing the effect of estrogen fluctuations. Further research is needed to extend these findings to other estrogen-sensitive end organs.
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| 15. |
- Hammar, Mats, et al.
(författare)
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The Effects of Physical Activity on Menopausal Symptoms and Metabolic Changes around Menopause
- 1995
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Ingår i: Menopause. - : Raven Press. - 1072-3714 .- 1530-0374. ; 2:4, s. 201-209
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Tidskriftsartikel (refereegranskat)abstract
- Perimenopausal women experience symptoms like hot flushes and night sweats, dyspareunia and urethritis, mood swings, and sleep disturbances. Furthermore, the decreasing ovarian steroid hormone production, including both 17 beta-estradiol and progesterone, affects several metabolic systems such as the turnover of bone tissue, lipoprotein metabolism, and also the direct estrogen effects on the vessel walls. Estrogen substitution treatment has been proven to counteract many of these symptoms and metabolic changes, but some women have medical contraindications for estrogen treatment while some other women prefer to avoid such treatment. There is thus a need for alternative treatment. Regular physical exercise counteracts some of the changes due to menopause. Thus, exercise protects against bone loss, changes in lipoprotein metabolism, hypertension, and may even decrease vasomotor symptoms. Exercise also has a positive impact on mental health. This article reviews data concerning the effects of exercise in peri- and postmenopausal women. Exercise may cause the same magnitude of change as that induced by estrogen therapy. Positive effects of exercise are influenced by other factors such as general awareness of lifestyle, diet, smoking habits. There is a need for long-term prospective, randomized studies before definitive conclusions can be drawn as to the benefits of exercise on well-being and various menopause and other age-related health factors.
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Järvstråt, Lotta, et al.
(författare)
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Use of hormone therapy in Swedish women aged 80 years or older
- 2015
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Ingår i: Menopause. - 1072-3714 .- 1530-0374. ; 22:3, s. 275-278
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Menopausal symptoms such as hot flashes and night sweats may persist for 10 to 20 years or even longer. Information about the extent to which older women use hormone therapy is limited. The aim of this study was to determine the use of hormone therapy in Swedish women aged 80 years or older.Methods: The study is based on national register data on dispensed drug prescriptions (ie, prescribed therapy that has been provided to individuals by pharmacies) for hormone therapy and local low-dose estrogens.Results: Of 310,923 Swedish women who were aged at least 80 years, 609 (0.2%) were new users of hormone therapy. A total of 2,361 women (0.8%) were current users of hormone therapy. The median duration of hormone therapy use in new users was 257 days (25th to 75th percentiles, 611-120 d). About one in six women aged 80 years or older had used local vaginal estrogen therapy for at least four 3-month periods. The drugs were mainly prescribed by gynecologists and general practitioners.Conclusions: Our results show that a number of women aged 80 years or older still use hormone therapy and that most women who started a new treatment period had only one or two dispensations despite the median duration of treatment being more than half a year. Because at least some of the women aged 80 years or older who used hormone therapy probably did so owing to persistent climacteric symptoms, vasomotor symptoms and hormone therapy are still relevant issues that need to be discussed when counseling women around and after age 80.
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| 20. |
- Kallak, Theodora Kunovac, 1985-, et al.
(författare)
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Aromatase inhibitors affect vaginal proliferation and steroid hormone receptors
- 2014
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Ingår i: Menopause. - : Lippincott Williams & Wilkins. - 1072-3714 .- 1530-0374. ; 21:4, s. 383-390
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Women with breast cancer who are treated with aromatase inhibitors often experience vaginal atrophy symptoms and sexual dysfunction. This work aims to study proliferation and the presence and distribution of steroid hormone receptors in vaginal biopsies in relation to vaginal atrophy and vaginal pH in women with breast cancer who are on adjuvant endocrine treatment and in healthy postmenopausal women.Methods: This is a cross-sectional study that compares postmenopausal aromatase inhibitor-treated women with breast cancer (n = 15) with tamoxifen-treated women with breast cancer (n = 16) and age-matched postmenopausal women without treatment (n = 19) or with vaginal estrogen therapy (n = 16). Immunohistochemistry was used to study proliferation and steroid hormone receptor staining intensity. Data was correlated with estrogen and androgen levels, vaginal atrophy scores, and vaginal pH.Results: Aromatase inhibitor-treated women had a lower grade of proliferation, weaker progesterone receptor staining, and stronger androgen receptor staining, which correlated with plasma estrone levels, vaginal atrophy scores, and vaginal pH.Conclusions: Women with aromatase inhibitor-treated breast cancer exhibit reduced proliferation and altered steroid hormone receptor staining intensity in the vagina, which are related to clinical signs of vaginal atrophy. Although these effects are most probably attributable to estrogen suppression, a possible local inhibition of aromatase cannot be ruled out.
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| 21. |
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| 22. |
- Khatibi Esfanjani, Ali, et al.
(författare)
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Nonhormonal drug use and its relation to androgens in perimenopausal women: a population-based study of Swedish women. The Women's Health in the Lund Area Study.
