摘要:

ObjectiveDecreases in circulating growth hormone (GH) and its main biological messenger insulin-like growth factor-I (IGF-I) have been interpreted as part of the aging process. Because estrogens participate in modulating GH synthesis and secretion, hypoestrogenism in menopausal women may lead to GH deficiency. The aim of the present study was to determine the effect of hormone replacement therapy (HRT) on both GH and IGF-I levels as well as insulin concentrations in 50 menopausal women.DesignPatients were assigned randomly into two treatment groups of 25 each; one group received three cycles of conjugated equine estrogen (CEE) 0.625 nig/day for 21 days, and the other, 1.25 mg/day during 21 days. Each also received chlormadinone acetate for 5 days. There was a control group consisting of regularly menstruating women.ResultsIn the menopausal women, HRT increased significantly (p< 0.001) the low levels of GH and IGF-I; on the contrary the baseline insulin levels declined (p< 0.001) with HRT. A significant linear correlation (r= 0.90) was found between GH and IGF-I as well as with estradiol levels (r= 0.74) in the group of menopausal women receiving CEE 0.625 mg/day. This group of patients had a significant correlation (r= —0.63) between insulin and estradiol levels. No correlation was observed in the group receiving CEE 1.25 mg/day.ConclusionsHRT restored GH, IGF-I, and insulin levels to normal values in all women. Further research needs to be done to establish the beneficial effect of HRT regarding the prevention of the metabolic effects presumably caused by derangement in the somatotropic axis associated with aging.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveA survey was designed to determine why menopausal women do not take hormone replacement therapy (HRT).DesignA sample of 3,600 women >50 years old were randomly selected from six zip codes in northwest suburban Chicago. They received a maximum of three survey mailings. Those who did not respond were called and asked to respond over the phone. The data that were obtained included knowledge of, physician discussion about, use of, and reason for not currently taking HRT; menopausal status, last physician visit, and age grouping.ResultsA total of 1,966 (65%) women responded. Of these, 1,448 (74%) knew about HRT, 1,193 (61%) had discussed HRT with their physicians, and 815 (41%) had been treated with HRT in the past. A total of 552 women (28%) were currently being treated with HRT, of whom 419 (76%) had been treated for >2 years. A total of 1,356 respondents were not being treated with HRT. Of these, 1,114 (82%) were menopausal, of whom 742 (67%) knew about HRT, 551 (50%) had discussed HRT with their physicians, 837 (75%) had seen their physician in the past year, and 236 (21%) had been treated with HRT in the past. Reasons for not taking HRT included the following: 49% no longer had menopausal symptoms, 45% did not want to take HRT, 33% were not offered it by their doctors, 28% were afraid to use it, and 27% were not menopausal.ConclusionsSeeing a physician in the past year did not ensure that these women understood the symptom course of menopause. Confirming women's knowledge about menopausal health or assisting physician education about menopausal health may offer opportunities both to assist women's decision making about HRT and to improve women's health care.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo assess the utility of performing routine sonohysterography in conjunction with endometrial thickness measurement for detecting intrauterine pathology in asymptomatic postmenopausal women.DesignAsymptomatic postmenopausal women (n= 60, mean age 52.7 ± 4.5 years, amenorrhea ≥ 6 months, follicle stimulating hormone ≥40 mIU/mL) were evaluated with sonohysterography followed by endometrial biopsy before initiating hormone replacement therapy.ResultsHyperplasia was detected in 5 of 22 (22.7%) patients with endometrial thickness of >5 mm and in 0 of 38 (0.0%) patients with endometrial thickness of ≤5 mm. When sonohysterography was performed, intracavitary pathology was discovered in 14 of 38 (36.8%) patients with endometrial thickness of ≥5 mm (10 polyps, three submucosal myomas, and one septate uterus) and 14 of 22 (63.6%) patients with endometrial thickness of >5 mm (nine polyps, four submucosal myomas, and one Asherman's syndrome).ConclusionsEndometrial thickness of ≤5 mm excludes hyperplasia but does not eliminate other intrauterine pathology that may be discovered by sonohysterography.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveA limited review of the medical literature was performed to determine whether there is an increase in the prevalence of depressive symptomatology in women undergoing menopause and whether this increase can be related to fluctuating levels of estrogen. In addition, we evaluate the possible effect that estrogen has on the concentrations of neurotransmitters, specifically serotonin, in the central nervous system and the subsequent impact on mood in peri- and postmenopausal women. Finally, we examine whether estrogen replacement therapy is efficacious in the treatment of depression during the climacteric.DesignLimited MEDLINE review of the medical literature on depression in women, the evidence for a serotonergic role in depression, evidence linking estrogen to changes in serotonergic activity and evidence that estrogen therapy can improve depression.ResultsDepression is more common in women than in men and seems to be increased at times of changing hormone levels in women. The serotonergic system seems to play a major role in depression, although other neurotransmitters are also involved. Estrogen can alter not just serotonergic activity but also has an impact on the activity of several other neurotransmitters that might result in an antidepressant effect. At this time, estrogen therapy for the treatment of depression in peri- and postmenopausal women may be useful, but confirmatory studies are still lacking.ConclusionsThere is suggestive evidence that estrogen therapy is appropriate treatment for mild-to-moderate depression in peri- and postmenopausal women.

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:1999

数据来源: OVID