| 1. |
- Asplund, Ragnar, et al.
(author)
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Nocturia and health in women aged 40-64 years
- 2000
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 35:2, s. 143-148
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Journal article (peer-reviewed)abstract
- To analyse the relationship between nocturnal micturition and health in 40- to 64-year-old women. A questionnaire study was carried out in 3669 randomly selected women (out of 6000 invited) in the County of Jamtland, Sweden. Questions were asked about the general health status of health, health development during the last 5 years, nocturnal micturition, parity, menstrual status, menopausal symptoms, hormone replacement therapy, cardiac diseases, diabetes and snoring. Poor health was reported by 10.4%. In 24.1% of the women health development had been unfavourable in the last 5 years. Poor health was reported by 4.7% of women without nocturnal micturition, and by 11.2, 20.1 and 39.0% (P < 0.0001) of women with one, two, and three or more nocturnal voiding episodes, respectively. In a multiple logistic regression analysis significant independent correlates of health were: one versus no nocturnal micturitions (odds ratio [OR] 2.2; confidence interval [CI] 1.5-3.3), two versus none (OR 3.2; 1.9-5.3), and three or more versus none (OR 6.5; 3.5-11.9), spasmodic chest pain (OR 6.6: CI 3.0-14.5)), irregular heart beats (OR 3.0; CI 2.1-4.3), diabetes (OR 5.1; CI 2.8-9.4), leg oedema greater than or equal to 6 days/month versus < 6 days/month (OR 23; CI 1.6-3.3), snoring: less than or equal to 3 times/week versus never (OR 1.4; CI 1.0-2.0), snoring 4-7 times/week versus never (OR 1.6; CI 1.1-2.2), being (5 years after versus bring before the menopause (OR 1.6; 95% CI 1.0-2.5), 5-9 years after versus before the menopause (OR 1.7; CI 1.0-2.9), greater than or equal to 10 years after versus before the menopause (OR 2.2; CI 1.3-3.7), diuretic treatment (OR 2.8; CI 1.7-4.6). The perceived state of health in 40- to 64- year-old women is profoundly affected by nocturia, independently of heart diseases, diabetes, snoring, age and menopausal status.
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| 2. |
- Björn, Inger, 1953-, et al.
(author)
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Drug related negative side effects is a common reason for poor compliance in hormone replacement therapy
- 1999
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In: Maturitas. - : Elsevier. - 0378-5122 .- 1873-4111. ; 32:2, s. 77-86
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Journal article (peer-reviewed)abstract
- Objectives: The reasons for poor compliance with hormone replacement therapy (HRT) and, in particular drug-related reasons, have not yet been fully elucidated. In this study, a cohort of peri- or postmenopausal women—mainly workers from a small town and surrounding rural area—was studied. The aim of the study was to investigate why some women never start or discontinue HRT, even when great effort has been made to inform and fulfill the demands of the patient. Methods: All women who were given a HRT prescription at a gynecological practice between September 1991 and December 1992 participated in a longitudinal study. A written questionnaire was mailed to these patients in 1996. Data from the questionnaire was supplemented with information from the medical records. Care of patients included initial information, follow-up within 4 months, yearly visits supplemented with contacts on demand. Results: 356 women received the questionnaire, among which 92% replied. A total of 2% never started HRT. Seventy-five percent continued the therapy for more than 3 years. Reasons for discontinuing HRT were negative side-effects (35%), desire to find out if climacteric symptoms had ended (26%), fear of cancer and thrombosis (25%), weariness of bleeding (19%) and a wish to deal with the problems ‘naturally’ (15%). Conclusions: Compliance with HRT can be high if adequate information is given and follow-ups are made. The main reason for poor compliance was negative side-effects, most likely progestin-related. The results of this study suggest that the future challenge will be to minimize negative side-effects of HRT.
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| 3. |
- Granberg, S, et al.
(author)
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The effects of oral estriol on the endometrium in postmenopausal women
- 2002
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 42:2, s. 149-156
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Journal article (peer-reviewed)abstract
- Objectives: To study the long-term effects of oral estriol tablets on the endometrium of postmenopausal women by TVS and histology. Method: This was a cross sectional, parallel-group, multicenter trial of 241 postmenopausal women, out of whom 125 were treated with oral estriol and 116 were untreated controls. Endometrial histology using Pipelle biopsies and/or dilatation and curettage (D&C) was taken, endometrial thickness was assessed by use of transvaginal ultrasound (TVS), and the relation between endometrial thickness and histology was calculated. Results: No statistically significant differences between the two groups were found in endometrial histology. There were found more polyps in the oral estriol group (14.0%) as compared with the control group (2.9%). The mean endometrial thickness in the oral estriol group was 3.0 mm compared with a mean value of 2.4 mm in the control group: P=0.01. Conclusions: No clinically relevant difference was found between the endometrium status (assessed by histology and TVS) of postmenopausal women on long-term oral estriol therapy and untreated controls. This trial supports the endometrial safety of maintenance treatment with oral estriol tablets. However, there are signs, not statistically significant, that may be associated with more endometrial polyps in postmenopausal women than if therapy is not given and that TVS is a useful instrument for the diagnosis. ⌐ 2002 Elsevier Science Ireland Ltd. All rights reserved.
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| 4. |
- Hammar, Mats, 1950-, et al.