- 2009
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1530-0374 .- 1072-3714. ; 16, s. 315-319
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: To outline the prevalence of nonhormonal drug use in middle-aged women and to assess plausible associations between serum androgen levels and variables associated to health such as drug use and planned visits to healthcare units. METHODS:: This was a population-based study of women aged 50 to 59 years (n = 6,893). Women were divided into three groups according to their menopause status: premenopausal (PM), postmenopausal without hormone therapy (PM0), and postmenopausal with hormone therapy (PMT). Data regarding current drug use and healthcare visits were collected from a questionnaire. RESULTS:: The overall prevalence of nonhormonal drug use was 36.4% in all women. In the PM, PM0, and PMT groups, these percentages were 28.3%, 35.3%, and 39.3%, respectively, and the differences between them were statistically significant (P < 0.01). In all women, the most common medication used was for cardiovascular conditions (12.0%), followed by those for asthma (4.0%) and pain (3.7%). The number of drugs used by all women and women in the PM0 and the PMT groups were negatively associated with the serum levels of androstenedione (P < 0.05). In the postmenopausal groups, the number of visits to healthcare units was negatively associated to the levels of serum testosterone and androstenedione (P < 0.05). CONCLUSIONS:: Hormone therapy in postmenopausal women seems to be associated with increased use of nonhormonal pharmacotherapy, rendering higher prevalence of such drugs in middle-aged women. Postmenopausal women with lower serum testosterone and a higher number of office visits used medications for cardiovascular problems and depression more than other medications. Whether this is an effect related to the hormone therapy itself or to experiencing more perimenopausal symptoms in this group of women is still unclear.
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| 23. |
- Lindh-Astrand, Lotta, et al.
(författare)
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Effects of applied relaxation on vasomotor symptoms in postmenopausal women: a randomized controlled trial
- 2013
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Ingår i: Menopause. - : Lippincott, Williams and Wilkins. - 1072-3714 .- 1530-0374. ; 20:4, s. 401-408
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This work aimed to study the efficacy of group therapy with applied relaxation on vasomotor symptoms and health-related quality of life in postmenopausal women. less thanbrgreater than less thanbrgreater thanMethods: In this open, randomized controlled trial, 60 healthy postmenopausal women with at least seven moderate to severe hot flashes per 24 hours were randomized to either group therapy with applied relaxation (n = 33) or untreated control group (n = 27) for 12 weeks. A follow-up visit was scheduled 3 months after the end of therapy or participation in the control group. Salivary cortisol was measured three times during a 6-month period. Hot flashes were recorded in self-registered diaries, and health-related quality of life was assessed with the Womens Health Questionnaire. less thanbrgreater than less thanbrgreater thanResults: The number of hot flashes decreased by 5.0 per 24 hours in the applied relaxation group compared with 1.9 in the control group on the 12th week (P andlt; 0.001) and still remained at the same level at the 3-month follow-up (P andlt; 0.001). Health-related quality of life for vasomotor symptoms, sleep, and memory improved significantly on the 12th week measurement in the applied relaxation group compared with the control group. Salivary cortisol concentration was lowered markedly in the applied relaxation group on a single measurement but was otherwise mainly stable in both groups. less thanbrgreater than less thanbrgreater thanConclusions: Applied relaxation can be used to treat vasomotor symptoms in healthy postmenopausal women.
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| 24. |
- Lindh-Åstrand, Lotta, et al.
(författare)
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A randomized controlled study of taper-down or abrupt discontinuation of hormone therapy in women treated for vasomotor symptoms
- 2010
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 17:1, s. 72-79
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to investigate whether tapering down of combined estrogen plus progestogen therapy (EPT) reduced the recurrence of hot flashes and resumption of therapy compared with abrupt discontinuation. A secondary aim was to evaluate whether health-related quality of life (HRQoL) was affected after discontinuation of EPT and to investigate the possible factors predicting resumption of EPT. Methods: Eighty-one postmenopausal women undergoing EPT because of hot flashes were randomized to tapering down or abrupt discontinuation of EPT. Vasomotor symptoms were recorded in self-registered diaries, and resumption of hormone therapy (HT) was asked for at every follow-up. The Psychological General Well-being Index was used to assess HRQoL. Results: Neither the number nor the severity of hot flashes or HRQoL or frequency of resumption of HT differed between the two modes of discontinuation of EPT during up to 12 months of follow-up. About every other woman had resumed HT within I year. Women who resumed HT after 4 or 12 months reported more deteriorated HRQoL and more severe hot flashes after discontinuation of therapy than did women who did not resume HT. Conclusions: Women who initiate EPT because of hot flashes may experience recurrence of vasomotor symptoms and impaired HRQoL after discontinuation of EPT regardless of the discontinuation method used, abrupt or taper down. Because, in addition to severity of flashes, decreased well-being was the main predictor of the risk to resume HT, it seems important to also discuss quality of life in parallel with efforts to discontinue HT.
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| 25. |
- Lindh-Åstrand, Lotta, 1958-, et al.
(författare)
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Knowledge of reproductive physiology and hormone therapy in 53- to 54-year-old Swedish women
- 2007
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Ingår i: Menopause. - : Raven Press. - 1072-3714 .- 1530-0374. ; 14:6, s. 1039-1046
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate knowledge of hormone therapy (HT), reproductive physiology, and menopause in a population of 53- to 54-year-old women. Further aims were to determine whether the knowledge differed between users and nonusers of HT and between groups with different levels of education.Design: In 2003, all 53- and 54-year-old women (N = 1,733) in Linkoping, Sweden, were sent a questionnaire containing questions about reproductive physiology related to menopause and HT. Answers from 73% of the women were analyzed.Results: Swedish women had limited knowledge of HT, reproductive physiology, and menopause irrespective of HT use or educational level. Most of the women knew that hot flashes are common around menopause and decreasing estrogen production causes the menopause. They knew little about the effects of progestagens and the effects of HT on fertility. Women with low educational level were more likely to answer the questions by stating that they were unsure than did women with high educational level. Ever-users of HT knew more than never-users about risks and benefits of HT in relation to breast cancer and osteoporosis, and ever-users thought that the risks of thrombosis and myocardial infarction were lower than did never-users.Conclusions: Women need improved knowledge of the risks and benefits of HT as well as education about the reproductive system around menopause. This would probably better support and empower women to manage an important period of their lives.
