ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo describe the prevalence and correlates of using conventional therapies, complementary and alternative therapies, or a combination of both types of therapies for menopausal symptoms and to examine the association between severity of symptoms and type of therapy use.DesignData on 2,602 women aged 45 years or older were gathered through a cross-sectional telephone survey conducted in Florida, Minnesota, and Tennessee during 1997 and 1998 using the Behavioral Risk Factor Surveillance System. Participants were asked a series of questions about their menopausal status, menopausal symptoms, healthcare provider selection in relation to menopause, and therapies used for menopausal symptoms.ResultsOf the eight menopausal symptoms assessed, the highest prevalence estimates were reported for hot flashes (62.9%), night sweats (48.3%), and trouble sleeping (41.1%). The average number of symptoms (range 0–8) was 3.10 (SD ± 2.25) and, for women reporting symptoms, the average symptom severity score (range 1–24) was 6.78 (SD ±4.63). About 45% of the women had not consulted with a healthcare provider for treatment of menopausal symptoms or for medical conditions related to menopause even though only 16.3% did not report any of the symptoms included in the survey. Forty-six percent of the women used complementary/alternative therapy either alone or in combination with conventional therapies. Age-adjusted average symptom severity scores were significantly higher among women who had undergone a hysterectomy, with removal of the ovaries (7.73; 95% CI 7.33,8.12) or without (7.60; 95% CI 7.16,8.05), than among women who experienced a natural menopause (6.42; 95% CI 6.14,6.71). Average severity scores were significantly higher among women who used both conventional and complementary/alternative therapies in relation to menopause (8.61; 95% CI 8.26,8.96) than among women who used only conventional therapies (7.09; 95% CI 6.67,7.50). This statistically significant association persisted when adjusted for age, education, income, race/ethnicity, state of residence, and menopausal category.ConclusionsIn this sample, 46% of the women used complementary/alternative therapy either alone or in combination with conventional therapies, whereas a third of the women did not use any therapy in relation to menopause. Although causal inferences cannot be made, the menopausal symptom severity score was significantly higher among women who reported using a combination of conventional and complementary/alternative therapies than among women who used only conventional therapy, only complementary/alternative, or no therapy.

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo determine the efficacy and tolerability of two strengths of percutaneous 17&bgr;-estradiol in a hydroalcoholic gel and placebo in controlling vasomotor symptoms of menopause.DesignA total of 221 postmenopausal women were assigned randomly to treatment with percutaneous 17&bgr;-estradiol gel 1.25 g (containing 0.75 mg of estradiol) or 2.5 g (containing 1.5 mg of estradiol) or placebo gel applied once daily for 12 weeks. The primary efficacy variable was the mean change from baseline in the frequency of moderate/severe hot flushes. In addition, the mean changes from baseline in the frequency and severity of all hot flushes were assessed. Safety and tolerability were evaluated from endometrial biopsy, adverse events, and laboratory tests.ResultsA significant reduction (P< 0.05) in the mean frequency of moderate-to-severe hot flushes and mean frequency and severity of all hot flushes was observed with both 17&bgr;-estradiol gel groups compared with placebo. The mean number of moderate-to-severe hot flushes at the end of the study with 17&bgr;-estradiol gel 2.5 g, 17&bgr;-estradiol gel 1.25 g, and placebo gel was 2.0, 2.8 and 5.2, respectively. The overall incidence of adverse events was not significantly different among groups, though a higher incidence of estrogen-related adverse events was reported with the 17&bgr;-estradiol gel 2.5-g dose.Conclusions17&bgr;-estradiol gel was effective and well tolerated for alleviating moderate-to-severe hot flushes in postmenopausal women. Therapy may be initiated with the 1.25-g dose with an increase to the 2.5-g dose if needed.

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo evaluate the efficacy of Tofupill/Femarelle (DT56a), a novel phyto-selective estrogen receptor modulator (SERM), in preserving bone mineral density (BMD) in postmenopausal women.DesignThe study sample consisted of 98 healthy, postmenopausal women who were randomly allocated, on a double-blind basis, to receive either 644 mg/d DT56a (study group) or 344 mg/d DT56a supplemented with calcium (low-dose group) for 12 months. Each participant was assessed with a comprehensive health questionnaire, a detailed physical, and laboratory and pelvic sonogram examinations at entry and every 3 months thereafter. BMD was assessed by dual-energy x-ray absorptiometry (Lunar) of the lumbar spine and femoral neck before the study began and after 12 months of treatment.ResultsAfter 12 months of treatment, BMD had increased in the study group by 3.6% in the lumbar spine (P= 0.039) and by 2.0% in the femoral neck (NS). In the low-dose group, BMD had decreased in the lumbar spine by 0.6% (NS) and by 0.6% in the femoral neck (NS). Comparison of the change in bone density between the groups yielded a significant difference for the lumbar spine (P= 0.037). Neither group showed a change in endometrial thickness and sex hormone levels nor reported any side effects of treatment.ConclusionsTofupill treatment in postmenopausal women increases BMD without unwanted estrogenic effect. Tofupill appears to be a promising phyto-SERM for the prevention of postmenopausal osteoporosis.

