| 1. |
- 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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| 2. |
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| 3. |
- 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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| 4. |
- 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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| 5. |
- Komi, J, et al.
(författare)
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Effects of ospemifene and raloxifene on hormonal status, lipids, genital tract and tolerability in postmenopausal women
- 2005
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Ingår i: Menopause. - 1530-0374. ; 12:2, s. 202-209
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare ospemifene and raloxifene regarding their effects on hormones, lipids, genital tract, and tolerability in postmenopausal women. DESIGN: A randomized, double-blind study in which 118 healthy postmenopausal women received 30 (n = 29), 60 (n = 30), or 90 mg (n = 30) of ospemifene or 60 mg (n = 29) of raloxifene for 3 months. RESULTS: There were no significant differences in the baseline characteristics between study groups. In comparison with raloxifene, follicle-stimulating hormone levels decreased significantly more in the 90-mg ospemifene group and sex hormone-binding globulin levels increased more in all ospemifene groups. Total cholesterol and low-density lipoprotein cholesterol levels decreased more in raloxifene than in ospemifene groups, although the difference in low-density lipoprotein cholesterol between 90-mg ospemifene and raloxifene was not significant. Endometrial thickness did not change in any study group and endometrial biopsies showed atrophy in the majority of subjects at 3 months. All ospemifene groups demonstrated a clear estrogenic effect on the vaginal epithelium, as seen in Pap smears. This was in sharp contrast to the raloxifene group, which had no effect on the vaginal epithelium. Kupperman index decreased in all study groups during treatment. The adverse events were mild, mainly single cases, and no clustering of events was observed. There were no clinically significant abnormal findings in laboratory safety parameters. CONCLUSIONS: Ospemifene, at the dose of 90 mg/day, was more estrogenic than raloxifene, as shown by changes in serum follicle-stimulating hormone and sex hormone-binding globulin levels. Neither agent stimulated endometrium, but in contrast to raloxifene, ospemifene had a clear estrogenic effect in the vagina. Further studies with ospemifene are needed in subjects with vaginal atrophy.
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| 6. |
- 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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| 7. |
- 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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| 8. |
- 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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| 9. |
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| 10. |
- 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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| 11. |
- 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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| 12. |
- 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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| 13. |
- Naessen, Tord
(författare)
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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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| 14. |
- 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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| 15. |
- 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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| 16. |
- 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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| 17. |
- Ödmark, Inga-Stina, 1948-, et al.
(författare)
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Endometrial safety and bleeding pattern during a five-year treatment with long-cycle hormone therapy
- 2005
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 12:6, s. 699-707
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine compliance, the incidence of untoward effects, and endometrial safety in postmenopausal women treated with 3-month sequential hormone therapy for up to 5 years. Design: A prospective, uncontrolled multicenter study of 129 women treated with 0.625 mg conjugated estrogens daily plus 10 mg medroxyprogesterone acetate for 14 days every third month. Endometrial biopsy samples were taken before the initiation of the study and then yearly during the next 5 years. Bleeding patterns were recorded. Results: Upon completion of the first 12 months of treatment, 76 of 126 biopsied women (60%) had secretory endometrium. After 5 years, this finding was reversed in biopsy specimens completed by 59 women, among whom 32 (56%) had insufficient or atrophic endometrium.We did not find any hyperplasia when the biopsy specimen was taken according to the protocol. One endometrial cancer was found by biopsy after 12 months, but the subsequent hysterectomy showed no sign of cancer. Ultrasound determinations of mean endometrial thickness during therapy showed a thin endometrium (mean = 4 mm, range = 1-13 mm). Amenorrhea was reported by 6.2% of 129 women after 12 months of treatment. Among the 59 women who completed the study, 71.2% had regular bleeding patterns every third month, 25.4% reported amenorrhea, and 3.4% had irregular bleeding patterns. Conclusions: The addition of 10 mg of medroxyprogesterone acetate for 14 days every third month to treatment with 0.625 mg of conjugated estrogens daily was well tolerated, and was associated with high endometrial safety.
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