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| 26. |
- Lindh-Åstrand, Lotta, et al.
(författare)
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Vasomotor symptoms usually reappear after cessation of postmenopausal hormone therapy : a Swedish population-based study.
- 2009
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Ingår i: Menopause (New York, N.Y.). - : Ovid Technologies (Wolters Kluwer Health). - 1530-0374 .- 1072-3714.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: The purpose of this study was to investigate the extent of reappearance of vasomotor symptoms after cessation of postmenopausal hormone therapy (HT) in women who started HT because of hot flashes. METHODS:: A cross-sectional postal survey was conducted. A validated questionnaire was sent to all women 53 to 54 years old living in Linköping, Sweden (n = 1,733), including questions about menopause, HT, and vasomotor symptoms. Pearson's chi test and logistic regression were used for statistical analyses. RESULTS:: Response rate after one reminder was 77.3%. After omitting incomplete answers, 72.9% remained for analysis. In all women, 319 (25.3%) were current users of HT, 242 (19.2%) were previous users, and 702 (55.6%) were never-users. Of the 242 previous users, 165 (69%) women stated that they had vasomotor symptoms before starting HT. Vasomotor symptoms recurred after cessation of HT in 143 (87%) of these 165 women. We found no significant difference in symptom recurrence in comparisons of the three groups based on usage of HT for 0 to 1, 2 to 4, or 5 years or more. CONCLUSIONS:: Most women who had vasomotor symptoms when they initiated HT reported recurrence of symptoms after cessation of HT (87%), although the flashes were usually reported to be less frequent and bothersome than they were before HT. Effective and safe treatment approaches for women with recurrence of vasomotor symptoms are needed.
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| 27. |
- Lindh-Åstrand, Lotta, et al.
(författare)
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Vasomotor symptoms usually reappear after cessation of postmenopausal hormone therapy
- 2009
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Ingår i: Menopause. - : Raven Press. - 1072-3714 .- 1530-0374. ; 16:6, s. 1213-1217
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to investigate the extent of reappearance of vasomotor symptoms after cessation of postmenopausal hormone therapy (HT) in women who started HT because of hot flashes.Methods: A cross-sectional postal survey was conducted. A validated questionnaire was sent to all women 53 to 54 years old living in Linkoping, Sweden (n = 1,733), including questions about menopause, HT, and vasomotor symptoms. Pearson's chi(2) test and logistic regression were used for statistical analyses.Results: Response rate after one reminder was 77.3%. After omitting incomplete answers, 72.9% remained for analysis. In all women, 319 (25.3%) were current users of HT, 242 (19.2%) were previous users, and 702 (55.6%) were never-users. Of the 242 previous users, 165 (69%) women stated that they had vasomotor symptoms before starting HT. Vasomotor symptoms recurred after cessation of HT in 143 (87%) of these 165 women. We found no significant difference in symptom recurrence in comparisons of the three groups based on usage of HT for 0 to 1, 2 to 4, or 5 years or more.Conclusions: Most women who had vasomotor symptoms when they initiated HT reported recurrence of symptoms after cessation of HT (87%), although the flashes were usually reported to be less frequent and bothersome than they were before HT. Effective and safe treatment approaches for women with recurrence of vasomotor symptoms are needed.
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| 28. |
- McInnes, Kerry J., et al.
(författare)
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Association of 11 beta-hydroxysteroid dehydrogenase type I expression and activity with estrogen receptor beta in adipose tissue from postmenopausal women
- 2012
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 19:12, s. 1347-1352
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Tidskriftsartikel (refereegranskat)abstract
- Objective: 11 beta-Hydroxysteroid dehydrogenase type I (11 beta HSD1) regenerates active cortisol from inert cortisone in adipose tissue. Elevated adipose tissue 11 beta HSD1 activity is observed in obese humans and rodents, where it is linked to obesity and its metabolic consequences. Menopause is also associated with increased abdominal fat accumulation, suggesting that estrogen is also important in adipose tissue metabolism. The purpose of this current study was to establish whether estrogen signaling through estrogen receptor alpha (ER-alpha) and estrogen receptor beta (ER-beta) could influence 11 beta HSD1 in premenopausal and postmenopausal adipose tissues. Methods: Nineteen premenopausal (aged 26 +/- 5 y; body mass index, 23.6 +/- 1.6 kg/m(2)) and 23 postmenopausal (aged 63 +/- 4 y; body mass index, 23.4 +/- 1.9 kg/m(2)) healthy women were studied. Subcutaneous adipose tissue biopsies and fasting venous blood samples were taken. Body composition was measured by bioelectrical impedance analysis. Human Simpson-Golabi-Behmel syndrome adipocyte cells were treated with ER-alpha- and ER-beta-specific agonists for 24 hours. Basic anthropometric data, serum 17 beta-estradiol and progesterone concentrations, ER-alpha and ER-beta messenger RNA (mRNA) levels, and 11 beta HSD1 mRNA, protein, and activity levels were assessed. Results: ER-beta and 11 beta HSD1, but not ER-alpha, mRNAs were significantly increased in adipose tissue from postmenopausal women compared with premenopausal women. ER-beta had a significant positive correlation with the mRNA level of 11 beta HSD1 in adipose tissue from premenopausal and postmenopausal women. This association between ER-beta and 11 beta HSD1 was greatest in adipose tissue from postmenopausal women. In human Simpson-Golabi-Behmel syndrome adipocytes, diarylpropiolnitrile, a selective ER-beta agonist, increased 11 beta HSD1 mRNA, protein, and activity levels. Conclusions: We conclude that, in adipose tissue, ER-beta-mediated estrogen signaling can up-regulate 11 beta HSD1 and that this may be of particular importance in postmenopausal women.