(author)
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Few oligo-amenorrheic athletes have vasomotor symptoms
- 2000
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 34:3, s. 219-225
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Journal article (peer-reviewed)abstract
- Objective: To assess whether women with athletic oligo-amenorrhea have vasomotor symptoms. Material and methods: A mailed questionnaire was sent to 252 female athletes about vasomotor symptoms. Identical questions were also mailed to 1523 peri- and postmenopausal women. Results: The prevalence of vasomotor symptoms was low in female athletes with oligo- and amenorrhea and similar to that found in athletes with regular menstruations. The prevalence was significantly lower than in menopausal women. Although more than a third of the menopausal women had hormone replacement therapy, 30% of them still had vasomotor symptoms at least every week compared with only 2% of the oligo-amenorrheic athletes. Conclusion: Vasomotor symptoms are very uncommon in oligo-amenorrheic athletes, although many of them are hypoestrogenic. It was suggested that one factor contributing to these symptoms around menopause is low hypothalamic activity of ▀-endorphins, which makes the thermoregulatory centre labile. On the other hand, supraphysiological activity in hypothalamic ▀-endorphins may cause the oligo-amenorrhea in athletes, but may stabilise the thermoregulatory centre and thus prevent hot flushes. (C) 2000 Elsevier Science Ireland Ltd.
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| 5. |
- Hammar, M., et al.
(author)
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Hormone replacement therapy and previous use of oral contraceptives among Swedish women
- 1996
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In: Maturitas. - : Elsevier. - 0378-5122 .- 1873-4111. ; 25:3, s. 193-199
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Journal article (peer-reviewed)abstract
- Objectives: To assess the current and previous use of hormone replacement therapy (HRT) and alternative remedies in a postmenopausal population and to relate HRT use to previous use of oral contraceptives.Material and methods: All 1323 women living in Linkoping of 55 or 56 years old during 1995 were sent a questionnaire asking for data with relation to health and climacteric symptoms as well as to previous and current use of HRT, oral contraceptives and alternative remedies.Results: Current use of HRT was more common among women who previously used oral contraceptives (41.3%) than among women who had never used oral contraceptives (23.1%). HRT users were also more often physically active, had undergone hysterectomy and had lighter occupation than non-users. Of all women 35% were current users of HRT, half of them for at least 2 years, whereas only 5% had tried HRT and abandoned therapy. Alternative remedies were used by 5% of the women as therapy for climacteric complaints, and about four times as many women had tried such therapy but abandoned it. The only characteristic about use of alternative medicines was that they were used less often by women who had been hysterectomized. No woman treated for breast cancer used HRT and only few of them used alternative remedies.Conclusions: The prevalence of HRT use, as well as compliance, was high. Previous use of oral contraceptives probably affected the attitude towards using HRT.
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| 6. |
- Ivarsson, Ted, et al.
(author)
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Physical exercise and vasomotor symptoms in postmenopausal women
- 1998
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In: Maturitas. - : Elsevier Science B.V., Amsterdam.. - 0378-5122 .- 1873-4111. ; 29:2, s. 139-146
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Journal article (peer-reviewed)abstract
- Background: The mechanisms causing postmenopausal vasomotor symptoms are unknown, but changes in hypothalamic beta-endorphins have been suggested to be involved. beta-endorphin production may be increased by regular physical exercise. Objective: To assess if physically active women suffered from vasomotor symptoms to a lower extent than sedentary women. Material and methods: All women (n = 1323) in the ages ranging from 55-56 years in the community of Linkoping Sweden, were included. In a questionnaire these women were asked about their physical exercise habits and their complaints from vasomotor symptoms. Only those 793 women who had reached a natural menopause were grouped into sedentary, moderately or highly active women, based on a physical activity score. Results: Only 5% of highly physically active women experienced severe hot flushes as compared with 14-16% of women who had little or no weekly exercise (P less than 0.05; relative risk 0.26; CI 95%: 0.10-0.71). This was not explained by differences in body mass index, smoking habits or use of hormone replacement therapy. Women who used hormone replacement therapy were more physically active than non-users (P less than 0.05). Conclusion: Fewer physically active women had severe vasomotor symptoms compared with sedentary women. This may be due to a selection bias but also to the fact that physical exercise on a regular basis affects neurotransmitters which regulate central thermoregulation.
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| 7. |
- Jansson, C, et al.
(author)
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The prevalence of symptoms possibly related to the climacteric in pre- and postmenopausal women in Link÷ping, Sweden
- 2003
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 45:2, s. 129-135
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Journal article (peer-reviewed)abstract
- Background: Some extragenital symptoms have been suggested to be associated with the menopause and thus to be affected by estrogen status. In such case extragenital symptoms may be more frequent in postmenopausal women without hormone replacement therapy (HRT) than in premenopausal women or women using HRT. Objective: To assess if the prevalence of a number of extragenital symptoms is higher in postmenopausal women without than with HRT, or in premenopausal women of the same age. Material and methods: All women aged 53 and 54 years in the community of Link÷ping (n=1760) were sent a validated questionnaire about use of HRT, time since last menstruation and about different extragenital symptoms. Results: 1298 (73.8%) women answered the questionnaire and answers from 1180 (67%) women were possible to analyze. Postmenopausal women woke up significantly more often during night than premenopausal, and those without HRT often due to hot flushes and sweating. Women with HRT reported more muscular pain than the others. We found no other significant difference in prevalence of extragenital symptoms between the three groups of women. Conclusions: Sleeping disorders, arthralgia, xerophthalmia, xerostomia and dry skin are not more prevalent in 53 and 54 years old postmenopausal women without HRT than in women with HRT or in premenopausal women of the same age. It may still be that some of these symptoms are related to estrogen deficiency, but do not develop until some years after menopause. It may also be that women with the most severe symptoms decided to use HRT and thereby decreased symptoms to the same level as in non-users. ⌐ 2003 Elsevier Science Ireland Ltd. All rights reserved.
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| 8. |
- Lindgren, Richard, et al.