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to develop an integrative assessment of pituitary follicle-stimulating hormone (FSH) secretion and to validate these measurements in a population of perimenopausal (PERI) and postmenopausal (POST) women.DesignIn this cross-sectional study, 170 POST and 20 PERI women collected first-void morning urine samples and had a single blood sample drawn on the same day. For comparison, 11 midreproductive-aged women had urine samples collected for one menstrual cycle. In addition, one 48.5-year-old woman collected daily urine samples for 4 consecutive years during her menopausal transition. Urine samples were assayed for estrone glucuronide (E1G) and pregnanediol-3-glucuronide (PdG) and were normalized to creatinine. An ELISA assay was developed for measurement of the free &bgr;-FSH subunit in urine.ResultsMean age (± SD) of the PERI and POST women were 48.1 ± 3.0 and 52.8 ± 4.1 years, respectively. Mean serum FSH levels were 9.5 ± 5.8 and 79.3 ± 32 IU/L (P< 0.001) in the PERI and POST women. Mean urinary &bgr;-FSH/Cr for the PERI were 1.8 ± 1.2 ng/mg; for the POST, 9.3 ± 4.5 ng/mg (P< 0.001). Mean estradiol, E1G/Cr, and PdG/Cr levels were also significantly different between the two groups. There was a high correlation between serum FSH and urinary &bgr;-FSH/Cr for the PERI (r = 0.584,P= 0.007) and POST (r = 0.54,P< 0.001), with minimal overlap in the urinary &bgr;-FSH/Cr levels between the PERI and POST groups. A significant correlation between PdG/Cr and urinary &bgr;-FSH/Cr was observed for POST (r = 0.581,P= 0.002). No correlation was seen between urinary &bgr;-FSH/Cr and E1G/Cr or estradiol levels. In the perimenopausal participant, who collected 4 years of daily urine samples, urinary &bgr;-FSH/Cr levels progressively increased during the follicular phase and, by the fourth year, there were persistent, almost tonically high elevations of &bgr;-FSH/Cr in the urine.ConclusionsUrinary &bgr;-FSH subunit measurements are a useful marker for monitoring ovarian function during the menopausal transition. Urinary free &bgr;-FSH subunit concentrations reflect pituitary FSH secretion and serve as a biomarker for ovarian reserve.

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo assess the incidence of endometrial polyps during postmenopausal replacement therapy with tibolone, using an appropriate control group.DesignA total of 485 postmenopausal women were included in this open, prospective, comparative study for a duration of 36 months. Of this group, 249 women received 2.5 mg/day of tibolone and 244 women served as controls, receiving continuous-combined estrogen-progestogen therapy (HT). Transvaginal ultrasound, hysteroscopy, and directed biopsies were performed before treatment was initiated and at the end of the study.ResultsTwo hundred twenty-one of the women receiving tibolone and 203 receiving continuous-combined HT completed the study. Endometrial polyps were detected in 74 women (33.4%) from the tibolone group and in 22 women (10.8%) from the HT group (P< 0.01). The vaginal bleeding rate did not differ between the groups. The frequency of atrophic polyps was significantly higher in the tibolone group (P< 0.01). No difference was found in the size of the polyps.ConclusionsTibolone increases by threefold the risk for endometrial polyps.

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo describe secular trends in age of natural menopause.DesignA prospective study based on a random sample of the total female population in Gothenburg, Sweden, started in 1968 with follow-ups in 1974–75, 1980–81, 1992–93, and 2000–02. Participants: 1,462 women born in 1930, 1922, 1918, 1914, and 1908 (participation rate, 90.1%) representative of women of the same ages in the general population. Information regarding menopausal age was provided by 1,373 of the 1,462 women (93.9%). The number was further reduced to 1,017 after exclusion of women who had taken hormones, undergone a surgical menopause, or both.ResultsThe mean age at natural menopause showed a steady increase across birth cohorts. Trends were similar in women who had smoked and women who had never smoked, even after adjusting for different covariates. The upward trend was 0.1 years per birth year (SE 0.020,P< 0.0001). Interestingly, women with earlier menarche had a somewhat earlier age at menopause, independent of the cohort effect. When hormone users were included in the sample, the cohort effect was also found to be independent of oral contraceptive use and hormone therapy.ConclusionsThis study has shown that, independent of variations in socioeconomic status, smoking status, oral contraceptive use, or hormone therapy use, as well as other potential confounders, there was a highly significant secular trend of increase in menopausal age. The observation of a positive association between menarche and menopausal age has, to our knowledge, not previously been described.

ISSN:1072-3714    

出版商:OVID    

年代:2003

数据来源: OVID