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| 29. |
- Montalcini, Tiziana, et al.
(författare)
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Carotid and brachial arterial enlargement in postmenopausal women with hypertension.
- 2012
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1530-0374 .- 1072-3714. ; 19:2, s. 145-149
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: The aim of this study was to test whether systemic hypertension influences brachial and carotid artery remodeling in postmenopausal women. A secondary aim was to evaluate the possible role of pulse pressure. METHODS:: We enrolled 100 postmenopausal women affected by hypertension (cases) and 100 women with blood pressure within the reference range (controls) matched for age and body mass index because the influence of these variables on artery diameter is well known. Clinical and biochemical parameters were also assessed. All women underwent B-mode ultrasonography to measure the carotid and brachial artery diameter. RESULTS:: The case group had significantly larger brachial and common carotid artery diameters than control groups (P < 0.001). This result did not change after correction for confounding variables. Indeed, the women with hypertension had higher glucose and insulin levels and greater carotid atherosclerosis prevalence than did the control population. A multivariate linear regression analysis showed a correlation between artery diameters and hypertension status in the whole population. To evaluate the influence of pulse pressure, each group (cases and controls) was divided into two subgroups, according to the group-specific pulse pressure median. The women with a pulse pressure rate higher than the median value had larger artery diameters compared with those with lower pulse pressure rates in both groups with and without hypertension. CONCLUSIONS:: Hypertension can promote generalized artery enlargement, and pulse pressure also plays a role in artery remodeling. Interestingly, pulse pressure seems to influence arterial diameter in individuals with blood pressure within the reference range. The role of hypertension in artery remodeling behind age and the body mass index requires further investigations on the mechanisms underlying remodeling.
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| 30. |
- Mueck, Alfred, et al.
(författare)
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Low-dose continuous combinations of hormone therapy and biochemical surrogate markers for vascular tone and inflammation: transdermal versus oral application.
- 2007
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1530-0374 .- 1072-3714. ; 14:6, s. 978-984
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the effects of low-dose transdermal estradiol (E2)/norethisterone acetate (NETA) patches (Estalis 25/125) with low-dose oral E2/NETA (Activelle) on cardiovascular biochemical markers after 12 and 52 weeks of treatment in postmenopausal women with intact uteri. Design: Participants were randomly assigned to receive either transdermal E2/NETA (delivering daily doses of 25 [mu]g E2 and 125 [mu]g NETA, applied every 3-4 d) or oral E2/NETA (1 mg E2 and 0.5 mg NETA, given daily) in this open-label study. The following markers or their stable metabolites in serum or urine were assessed: P-selectin, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, monocyte chemoattractant protein-1, matrix metalloproteinase-9, homocysteine, cyclic guanosine monophosphate, serotonin, prostacyclin, thromboxane, and urodilatin. Results: Significant decreases were found for P-selectin, intercellular adhesion molecule-1, monocyte chemoattractant protein-1, and homocysteine for both hormone therapy (HT) regimens compared with baseline. Matrix metalloproteinase-9 was increased only by oral HT. The urinary concentrations of cyclic guanosine monophosphate, the ratio of prostacyclin to thromboxane metabolite, and the serotonin metabolite were significantly increased for both HT application modes, although the oral treatment showed a significantly greater increase than the transdermal one with respect to baseline. Urodilatin excretion was increased only by the oral regimen. Conclusions: Low-dose transdermal and oral HTs using E2 and NETA elicit favorable effects on cardiovascular biochemical markers. For most markers the magnitude of changes found were similar with respect to baseline; however, in some cases oral HT led to a significantly greater change, whereas in other cases the transdermal formulations seemed to provide greater benefits. Whether these differences may be attributed to the different administration routes or to different pharmacokinetic properties remains an open question. Overall low-dose transdermal HT seems to provoke the same benefit on the cardiovascular system as oral HT, as suggested by the results on vascular markers.
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| 31. |
- Möller, Marika C, et al.
(författare)
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Effects of testosterone and estrogen replacement on memory function
- 2010
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 17:5, s. 983-989
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Testosterone insufficiency has been associated with psychosexual problems, reduced psychological well-being, and negative metabolic consequences, whereas less is known about the effects on cognition. The aim of this study was to investigate the effect of adding testosterone to estrogen therapy on memory functions in oophorectomized women.METHODS:In a randomized, double-blind, placebo-controlled design, women with surgically induced menopause (n = 50; mean [SD] age, 54.0 [2.9] y) received estradiol valerate in combination with testosterone undecanoate or placebo. The women were assessed with a self-report questionnaire regarding memory and neuropsychological tests for verbal and spatial episodic memory and incidental learning at baseline, at the time of crossover, and after completion of treatment.RESULTS:Testosterone undecanoate 40 mg added to estrogen therapy had a negative effect on immediate but not delayed verbal memory at 24 weeks. Subjective and objective memory showed some correspondence as the women in the estrogen + placebo treatment group rated decreased everyday memory problems at 24 weeks compared with baseline. This was not observed in the women in the estrogen + testosterone treatment. Verbal attention span deteriorated from baseline with estrogen + placebo treatment but not with the estrogen + testosterone treatment. However, there was no significant treatment effect between the two groups.CONCLUSIONS:Adding testosterone to estrogen treatment deteriorated immediate verbal memory compared with estrogen + placebo, while other memory functions were unaffected.