(author)
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Hypersecretion of ovarian androgens may be gonadotrophin dependent many years after menopause
- 2000
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 34:1, s. 43-46
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Journal article (peer-reviewed)abstract
- Background: In fertile women both adrenals and ovaries contribute to androgen production, whereas after the menopause the ovarian contribution normally decreases. Objective: The objective of this case study was to assess whether ovarian androgen secretion was responsive to decreased gonadotrophin stimulation and whether gonadotrophins were sensitive to negative feedback from sex steroids many years after the menopause. Methods: In this uncontrolled case study a 72 years old slightly overweight woman with noninsulin-dependent diabetes mellitus presented with hirsuitism and elevated serum testosterone concentrations. The woman was reluctant to have an oophorectomy, and received an oral estradiol/progestagene preparation. Serum testosterone and gonadotrophin concentrations were measured before and after steroid hormone therapy. Results: Serum gonadotrophin concentrations decreased and testosterone levels returned to normal during therapy. When the hormone therapy was stopped for 1 month the high testosterone concentrations returned, but were again normalized when the hormone therapy was reinitiated. Conclusion: The ovaries of this woman were apparently still responsive to pituitary stimulation and her hypothalamic-pituitary-ovarian feed-back system still seemed to be working after 70 years of age.
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| 9. |
- Lindh-Åstrand, Lotta, 1963-, et al.
(author)
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Vasomotor symptoms and quality of life in previously sedentary postmenopausal women randomised to physical activity or estrogen therapy
- 2004
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 48:2, s. 97-105
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Journal article (peer-reviewed)abstract
- Objective: To assess if regular physical exercise or oral oestradiol therapy decreased vasomotor symptoms and increased quality of life in previously sedentary postmenopausal women. Setting: A prospective, randomised trial at a University Hospital. Methods: 75 postmenopausal, sedentary women with vasomotor symptoms were randomised to: exercise three-times weekly over 12 weeks (15 women), oral oestradiol therapy for 12 weeks (15 women) and 45 women to three other treatment arms. Results from the exercise and oestradiol groups are presented here. The effects on vasomotor symptoms and wellbeing were assessed with logbooks and validated questionnaires. Results: Ten women fulfilled 12 weeks of exercise. The number of flushes was rather unchanged in five women and decreased to 28% (range 18-42%) of baseline in the other five women. Five of the ten women continued to exercise another 24 weeks, thus in all 36 weeks. The mean number of flushes decreased by about 50% in these five women (from 6.2/24 to 3.2 flushes/24 h at 36 weeks). In the same group a score made as the product of reduction in number and severity of flushes decreased by 92% at 12 weeks, 75% at 24 weeks and 72% at 36 weeks compared with baseline. In the estrogen group flushes decreased from 8.4 to 0.8 (P<0.001) after 12 weeks of therapy and remained at this level after 36 weeks. Well-being according to different measurements improved significantly in both groups, albeit more markedly in the estrogen group. Conclusions: Apart from many other health benefits regular physical exercise may decrease vasomotor symptoms and increase quality of life in postmenopausal women, but this has to be further evaluated scientifically. Exercise should be introduced gradually to ensure compliance.
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| 10. |
- Nedstrand, Elizabeth, 1965-, et al.
(author)
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Climacteric symptoms in a postmenopausal Czech population
- 1996
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In: Maturitas. - : Elsevier. - 0378-5122 .- 1873-4111. ; 23:1, s. 85-89
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To assess the prevalence of climacteric symptoms and the use of hormone replacement therapy in a former eastern European country. All 55-, 57-, 59- and 61-year-old women in Kladno in the Czech Republic were asked to participate in the study.METHOD: In 1993, 1505 women in Kladno of the Czech Republic were sent a postal questionnaire concerning age at menopause and their climacteric symptoms.RESULTS: Answers were received from 799 women (53%); 98% were postmenopausal. The median age at spontaneous menopause was 50 years, 49.5 years among women smoking at least 5 cigarettes/day and 51.0 years among non-smokers (P < 0.05). About every fifth woman smoked. Totally 22% of the women had undergone hysterectomy and/or oophorectomy and 3% had been treated for a gynaecological malignancy. The majority of the women (58%) reported ongoing vasomotor symptoms; half of them had moderate to severe vasomotor symptoms. In all, 79% of the women reported ever having vasomotor symptoms. Only 3% of the women had ever tried hormone replacement therapy (HRT) and one woman had current treatment. Dysuria was reported by 22% and 4% had recurrent urinary tract infections; 70% of the women had a partner and 50% were sexually active. Reasons for not being sexually active were mostly lack of a partner, loss of sexual desire or partner's disease or impotence.CONCLUSION: Climacteric symptoms including vasomotor and urogenital symptoms had the same prevalence in the Czech Republic as previously reported in other Western Countries. Only a few women had tried HRT. Smokers had a slightly earlier menopause.
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| 11. |
- Nedstrand, Elizabeth, 1965-, et al.
(author)
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The climacteric among South-American women, who immigrated to Sweden and age-matched Swedish women
- 1995
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In: Maturitas. - : Elsevier. - 0378-5122 .- 1873-4111. ; 21:1, s. 3-6
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Journal article (peer-reviewed)abstract
- Forty-nine immigrated South-American (SA) and 48 Swedish women, aged 42-67 years, were studied in a comparative semi-structured interview survey, concerning the climacteric and its treatment. The mean age at natural menopause was 47 for the South-American women and 50 for the Swedish women. The prevalence of moderate to severe vasomotor symptoms at the time of the survey did not differ significantly between the non-treated, non-operated, postmenopausal South-American and Swedish women (36% and 21%; N.S.). One reason for the trend towards a higher prevalence among South-American women could be that a greater number of Swedish women used hormone replacement treatment compared to South-American women (11 vs. 4). The general attitude to hormone replacement therapy was more positive among South-American women, although they did not use hormone therapy, as could be expected from their symptoms. These results are probably an illustration of the difficulties in getting access to treatment for the immigrated SA women.