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| 32. |
- Naessen, Tord, et al.
(författare)
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Early postmenopausal hormone therapy improves postural balance
- 2007
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 14:1, s. 14-19
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Postmenopausal hormone therapy (HT) results in more substantial reductions in the risk of hip fracture when initiated sooner rather than later after menopause. We studied the effects of postmenopausal HT on the postural balance of postmenopausal women, with further assessment according to the time since they achieved menopause. Design: One hundred women with a mean age of 52.5 years (91 evaluable) were randomly and blindly assigned to either a sequential estradiol-norethisterone acetate regimen or placebo for 3 months, after which all participants received open HT for a further 3 months. Postural balance was assessed as sway velocity using a force platform. Results: After 3 months of HT, sway velocity had improved (decreased) from baseline by 7.0% (P = 0.007 vs baseline and P = 0.038 vs placebo). Continued HT for 6 months further improved sway velocity by 12% from baseline (P < 0.0001) to reach values similar to those historically found in younger women or in postmenopausal women after long-term HT. Closer proximity to menopause and more pronounced increases in serum estradiol values were associated with stronger improvements in sway velocity (P = 0.018 for interaction). HT also improved dizziness (P = 0.016 vs baseline and 0.022 vs placebo). (Nonparametric statistics are used throughout, except for analyses of interaction and dizziness.) Conclusions: Initiation of HT soon after menopause rapidly improved postural balance to levels normally seen in young women. We suggest that improved postural balance can contribute to the protection against fractures associated with HT and explain the more substantial reduction in hip fracture risk after HT initiated sooner, compared with later, after menopause. Further study is required to confirm these results.
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| 33. |
- Naessén, Tord, et al.
(författare)
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Higher endogenous estrogen levels in 70-year-old women and men : an endogenous response to counteract developing atherosclerosis?
- 2012
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 19:12, s. 1322-1328
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Reported associations between endogenous steroid hormone levels and cardiovascular disease in the older population have been contradictory. We evaluated plasma steroid concentrations in terms of the dimensions of the common carotid artery wall layers as a measure of the extent of atherosclerosis.METHODS:A subgroup of 70-year-old participants (32 women and 50 men) from the Prospective Investigation of the Vasculature in Uppsala Seniors study was investigated. All participants had assessments of common carotid artery wall layer parameters (intima thickness, media thickness, and intima-media thickness [IMT] ratio; measured by high-frequency ultrasound at 22 MHz) and endogenous steroid hormone concentrations (measured by liquid chromatography-tandem mass spectrometry).RESULTS:Low androgen levels, high aromatase enzyme activity (estrone [E1]/androstenedione and estradiol [E2]/testosterone), high E2/E1 ratio, and high estrogen levels (E1, E2, estriol, and E2/sex hormone-binding globulin) were consistently associated (often significantly) with a more unhealthy artery wall (thick intima, thin media, and high IMT ratio) in both sexes. Consistently strong associations were found between the aromatase index E2/testosterone and intima, media, and the IMT ratio. For IMT ratio, in both men (rs = 0.52) and women (rs = 0.58), P was <0.001 for both and remained significant after adjustment for cardiovascular disease risk factors and the Framingham risk score (both P < 0.01).CONCLUSIONS:Low androgens, high aromatase enzyme activity, and high estrogen levels are often significantly associated with an unhealthy artery wall on ultrasound. We suggest that the steroid hormone profile of older individuals with higher estrogens most probably reflects an endogenous response to developing atherosclerosis, rather than a cause-and-effect relationship. However, the reverse causality cannot be excluded.
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| 34. |
- Naessen, Tord, et al.
(författare)
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Hormone therapy and postural balance in elderly women
- 2007
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 14:6, s. 1020-1024
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Most fractures occur in elderly individuals without osteoporosis, and more than 90% of all hip fractures are associated with a fall. It is unclear whether hormone therapy (HT) can improve postural balance when initiated in elderly women and the effect of endogenous estradiol (E2) levels. Design: Forty healthy women (33 assessable), age 60 years or older, were recruited through advertising in the local media. They were randomly and blindly assigned to receive either estradiol patches (50 μg/24 h) combined with oral medroxyprogesterone acetate (2.5 mg/d) or placebo for 6 months. Postural balance was assessed as sway velocity using a force platform. Results: Low serum E2 levels were associated with greater impairment of sway velocity during the study in the placebo group. After 6 months sway velocity had improved (decreased) in the HT group by 4.3% from baseline and increased in the placebo group by 6.2%. The difference was not significant (1.30 cm/s, 95% CI: -3.0 to 0.4; P = 0.13). However, among women with low serum E2 levels at baseline (less than the median, 35 pmol/L), sway velocity improved in the HT group and deteriorated in the placebo group with a difference of 23% (2.9 cm/s, 95% CI: 0.6-5.1; P = 0.013). There were similar results after adjustment for baseline sway velocity (P = 0.003) and in the intention-to-treat analysis (P = 0.023). There was also a significant interaction between the study group and baseline serum E2 levels with regard to changes in sway velocity (P = 0.014). Conclusions: In elderly women low endogenous serum E2 levels were associated with greater impairment of postural balance function during the study, whereas HT, as compared with placebo, improved postural balance in women with low serum E2 levels.