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| 12. |
- Nedstrand, Elizabeth, et al.
(author)
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The relationship between stress-coping and vasomotor symptoms in postmenopausal women
- 1998
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 31:1, s. 29-34
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Journal article (peer-reviewed)abstract
- Objective: The objective was to assess whether menopausal women with vasomotor symptoms had a lower stress-coping than menopausal women without symptoms and if stress-coping changed when vasomotor symptoms had been effectively treated with estrogens. The objective was also to assess whether menopausal women, effectively treated for vasomotor symptoms, had a higher neuroticism score than women without such symptoms.Methods: Two groups of physically and mentally healthy postmenopausal women were recruited from the outpatient clinic at the Department of Obstetrics and Gynaecology, University Hospital of Linköping, Sweden. Sixteen women with vasomotor symptoms (target group) were treated with oral 17β-estradiol, 2 mg/day during 3 months. A comparison group was formed comprising 17 women without vasomotor symptoms. The Kupperman Index was used to cover menopausal characteristics in all women at baseline as well as at the second visit after 3 months. Stress-coping was measured by means of the Stress Coping Inventory, which is an instrument developed to measure of the individual's appraisal of having adaptive resources for handling stressful situations. At the second visit all women were also asked to complete the Eysenck Personality Inventory.Results: Women in the target group had a significantly lower stress-coping than women in the comparison group at baseline as well as after 3 months. Stress-coping did not change after estrogen therapy, although the vasomotor symptoms had virtually disappeared. Women in the target group successfully treated for vasomotor symptoms, had a significantly higher neuroticism score compared to the comparison group.Conclusions: Differences in behaviour patterns and personality are probably two reasons why some women report or seek advice due to vasomotor symptoms and some women do not. Stress-coping in women with moderate to severe vasomotor symptoms is unaffected by estrogens.
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| 13. |
- Ribom, Eva L., et al.
(author)
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Six months of hormone replacement therapy does not influence muscle strength in postmenopausal women
- 2002
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 42:3, s. 225-31
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Postmenopausal hormone replacement therapy (HRT) has positive effects on fracture incidence before any effects on bone mineral density can be demonstrated. This has been attributed to increased muscle strength by HRT. This study was designed to evaluate the effect of 6 months of HRT on muscle strength in postmenopausal women. METHODS: Forty postmenopausal women, aged 60-78 were included in the study. They were randomly divided in two groups with 20 women in each group. One group received Menorest 50 microg/24 h (estradiol 4.3 mg) and Gestapuran 2.5 mg (medroxyprogesteron) daily and the other group received placebo treatment. The study was conducted as a double blinded, prospective and placebo controlled trial. Hand grip strength, isokinetic knee flexion and extention, and physical activity were measured before treatment, after 3 and 6 months. Physical activity was estimated using a classification system of physical activity. A JAMAR hydraulic hand dynamometer and a Cybex II dynamometer were used to evaluate muscle strength. RESULTS: Hand grip strength in the right hand, increased significantly in both groups (HRT P<0.001 and placebo P<0.01) and in the left hand in the HRT group (P<0.01). However, there were no differences in muscle strength between the two groups. There was no significant change in isokinetic knee flexion or extension after 6 months in either of the groups. The estimated physical activity increased slightly in the placebo group, but there was no significant difference compared to the treatment group. CONCLUSIONS: Our data suggest that 6 months of HRT does not influence muscle strength in postmenopausal women.
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| 14. |
- Ruigomez, A, et al.
(author)
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Is hormone replacement therapy associated with an increased risk of irritable bowel syndrome?
- 2003
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 44:2, s. 133-140
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Journal article (peer-reviewed)abstract
- Objective: Hormonal status could be involved in the occurrence of irritable bowel syndrome (IBS). The authors examined the risk of developing IBS in women using hormone replacement therapy (HRT). Methods: Women 50–69 years old with at least one prescription for HRT during 1994–1999 were identified from the General Practice Research Database in the UK (n=40, 119). An aged-matched cohort of 50 000 women who never used HRT was sampled from the source population where the HRT cohort was ascertained. Women in the two cohorts were followed to assess the risk of development of IBS. Authors performed a nested case-control analysis to assess the role of duration, route and regimen of HRT use and other risk factors for IBS. The IBS diagnosis was validated by means of a questionnaire sent to the general practitioners (n=660). Results: The incidence rate of IBS per 1000 person-years was 1.7 in the cohort of never HRT users and 3.8 among HRT users, respectively. Both current and past users of HRT presented an increased risk of IBS compared to non-users, after adjusting for co-morbidity and consultation patterns. This increased risk was observed irrespective of treatment duration, regimen or route of administration of HRT. Conclusion: The result suggests that HRT use is associated with an increased risk of IBS similar to the one observed among younger premenopausal women with endogenous oestrogenic activity.
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| 15. |
- Skarsgård, Constance, et al.
(author)
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Effects of estrogen therapy on well-being in postmenopausal women without vasomotor complaints
- 2000
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 36:2, s. 123-130
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Journal article (peer-reviewed)abstract
- Objective: To establish whether estrogen treatment affects well-being in postmenopausal women without current or previous vasomotor symptoms. Design: Forty postmenopausal women, aged 45-59 years, without current or previous vasomotor complaints, were included. They were randomized to masked treatment with either transdermal 17▀-estradiol 50 ╡g/24 h or to placebo. At baseline and after 12 and 14 weeks of treatment, the women completed a questionnaire which reflects well-being, the Psychological General Well-Being (PGWB) Index. Results: The women scored high on the PGWB Index, both at baseline and after 12 and 14 weeks of treatment. There was no significant difference in well- being according to PGWB Index between the groups treated with estrogen and placebo, neither at baseline, nor after therapy. Furthermore, there was no difference in change during therapy between the treatment groups. Conclusion: There is a gradual decline in estrogen during the climacteric, and it is controversial to which extent this affects women's mental health. The PGWB scores in this study were high before therapy, reflecting that these women without previous or current vasomotor complaints represented a selected sample. Neither short-term estrogen treatment over 12 weeks nor addition with medroxyprogesterone acetate during 2 weeks improved well-being in postmenopausal women without vasomotor symptoms who had high well-being at baseline. (C) 2000 Elsevier Science Ireland Ltd.
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| 16. |
- Verheul, HAM, et al.
(author)
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Effects of estrogens and hormone replacement therapy on breast cancer risk and on efficacy of breast cancer therapies
- 2000
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 36:1
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Journal article (peer-reviewed)abstract
- This review summarises preclinical and clinical data on effects of endogenous and exogenous estrogens on probability of breast cancer diagnosis, and on the course and efficacy of breast cancer therapies. The data indicate that higher endogenous estrogen exposure (e.g. pregnancy, early menarche and late menopause, estrogen levels in future breast cancer patients, obesity) or exogenous estrogens (oral contraceptives, hormone replacement therapies) may be associated with an increased probability of breast cancer diagnosis. However, there is little evidence that estrogens have deleterious effects on the course of breast cancer. Moreover, increased incidence of breast cancer diagnosis after prolonged hormone replacement therapy (HRT) use seems to be associated with clinically less advanced disease. In studies assessing both diagnosis and mortality, HRT is frequently associated with reduced mortality compared to never users. The interaction of progestagens and estrogens on the probability of breast cancer diagnosis is complex and dependent on type of progestagens and regimens employed. Efficacy of current treatment modalities for breast cancer (surgery, irradiation, adjuvant therapy or chemotherapy) is not negatively influenced by estrogens at concentrations considerably higher than those attained with current HRT preparations. Although it cannot be excluded that estrogens increase the probability of breast cancer diagnosis, available data fail to demonstrate that, once breast cancer has been diagnosed, estrogens worsen prognosis, accelerate the course of the disease, reduce survival or interfere with the management of breast cancer. It may therefore be concluded that the prevalent opinion that estrogens and estrogen treatment are deleterious for breast cancer, needs to be revisited. However, results of ongoing prospective, randomised clinical trials with different HRT regimens in healthy women or breast cancer survivors are needed to provide more definite conclusions about risks and benefits of HRT.
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| 17. |
- Wyon, Yvonne, et al.
(author)
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Postmenopausal women with vasomotor symptoms have increased urinary excretion of calcitonin gene-related peptide
- 1998
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In: Maturitas. - 0378-5122 .- 1873-4111. ; 30:3, s. 289-294
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Journal article (peer-reviewed)abstract
- Objectives: To establish whether 24 h urinary excretion of the potent vasodilator calcitonin gene-related peptide (CGRP) was higher in postmenopausal women with vasomotor symptoms compared to the level in women without symptoms. We also wanted to establish whether urinary excretion of CGRP changed during the menstrual cycle in women of fertile age.Material and methods: Thirteen postmenopausal women with and 13 women without vasomotor symptoms were included. Urine was collected over 24 h and CGRP excretion was measured utilizing radio-immuno assay technique. Twenty-four hour CGRP excretion was also measured in ten fertile women with regular cycles in early follicular, preovulatory and midluteal phase.Results: Twenty-four hour urinary excretion of CGRP was significantly higher in women with vasomotor symptoms compared to non-flushing women (median 7.16 vs 5.15 pmol/24h; P=0.028). CGRP concentrations were stable throughout the ovulatory cycles.Conclusion: The 24 h urinary excretion of CGRP is higher in women with vasomotor symptoms than in women without these symptoms. CGRP may be the mediator of vasodilator signals originating from the thermoregulatory center.
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| 18. |
- Triebner, Kai, et al.
(author)
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Exogenous female sex steroids may reduce lung ageing after menopause : A 20-year follow-up study of a general population sample (ECRHS)
- 2019
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In: Maturitas. - : ELSEVIER IRELAND LTD. - 0378-5122 .- 1873-4111. ; 120, s. 29-34
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Journal article (peer-reviewed)abstract
- Objectives: Menopause involves hypoestrogenism, which is associated with numerous detrimental effects, including on respiratory health. Hormone replacement therapy (HRT) is often used to improve symptoms of menopause. The effects of HRT on lung function decline, hence lung ageing, have not yet been investigated despite the recognized effects of HRT on other health outcomes. Study design: The population-based multi-centre European Community Respiratory Health Survey provided complete data for 275 oral HRT users at two time points, who were matched with 383 nonusers and analysed with a two-level linear mixed effects regression model. Main outcome measures: We studied whether HRT use was associated with the annual decline in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Results: Lung function of women using oral HRT for more than five years declined less rapidly than that of nonusers. The adjusted difference in FVC decline was 5.6 mL/y (95%CI: 1.8 to 9.3, p = 0.01) for women who had taken HRT for six to ten years and 8.9 mL/y (3.5 to 14.2, p = 0.003) for those who had taken it for more than ten years. The adjusted difference in FEV1 decline was 4.4 mL/y (0.9 to 8.0, p = 0.02) with treatment from six to ten years and 5.3 mL/y (0.4 to 10.2, p = 0.048) with treatment for over ten years. Conclusions: In this longitudinal population-based study, the decline in lung function was less rapid in women who used HRT, following a dose-response pattern, and consistent when adjusting for potential confounding factors. This may signify that female sex hormones are of importance for lung ageing.