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| 35. |
- Naessen, Tord
(författare)
-
Untitled - In reply
- 2007
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 14:4, s. 808-809
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Tidskriftsartikel (refereegranskat)
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| 36. |
- Najar, Jenna, 1990, et al.
(författare)
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Reproductive period and preclinical cerebrospinal fluid markers for Alzheimer disease: a 25-year study
- 2021
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Ingår i: Menopause-the Journal of the North American Menopause Society. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714. ; 28:10, s. 1099-1107
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to examine the association between reproductive period, as an indicator of endogenous estrogen, and levels of cerebrospinal fluid (CSF) biomarkers for Alzheimer disease (AD). Methods: A population-based sample of women from Gothenburg, Sweden was followed from 1968 to 1994 (N = 75). All women had natural menopause and were free from dementia. Information on reproductive period (age at menarche to age at menopause) was obtained from interviews from 1968 to 1980. Lumbar puncture was performed from 1992 to 1994 and CSF levels of A beta 42, A beta 40, P-tau, and T-tau were measured with immunochemical methods. Linear regression models adjusted for potential confounders were used to analyze the relationship between reproductive period and CSF biomarkers for AD. Results: Longer reproductive period was associated with lower levels of A beta 42 (beta = -19.2, P = 0.01), higher levels of P-tau (beta = 0.03, P = 0.01), and lower ratio of A beta 42/A beta 40 (beta = -0.02, P = 0.01), while no association was observed for T-tau (beta = 0.01, P = 0.46). In separate analyses, examining the different components of reproductive period, earlier age at menarche was associated higher levels of P-tau (beta = -0.07, P = 0.031) and lower ratio of A beta 42/A beta 40 (beta = 0.05, P = 0.021), whereas no association was observed with A beta 42 (beta = 31.1, P = 0.11) and T-tau (beta = -0.001, P = 0.98). Furthermore, no association was observed between age at menopause and CSF biomarkers for AD. Conclusions: Our findings suggest that longer exposure to endogenous estrogen may be associated with increased levels of AD biomarkers in the preclinical phase of AD. These findings, however, need to be confirmed in larger samples.
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| 37. |
- Rahman, Iffat, et al.
(författare)
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Relationship between age at natural menopause and risk of heart failure
- 2015
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Ingår i: Menopause. - : LIPPINCOTT WILLIAMS & WILKINS. - 1072-3714 .- 1530-0374. ; 22:1, s. 12-16
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We investigated whether younger age at natural menopause confers a risk of heart failure. We also examined a possible modifying effect of tobacco smoking. Methods: This study used the population-based Swedish Mammography Cohort; 22,256 postmenopausal women with information on age at natural menopause were followed from 1997 through 2011. First event of heart failure was ascertained through the Swedish National Patient Register and the Cause of Death Register. Cox proportional hazards regression analyses were conducted to estimate multivariable-adjusted hazard ratios (HRs) and 95% CIs. Results: During a mean follow-up of 13 years, we ascertained 2,532 first events of heart failure hospitalizations and deaths. The mean age at menopause was 51 years. Early natural menopause (40-45 y), compared with menopause at ages 50 to 54 years, was significantly associated with heart failure (HR, 1.40; 95% CI, 1.19 to 1.64). In analyses stratified by smoking status, similar HRs were observed for this age group among never smokers (HR, 1.33; 95% CI, 1.06 to 1.66) and ever smokers (HR, 1.39; 95% CI, 1.09 to 1.78). Among ever smokers, increased incidence (HR, 1.25; 95% CI, 1.06 to 1.47) of heart failure could be detected even among those who entered menopause at ages 46 to 49 years. We found a significant interaction between age at natural menopause and smoking (P = 0.019). Conclusions: This study indicates that women who experience early natural menopause are at increased risk for developing heart failure and that smoking can modify the association by increasing the risk even among women who enter menopause around ages 46 to 49 years.
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| 38. |
- Ribom, Eva L., et al.
(författare)
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Low-dose tibolone (1.25 mg/d) does not affect muscle strength in older women
- 2011
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 18:2, s. 194-197
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: More than 50% of all fractures occur in people without osteoporosis. Hormone therapy increases bone density, improves postural balance, and reduces fracture risk in postmenopausal women. It is unclear whether tibolone, a synthetic steroid hormone drug, can improve muscle strength. Thus, the aim of this study was to study the effects of low-dose tibolone therapy on muscle strength in older women. METHODS:: Eighty healthy women (69 completed the study) 60 years or older were recruited through advertising in the local media. They were randomly allocated to receive either tibolone 1.25 mg/day or placebo for 6 months. The stand-up test was used to assess leg muscle strength and balance. Handgrip and leg muscle strength were measured using JAMAR and modified Cybex dynamometers. RESULTS:: Baseline characteristics, including serum estradiol values and muscle strength, were similar in the two groups. Compliance with the therapy regimen was very high, averaging more than 97% in both groups. After 6 months, mean values for handgrip strength, knee extensor strength, and average time to perform 10 stands were improved numerically in both groups compared with values during baseline. However, there were no significant differences in these parameters within or between groups, and differences remained nonsignificant after adjustment for age, serum estradiol, and baseline value. CONCLUSIONS:: Short-term treatment with low-dose tibolone (1.25 mg/d) seems not to affect muscle strength in older women.
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| 39. |
- Rödström, Kerstin, 1953, et al.
(författare)
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Is it possible to investigate menopausal age? A comparative cross-sectional study of five cohorts between 1968 and 2017 from the Population Study of Women in Gothenburg, Sweden.
- 2020
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Ingår i: Menopause (New York, N.Y.). - 1072-3714 .- 1530-0374. ; 27:4, s. 430-436
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine if the previously found trend of increasing menopausal age is continuing, taking into consideration hormonal use and surgical menopause in both 38- and 50-year-old women of today.Cohort comparisons of five generations of population-based samples of 38- and 50-year-old women from the Prospective Population Study of Women in Gothenburg with start in 1968/1969, and with follow-ups in 1980/1981, 1992/1993, 2004/2005, and 2016/2017. Across the time periods newly recruited women as well as earlier participants were included. Use of hormonal contraceptives, estrogen plus progestogen therapy (EPT), and time for menopause was registered. Changes between different generations of 38- and 50-year-old women from 1968/1969 until today were studied. The overall sample size across the time periods was 1,873 individuals.The prevalence of oral contraceptives in 38-year-old women was about 10% in 1968/1969, increasing from 16% in 2004/2005 to almost 22% in 2016/2017. From 2004/2005 the use of hormonal intrauterine contraceptive method (the Levonorgestrel-releasing intrauterine system [LNG-IUS]) increased from about 11% to 14% in 2016/2017. The same pattern was found in 50-year-old women using LNG-IUS, increasing from 6% to 15.5% between 2004/2005 and 2016/2017. The total hormonal use, including LNG-IUS, oral contraceptives, and EPT, was 28% in 50-year-old women in 2016/2017. The total proportion of hormone use in 50-year-old women increased over the years and together with surgical menopause it reached over 37% in the 2016/2017 survey.This study has shown an increase in the hormonal use, in both 38- and 50-year-old women, making it difficult to determine when the actual menopause occurs. Thus, the previously found increasing secular trend in menopausal age will be more complicated to assess in female generations of today and tomorrow.
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| 40. |
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| 41. |
- Spetz, Anna-Clara, 1973-, et al.
(författare)
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Hot flushes in a male population aged 55, 65, and 75 years, living in the community of Linköping, Sweden
- 2003
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 10:1, s. 81-87
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Hot flushes are as common in castrated men as in menopausal women. We investigated whether hot flushes exist in a normal aging male population and to what extent.DESIGN:A questionnaire was sent to all men living in Linköping, Sweden, who were 55, 65, and 75 years old ( = 1,885). The questionnaire asked for demographic data, medical history, mood status, medication, castrational therapy, and smoking, exercise, and alcohol habits, among other items. We asked specifically for current hot flushes unrelated to exercise or a warm environment.RESULTS:Of the questionnaires received, 1,381 were eligible for evaluation; 33 were analyzed separately because these men had been castrated. Hot flushes of any frequency were reported by 33.1% of noncastrated men, 4.3% reported flushes at least a few times per week, and 1.3% reported daily flushes. Half of the men reporting flushes were also bothered by them, ie, almost every sixth man in total. We found a relation between occurrence of hot flushes and other symptoms thought to be related to low testosterone concentration, such as decreased muscle strength or endurance, decreased enjoyment of life, sadness or grumpiness, and lack of energy ( < 0.05).CONCLUSIONS:Hot flushes occur in one third of a population of noncastrated older men, approximately half of whom consider flushes as bothersome. Neither the mechanisms nor whether the symptoms would respond to testosterone supplementation is known. Androgen substitution to treat symptoms possibly related to a male climacteric is still controversial. Studies are needed to evaluate the needs for and the effects of androgen treatment on vasomotor symptoms.
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| 42. |
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| 43. |
- Spetz, Anna-Clara, et al.
(författare)
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Prevalence of symptoms in relation to androgen concentrations in women using estrogen plus progestogen and women using estrogen alone
- 2009
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Ingår i: MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 16:1, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Women using estrogen plus progestogen therapy sometimes report difficult to describe symptoms, eg, changes in libido, mood, and memory, that may be related to decreased androgens. To evaluate the prevalence or such symptoms and relate these symptoms to androgen levels ill women using estrogen plus progestogen therapy, data from the Womens Health in the Lund Area Study were analyzed.Design: A total of 2,816 women using estrogen plus progestogen therapy were asked to complete a questionnaire consisting of questions concerning sexual well-being and different aspects of quality of life. Serum concentrations of testosterone, androstendione, sex lion-none-binding globulin, and estradiol were measured.Results: A total of 2,048 questionnaires were eligible for evaluation. Almost 40% of the women reported decreased libido. Approximately 70% were satisfied with their current sex life. Eight percent reported that intercourse was unpleasant because of vaginal dryness. No evident associations were found between libido and serum hormone concentrations. The most positive effects of estrogen plus progestogen therapy concerning memory and urinary tract and vaginal complaints were found in women with the highest and/or moderate testosterone levels (P < 0.05).Conclusions: We found no strong association between symptoms related to sexual well-being or quality of life and androgen concentrations in this study. Estrogen plus progestogen therapy did not seem to affect
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| 44. |
- Spetz, Anna-Clara, 1973-, et al.