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| 21. |
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| 23. |
- Bamia, Christina, et al.
(author)
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Self-rated health and all-cause and cause-specific mortality of older adults : Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium
- 2017
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In: Maturitas. - : Elsevier BV. - 0378-5122 .- 1873-4111. ; 103, s. 37-44
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Journal article (peer-reviewed)abstract
- Objectives: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.Study design: Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.Main outcome measures: All-cause, cardiovascular and cancer mortality.Results: Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).Conclusion: SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”.
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| 24. |
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| 25. |
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| 26. |
- Berglund, A., et al.
(author)
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Sex differences in the presentation of stroke
- 2017
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In: Maturitas. - Amsterdam, Netherlands : Elsevier. - 0378-5122 .- 1873-4111. ; 99, s. 47-50
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Research review (peer-reviewed)abstract
- Stroke affects both men and women of all ages, although the condition is more common among the elderly. Stroke occurs at an older age among women than among men; although the incidence is lower among women than among men, as women have a longer life expectancy their lifetime risk is slightly higher. Ischemic stroke is the most common type of stroke; and reperfusion treatment is possible if the patient reaches hospital early enough. Thrombolysis and thrombectomy are time-sensitive treatments - the earlier they are initiated the better is the chance of a positive outcome. It is therefore important to identify a stroke as soon as possible. Medical personnel can readily identify typical stroke symptoms but the presentation of non-traditional stroke symptoms, such as impaired consciousness and altered mental status, is often associated with a significant delay in the identification of stroke and thus delay in or inability to provide treatment. Non-traditional stroke symptoms are reported to be more common in women, who are thereby at risk of delayed recognition of stroke and treatment delay.
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| 27. |
- Berin, Emilia, et al.
(author)
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Resistance training for hot flushes in postmenopausal women: A randomised controlled trial
- 2019
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In: Maturitas. - : ELSEVIER IRELAND LTD. - 0378-5122 .- 1873-4111. ; 126, s. 55-60
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Journal article (peer-reviewed)abstract
- Objectives: To investigate the effect of 15 weeks of resistance training on the frequency of moderate to severe hot flushes in postmenopausal women. Study design: Postmenopausal women with at least 4 moderate or severe hot flushes or night sweats per day day were randomized to a 15-week resistance training intervention or unchanged physical activity. Participants did not exercise regularly at baseline and had not used any therapy for hot flushes two months prior to study entry. The resistance training was performed three times per week and the program contained 8 exercises performed with 8-12 repetitions in 2 sets. Loads were set individually from eight-repetition maximum-strength tests and increased progressively. Main outcome measures: The primary outcome was change in mean moderate or severe hot flushes per day from baseline to week 15, assessed with symptom diaries. Secondary outcomes included change in hot flush score and time spent on physical activity. Results: Between November 19, 2013, and October 26, 2016, 65 women were enrolled; 58 completed the trial and were included in the analyses. The mean age was 55 and the mean number of moderate or severe hot flushes per day at baseline was 7.1; there were no baseline differences between groups. The frequency of hot flushes decreased more in the intervention group than in the control group (mean difference -2.7, 95% CI -4.2 to -1.3). The mean percentage change was -43.6% (-56.0 to -31.3) in the intervention group and -2.0% (16.4-12.4) in the control group. Conclusion: A 15-week resistance-training program decreased the frequency of moderate and severe hot flushes among postmenopausal women and could be an effective and safe treatment option to alleviate vasomotor symptoms.
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| 28. |
- Berin, Emilia, et al.
(author)
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Resistance training for hot flushes in postmenopausal women: Randomized controlled trial protocol
- 2016
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In: Maturitas. - : ELSEVIER IRELAND LTD. - 0378-5122 .- 1873-4111. ; 85, s. 96-103
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Journal article (peer-reviewed)abstract
- Objectives: Hot flushes and night sweats affect 75% of all women after menopause and is a common reason for decreased quality of life in mid-aged women. Hormone therapy is effective in ameliorating symptoms but cannot be used by all women due to contraindications and side effects. Engagement in regular exercise is associated with fewer hot flushes in observational studies, but aerobic exercise has not proven effective in randomized controlled trials. It remains to be determined whether resistance training is effective in reducing hot flushes and improves quality of life in symptomatic postmenopausal women. The aim of this study is to investigate the effect of standardized resistance training on hot flushes and other health parameters in postmenopausal women. Study design: This is an open, parallel-group, randomized controlled intervention study conducted in Linkoping, Sweden. Sixty symptomatic and sedentary postmenopausal women with a mean of at least four moderate to severe hot flushes per day or 28 per week will be randomized to an exercise intervention or unchanged physical activity (control group). The intervention consists of 15 weeks of standardized resistance training performed three times a week under supervision of a physiotherapist. Main outcome measures: The primary outcome is hot flush frequency assessed by self-reported hot flush diaries, and the difference in change from baseline to week 15 will be compared between the intervention group and the control group. Conclusion: The intention is that this trial will contribute to the evidence base regarding effective treatment for hot flushes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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| 32. |
- Brynhildsen, Jan, 1962-, et al.
(author)
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Lipids and clotting factors during low dose transdermal estradiol/norethisterone use
- 2005
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In: Maturitas. - : Elsevier. - 0378-5122 .- 1873-4111. ; 50:4, s. 344-352
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Journal article (peer-reviewed)abstract
- Objective: To demonstrate the effects of 2-year transdermal continuous combined low-dose estradiol (0.025 mg/day) and norethisterone acetate (0.125 mg/day) on lipid/lipoprotein profile and coagulation/fibrinolysis.Methods: A double-blind, randomized, multicenter, parallel, 1-year trial enrolled 266 healthy women at least 2 years post menopause. Patients received either 0.025 mg estradiol and 0.125 mg norethisterone acetate daily or placebo transdermally. One hundred and thirty five women completed a second year open follow-up (96 had used Estragest TTS, 39 placebo during the first year), where all women had the estradiol/norethisterone patch. Lipid/lipoprotein profile and coagulation/fibrinolysis parameters were studied at 0, 24, 48, 72 and 96 weeks.Results: In women on estradiol/norethisterone total cholesterol, Lp(a) and VLDL cholesterol decreased significantly more than in the placebo group after 24 weeks and LDL cholesterol after 48 weeks. Women on estradiol/norethisterone had no change in HDL, triglycerides or Lp(a), an increased HDL/total cholestrol ratio and decreased LDL, VLDL and total cholesterol at 48 weeks compared to placebo. Women with active treatment also showed a significant reduction compared with the placebo group of Factor VII and antithrombin III at 24 and 48 weeks and a reduction of fibrinogen at 24 weeks. These changes persisted over the second year.Conclusions: A continuous combined low-dose transdermal patch daily delivering 0.025 mg estradiol and 0.125 mg norethisterone acetate provided beneficial effects on lipid/lipoprotein profile and coagulation/fibrinolysis. The changes were similar to those previously described after higher dose oral and transdermal estrogen/progestogen regimens. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Frisk, Jessica
(author)
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Managing hot flushes in men after prostate cancer-A systematic review
- 2010
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In: Maturitas. - : Elsevier BV. - 0378-5122 .- 1873-4111. ; 65:1, s. 15-22
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Research review (peer-reviewed)abstract
- Context and objective: The aim of this study was to describe hot flushes in men with prostate cancer, and their treatment methods. Method: A systematic review was conducted of the literature indexed between 1966 and 2009 on the MEDLINE, the ISI Web of Knowledge, Cinahl and PsycINFO. Of 252 articles identified, 32 were selected for consideration of their complete texts, of which five were subject to detailed analysis. Results: Diethylstilbestrol, megestrol acetate and cyproterone acetate have the strongest effect, giving a 75% or larger decrease of the number of hot flushes, but they may have severe or bothersome side-effects. Gabapentin has an uncertain effect. Clonidine is not proven effective for hot flushes. Long-term effects were not evaluated in any of the studies. SSRI/SNRI and acupuncture may have a moderate effect on hot flushes but are not proven in any RCTs. Conclusion: Hot flushes are common and bothersome symptoms in men with prostate cancer and those taking anti-androgen treatment, and reduce quality of life. Few treatments are available and some are avoided for these patients. Additional prospective treatment studies are needed, with long-term follow-up, in order to evaluate the effects and risks of treatments. Treatments with few or no severe side-effects should be prioritised in future investigations. Experimental studies are also needed to elucidate the mechanism behind hot flushes in men and to suggest routes for the development of new treatments.
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| 42. |
- Gast, Gerrie-Cor M, et al.
(author)
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Hormone therapy and coronary heart disease risk by vasomotor menopausal symptoms.
- 2011
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In: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; 70:4, s. 373-378
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Journal article (peer-reviewed)abstract
- OBJECTIVES: We examined whether the association between hormone therapy (HT) use and coronary heart disease (CHD) risk differed between women with and without vasomotor symptoms (VMS). STUDY DESIGN: We used data from a Dutch (EPOS) and Swedish (WHILA) population-based sample of 8865 women, aged 46-64 years, and free of CHD, stroke, venous thrombosis/pulmonary embolism or cancer at baseline. Data on HT use, VMS and potential confounders were collected by questionnaires. MAIN OUTCOME MEASURES: CHD endpoints, obtained via registries. RESULTS: 252 CHD cases occurred during 10.3 years of follow-up. Neither for women with nor for women without flushing or (night) sweats ever HT use was associated with CHD risk, compared with never HT use. Among women with intense VMS, ever HT use borderline significantly decreased CHD risk compared with never HT use (HR 0.48 [95% CI 0.20-1.03]). Among women without intense VMS, ever HT use was associated with a borderline significant increased CHD risk (HR 1.28 [95% CI 0.96-1.70]; P for interaction=0.02). However, after multivariate adjustment, as compared to never HT use, ever HT use was not associated with risk of CHD among women with or without intense VMS. CONCLUSIONS: In both groups of women with and without VMS, HT use does not seem to be associated with the risk of CHD. Hence, our findings do not support the view that HT use increases the CHD risk among women with an indication, i.e. VMS, but this needs to be confirmed in specifically designed studies.
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| 43. |
- Gast, Gerrie-Cor M, et al.
(author)
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Vasomotor symptoms, estradiol levels and cardiovascular risk profile in women.
- 2010
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In: Maturitas. - : Elsevier BV. - 1873-4111 .- 0378-5122. ; Mar 4, s. 285-290
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Journal article (peer-reviewed)abstract
- OBJECTIVES: We investigated whether menopausal vasomotor symptoms (VMS) are related to an adverse cardiovascular risk profile. Furthermore, we examined the association between estradiol levels and VMS, and whether an association between VMS and cardiovascular risk factors can be explained by estradiol levels. STUDY DESIGN: We used data from a Swedish population-based sample of 5857 women, aged 50-64 years. Data on VMS and potential confounders were collected by questionnaires. MAIN OUTCOME MEASURES: Body mass index (BMI), waist hip ratio (WHR), glucose, blood pressure, lipid profile and estradiol levels were measured. RESULTS: Symptoms of flushing/sweats were reported by 55% and sweats by 31% of all women. Estradiol concentrations were significantly lower in women with VMS. After multivariate adjustment, women with symptoms of sweats had a statistically significantly higher BMI, waist hip ratio, total cholesterol level, LDL level, triglycerides level, glucose level, systolic and diastolic blood pressure. These patterns did not change after correction for estradiol. The associations between flushing/sweats combined and cardiovascular risk factors were less pronounced. CONCLUSIONS: Women with VMS have a less favorable cardiovascular risk profile. Although estradiol levels were significantly lower among women with VMS, the increased cardiovascular risk profile cannot be explained by circulating estradiol levels.