(författare)
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Testosterone correlated to symptoms of partial androgen deficiency in aging men (PADAM) in an elderly Swedish population
- 2007
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 14:6, s. 999-1005
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the prevalence of different symptoms of partial androgen deficiency in aging men (PADAM) and to correlate them with blood concentrations of testosterone and bioavailable testosterone. DESIGN: A total of 370 men, aged 55 to 75 years, were invited to one of three primary healthcare centers in Sweden. They were asked to complete a questionnaire regarding demographic data, medical history, mood status, medication, castration therapy and smoking, exercise and alcohol habits, as well as different symptoms of PADAM. The 10 questions from a previously used questionnaire (the ADAM questionnaire) were included. The men were offered blood tests for analyses of testosterone, follicle stimulating hormone, luteinizing hormone, steroid hormone-binding globulin, and albumin. From these test results, we calculated the bioavailable testosterone. RESULTS: Of the questionnaires sent out, 81.6% were returned and eligible for evaluation. Blood samples were obtained from 85.8% of men answering the questionnaire. Many of the symptoms, including five from the ADAM questionnaire, were more common in older age groups (P < 0.05). Three symptoms, deterioration in work performance, decreased strength and/or endurance, and bothersome hot flushes, were associated with low bioavailable testosterone and/or testosterone (P < 0.05). Testosterone and bioavailable testosterone did not differ between age groups, but bioavailable testosterone was higher in men with three or fewer symptoms on the ADAM questionnaire. CONCLUSIONS: Symptoms associated with PADAM often occur in an elderly population, but we could only find an association between three symptoms and blood testosterone concentrations, one being bothersome hot flushes. It is likely that these symptoms have a more complex background than only PADAM. ©2007The North American Menopause Society.
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| 45. |
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| 46. |
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| 47. |
- Waidyasekera, Himansu, et al.
(författare)
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Menopausal symptoms and quality of life during the menopausal transition in Sri Lankan women
- 2009
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 16:1, s. 164-70
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the prevalence of menopausal symptoms in a population of Sri Lankan women and the relationship with their health-related quality of life. DESIGN: A community-based, cross-sectional study was conducted on 683 women ages 45 to 60 years living in the district of Colombo, Sri Lanka. A cluster sampling method was used for recruitment of the sample. Information was collected on demographic, socioeconomic, menstrual, and reproductive history using structured interviews. The Menopause Rating Scale was used to assess menopausal symptoms and the Short Form 36 health survey was used to assess the health-related quality of life. RESULTS: Of the sample, 59.4% were postmenopausal and 18.4% were perimenopausal; 90% of the sample had one or more menopausal symptoms. The most prevalent menopausal symptoms were joint and muscular discomfort (74.7%), physical and mental exhaustion (53.9%), and hot flushes (39.1%). Hot flushes, sleep problems, and joint/muscular discomfort showed an increase in prevalence from the premenopausal category to the postmenopausal category (P < 0.05 for all). Chronic illness in the women was significantly associated with the presence of menopausal symptoms (P < 0.01). Women with menopausal symptoms had significantly lower (P < 0.05) quality-of-life scores in most of the domains of the Short Form 36 compared with women without symptoms. CONCLUSIONS: The majority of these Sri Lankan women reported one or more menopausal symptom. Chronic illness was significantly associated with these symptoms. The presence of menopausal symptoms was significantly associated with a decreased health-related quality of life in the women.
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| 48. |
- Wyon, Yvonne, 1960-, et al.
(författare)
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Concentrations of Calcitonin Gene-Related Peptide and Neuropeptide Y in Plasma Increase During Flushes in Postmenopausal Women
- 2000
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Ingår i: Menopause. - 1072-3714 .- 1530-0374. ; 7:1, s. 25-30
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess whether the plasma concentrations of calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), or neurokinin A (NKA) increase during hot flushes in postmenopausal women with vasomotor symptoms.Design: Eight postmenopausal women (age range = 49-63 years) with vasomotor symptoms were included. During 1 day, repeated blood samples were taken between and during flushes; four samples were taken during each flush. The samples were analyzed for CGRP, NPY, and NKA using radioimmunoassay technique.Results: The serum concentrations of CGRP and NPY increased significantly-73% and 34%, respectively-during the flushes (p = 0.018; p = 0.028), whereas the concentrations of NKA did not change significantly.Conclusions: CGRP and NPY may be involved in the mechanisms that cause vasomotor symptoms.
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| 49. |
- Wyon, Yvonne, et al.
(författare)
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Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women
- 1995
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Ingår i: Menopause. - 1072-3714 .- 1530-0374. ; 2:1, s. 3-12
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Tidskriftsartikel (refereegranskat)abstract
- Most perimenopausal women suffer from vasomotor symptoms. Changes in central opioid activity have been proposed to be involved in the mechanisms of hot flushes after menopause. Because acupuncture increases central opioid activity, it may affect postmenopausal hot flushes. The aim was to study if and to what extent two different kinds of acupuncture affected postmenopausal hot flushes, urinary excretion of certain neuropeptides, and quality of life in a group of postmenopausal women. Twenty-four women with natural menopause and hot flushes were included. Twenty-one women completed the study. One group was randomized to electroacupuncture at 2 Hz, whereas the other group was treated with another form of acupuncture (i.e., superficial needle insertion) for a total of 8 weeks. All women daily registered the number and severity of flushes from 1 month before to 3 months after treatment. They completed Quality of Life questionnaires before, during, and after treatment. Twenty-four-hour urine was sampled before, during, and after treatment and analyzed for neuropeptides using radioimmunoassay methods. The number of flushes decreased significantly by >50% in both groups and remained decreased in the group receiving electroacupuncture, whereas in the superficial-needle-insertion group, the number of flushes increased again during the 3 months after treatment. The Kupperman Index decreased significantly in both groups during and after treatment. The excretion of the potent vasodilating neuropeptide calcitonin gene-related peptide-like immunoreactivity decreased significantly during treatment. Acupuncture significantly affects hot flushes and sweating episodes after menopause, with effects persisting at least 3 months after the end of treatment. Changes in calcitonin gene-related peptide, which is a very potent vasodilator, could be involved in the mechanisms behind hot flushes.
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