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| 44. |
- Gladh, Mathias, 1971-, et al.
(author)
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Prevalence of symptoms possibly related to PADAM, in a Swedish population aged 55, 65 and 75 years
- 2005
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In: Maturitas. - : Elsevier BV. - 0378-5122 .- 1873-4111. ; 50:3, s. 161-166
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Journal article (peer-reviewed)abstract
- Objectives: With age there is an average decline in the concentration of biologically active testosterone. It is still controversial if this leads to a clinically relevant deficit, "partial androgen deficiency of the ageing man" (PADAM). Our objective was to investigate the prevalence of a series of symptoms possibly associated with PADAM in an assumed normal-population of older men. Methods: We developed a questionnaire including items about symptoms possibly associated with PADAM as well as background data covering demography, medical history, mood status, medication, castration therapy, as well as smoking, exercise and alcohol habits. The 10 items of the ADAM-questionnaire, designed to predict low bio-available T, were also included. The questionnaire was sent to all 1885 men 55, 65 or 75-years-old, living in Linköping, Sweden. Results: We identified a number of symptoms that differed significantly (P<0.01) between age groups, e.g., "increased abdominal circumference", "decrease in muscle strength and/or endurance", "decreased libido", "less strong erection" and "lack of energy". From factorial analysis we found that the symptoms co-varied in four different groups. Conclusion: The prevalence of a number of symptoms differed significantly between age groups, but we cannot infer that there is a causal connection between an average age-dependent decline in testosterone function and these symptoms. There are several other ways to interpret these results like the existence of concurrent somatic and/or mood disorders or ageing as such. For this purpose further studies including measurements of testosterone concentrations relating to the findings of this study have to be performed. © 2004 Elsevier Ireland Ltd. All rights reserved.
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| 45. |
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| 46. |
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| 47. |
- Helmersson, Johanna, et al.
(author)
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Reference values for 34 frequently used laboratory tests in 80-year-old men and women
- 2016
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In: Maturitas. - : Elsevier BV. - 0378-5122 .- 1873-4111. ; 92, s. 97-101
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Journal article (peer-reviewed)abstract
- OBJECTIVES: Reference values are usually based on blood samples from healthy individuals in the age range 20-50 years. Most patients seeking health care are older than this reference population. Many reference intervals are age dependent and there is thus a need to have appropriate reference intervals also for elderly individuals.METHODS: We analyzed a group of frequently used laboratory tests in an 80-year-old population (n=531, 266 females and 265 males). The 2.5th and 97.5th percentiles for these markers were calculated according to the International Federation of Clinical Chemistry guidelines on the statistical treatment of reference values.RESULTS: Reference values are reported for serum alanine transaminase (ALT), albumin, alkaline phosphatase, pancreatic amylase, apolipoprotein A1, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, aspartate aminotransferase (AST), AST/ALT ratio, bilirubin, calcium, calprotectin, cholesterol, HDL-cholesterol, creatinine kinase (CK), creatinine, creatinine estimated GFR, C-reactive protein, cystatin C, cystatin C estimated GFR, gamma-glutamyltransferase (GGT), iron, iron saturation, lactate dehydrogenase (LDH), magnesium, phosphate, transferrin, triglycerides, urate, urea, zinc, hemoglobin, platelet count and white blood cell count. The upper reference limit for creatinine and urea was significantly increased while the lower limit for iron and albumin was decreased in this elderly population in comparison with the population in the Nordic Reference Interval Project (NORIP).CONCLUSIONS: Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% confidence interval of NORIP.
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| 48. |
- Hickey, A, et al.
(author)
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Estimating cut points : a simple method for new wearables
- 2016
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In: Maturitas. - : Elsevier BV. - 0378-5122 .- 1873-4111. ; 83, s. 78-82
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Journal article (peer-reviewed)abstract
- Wearable technology is readily available for continuous assessment due to a growing number of commercial devices with increased data capture capabilities. However, many commercial devices fail to support suitable parameters (cut points) derived from the literature to help quantify physical activity (PA) due to differences in manufacturing. A simple metric to estimate cut points for new wearables is needed to aid data analysis.ObjectiveThe purpose of this pilot study was to investigate a simple methodology to determine cut points based on ratios between sedentary behaviour (SB) and PA intensities for a new wrist worn device (PRO-Diary™) by comparing its output to a validated and well characterised ‘gold standard’ (ActiGraph™).Study designTwelve participants completed a semi-structured (four-phase) treadmill protocol encompassing SB and three PA intensity levels (light, moderate, vigorous). The outputs of the devices were compared accounting for relative intensity.ResultsCount ratios (6.31, 7.68, 4.63, 3.96) were calculated to successfully determine cut-points for the new wrist worn wearable technology during SB (0–426) as well as light (427–803), moderate (804–2085) and vigorous (≥2086) activities, respectively.ConclusionOur findings should be utilised as a primary reference for investigations seeking to use new (wrist worn) wearable technology similar to that used here (i.e., PRO-Diary™) for the purposes of quantifying SB and PA intensities. The utility of count ratios may be useful in comparing devices or SB/PA values estimated across different studies. However, a more robust examination is required for different devices, attachment locations and on larger/diverse cohorts.
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