ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:Given the increasing interest in the effect of isoflavones on menopause‐related symptoms and diseases related to menopause/aging combined with the growing body of published literature on isoflavones, much of which presents conflicting data, The North American Menopause Society (NAMS) established a goal to develop an evidence‐based consensus opinion on the role of isoflavones in menopausal health.Design:NAMS appointed a panel of clinicians and researchers acknowledged to be experts in the field of isoflavones. Their advice was used to assist the NAMS Board of Trustees in developing this consensus opinion.Results:Many animal and human studies have evaluated the health effects of isoflavones on menopause‐related symptoms and diseases related to menopause/aging. However, data are inconclusive regarding whether the observed health effects in humans are attributable to isoflavones alone or to isoflavones plus other components in whole foods. The most convincing health effects have been attributed to the actions of isoflavones on lipids. Studies have associated isoflavones with statistically significant reductions in low‐density lipoproteins and triglycerides as well as increases in high‐density lipoproteins. Although some data seem to support the efficacy of isoflavones in reducing the incidence and severity of hot flashes, many studies have not found any difference between the isoflavone recipients and the controls. Inadequate data exist to evaluate the effect of isoflavones on breast and other female‐related cancers, bone mass, and vaginal dryness.Conclusions:Although the observed health effects in humans cannot be clearly attributed to isoflavones alone, it is clear that foods or supplements that contain isoflavones have some physiologic effects. Clinicians may wish to recommend that menopausal women consume whole foods that contain isoflavones, especially for the cardiovascular benefits of these foods; however, a level of caution needs to be observed in making these recommendations. Additional clinical trials are needed before specific recommendations can be made regarding increased consumption of foods or supplements that contain high amounts of isoflavones. (Menopause2000;7:215‐229. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:Soy phytoestrogens (SPEs) seem to have beneficial effects on the cardiovascular system with no adverse effects on the breast and uterus. Our objective was to examine the effects of oral estradiol alone, soy protein with phytoestrogens alone, and combinations of estradiol and SPEs on working memory of ovariectomized retired breeder female rats using the radial arm maze test.Design:Eighty‐four bilaterally ovariectomized retired breeder female rats were randomized into 12 groups to examine the effects of chronic treatment (10 months) with oral micronized estradiol (0, 0.5, 1, and 2 mg/1,800 Cal), SPEs (0, 72, and 144 mg/1,800 Cal), and all combinations of these doses of estradiol and SPEs on working memory.Results:Oral administration of estradiol or SPEs resulted in a dose‐dependent improvement in the performance of the radial arm maze tests. In addition, at each of the three doses of oral micronized estradiol tested, the performance of the radial arm tests was not significantly different in the presence or absence of SPEs.Conclusions:Our data suggest that SPEs may function as estrogen agonists in improving working memory in the ovariectomized retired breeder female rats and that SPEs do not antagonize the beneficial effects of estradiol on the working memory of these rats. No additional benefits on the radial arm maze test performance were observed with the tested combinations of estradiol and SPEs. (Menopause2000;7:230‐235. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:To determine the safety and efficacy of an oral soy isoflavone extract for relief of menopausal hot flushes.Design:This was a double‐blind, randomized, parallel group, outpatient, multicenter (15 sites) study. A total of 177 postmenopausal women (mean age = 55 years) who were experiencing five or more hot flushes per day were randomized to receive either soy isoflavone extract (total of 50 mg genistin and daidzin per day) or placebo. Physical examinations and endometrial and biochemical evaluations were performed upon admission and completion. Body weight, symptoms, and safety were evaluated at all visits.Results:Relief of vasomotor symptoms was observed in both groups. Decreases in the incidence and severity of hot flushes occurred as soon as 2 weeks in the soy group, whereas the placebo group experienced no relief for the first 4 weeks. Differences between evaluable subjects in both groups were statistically significant over 6 weeks (p= 0.03). Over 12 weeks, between‐group differences approached significance (p= 0.08). Endometrial thickness evaluated by ultrasound, lipoproteins, bone markers, sex hormone‐binding globulin and follicle‐stimulating hormone, and vaginal cytology did not change in either group.Conclusions:Soy isoflavone extract was effective in reducing frequency and severity of flushes and did not stimulate the endometrium. Soy isoflavone extracts provide an attractive addition to the choices available for relief of hot flushes. (Menopause2000;7:236‐242. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:To compare the effects of three commonly prescribed estrogen replacement therapies—oral conjugated equine estrogens (CEE;n= 37), oral micronized estradiol (ME;n= 25), and transdermal estradiol (TE;n= 24)—on the binding characteristics of plasma estradiol as related to the concentrations of blood sex hormone‐binding globulin (SHBG), estradiol, and estrone.Design:Menopausal volunteers, opting for estrogen replacement therapy, gave blood at 0, 2, and 4 months. SHBG was assayed by automated immunoabsorbent technology. Estradiol and estrone were determined by quantitative gas chromatography/mass spectrometry. After tritiated estradiol was added to serum, the percentage of estradiol not bound to protein was determined by ultrafiltration and the percentage of estradiol bound to SHBG was measured by a method exploiting that this protein, even when bound to estradiol, binds avidly to Concanavalin A‐Agarose.Results:In each study, 2‐ and 4‐month data were similar. Increases in SHBG concentrations were 100% (p< 0.001), 45% (p< 0.001), and 12% (nonsignificant) for subjects who were receiving CEE, ME, and TE regimens, respectively. Decreases in the percentage of estradiol not bound to protein and increases in the percentage of estradiol bound to SHBG correlated with changes in the concentrations of this protein mediated by the therapies. The order for increases in estradiol was ME∽TE >> CEE, whereas for estrone, the order was ME > CEE >> TE, divergent from the SHBG responses.Conclusions:The diverse responses observed can be explained by differences in the estrogen load delivered to target tissues as controlled by the intermediary circulation and metabolism of the hormones introduced in these regimens. (Menopause2000;7:243‐250. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:To investigate serum androgens, estradiol, and gonadotrophins after treatment with testosterone undecanoate 40 mg daily in postmenopausal women.Design:Ten postmenopausal women received 40 mg testosterone undecanoate orally every day for 4 days. Blood samples were drawn before and 2, 4, 6, and 8 hours after administration on the first day and then at 24, 48, 72, and 96 hours after administration of the first dose. Serum concentrations of testosterone, dihydrotestosterone, androstenedione, estradiol, sex hormone‐binding globulin, follicle‐stimulating hormone, and luteinizing hormone were analyzed.Results:A rapid absorption of testosterone undecanoate was found with the highest concentrations of testosterone, dihydrotestosterone, and androstenedione 2‐4 hours after administration. Significant increases from basal values were found for serum testosterone, dihydrotestosterone, androstenedione, and estradiol and a slight but significant decrease for sex hormone‐binding globulin. Serum follicle‐stimulating and luteinizing hormone levels were unchanged. Median levels of 3.2 nmol/L for testosterone and 3.6 nmol/L for dihydrotestosterone were recorded after the first day.Conclusions:Testosterone undecanoate displayed a rapid absorption and turnover and may offer an alternative for androgen treatment in women. Expanded pharmacokinetic studies in larger and more homogeneous groups of postmenopausal women should be performed. The individual variations were considerable, and regular monitoring of testosterone serum levels to avoid overtreatment is recommended. (Menopause2000;7:251‐256. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:As the number of midlife women increases, there is an increased interest in women's experiences of the perimenopause. Because of the evidence linking estrogen with cholinergic and serotonergic activity in the brain and with central nervous system development of dendritic arborization, and mixed evidence of estrogen use with incidence of Alzheimer's disease, the effects of the perimenopause on memory functioning are of interest. The purpose of these analyses, part of the Seattle Midlife Women's Health Study, was to describe changes in women's perceived memory functioning according to their perimenopausal group, age, perceived stress, health status, and mood.Design:Memory functioning was assessed with the Memory Functioning Questionnaire as part of a questionnaire mailed to study participants annually. Perimenopausal group was assessed using Mitchell's rating schema.Results:Age was unrelated to any of the Memory Functioning Questionnaire indicators except for retrospective memory; younger women reported more memory problems than older women. Perimenopausal groups were unrelated to most memory functioning ratings with few exceptions. Memory functioning ratings of current memory compared with the past were worse for women who were in early and middle transition and for those who were using hormone therapy than for those who were in late transition and postmenopause. Women reported more current memory problems compared with 10 and 20 years ago and at age 18. Health ratings were negatively correlated with memory functioning ratings, and depressed mood positively correlated with nearly every indicator of memory functioning (frequency of memory problems, ratings of current memory, past memory, and memory change). Greater perceived stress levels were associated with more memory problems.Conclusions:Perceived memory functioning seems more closely related to perceived health, depressed mood, and perceived stress than to perimenopausal stage or age. Further work is needed to determine whether these ratings provided by the Seattle cohort will change over time as women age and as they make the transition to menopause and beyond. (Menopause2000;7:257‐265. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:To determine whether women's global self‐assessment of their knowledge about hormone replacement therapy (HRT) corresponds to their performance on an explicit knowledge test about HRT and to measure associations among knowledge, personal characteristics, decision conflict, and intention to use HRT.Design:Preintervention telephone survey of 156 women enrolled in a randomized, placebo‐controlled trial of HRT decision aids.Results:The mean rating of menopause knowledge, on a scale from 1 to 10, with 10 indicating being “extremely knowledgeable,” was 5.6 (range = 0‐10) and of HRT was 4.2 (range = 0‐9). The mean summary score for the explicit HRT knowledge test, on a 16‐point scale, was 7.8 (range = 0‐15). After adjustment for demographic characteristics and exposure to a provider conversation, higher income, white race, and the provider discussion were significant correlates of knowledge.Explicit knowledge was positively correlated with self‐assessed menopause knowledge and HRT knowledge (Spearman's correlation coefficient = 0.39 and 0.52, respectively;p< 0.0001). Greater knowledge was not associated with intention to use HRT 1 year later. Women who had greater knowledge reported less conflict about the HRT decision (Spearman's correlation coefficient = −0.32;p< 0.0001).Conclusions:A global question about level of knowledge is an effective clinical tool for identifying patients who are in need of additional education about HRT and menopause in this managed care population. Increased knowledge may decrease women's conflict about the HRT decision. Having had a previous conversation about menopause with a primary care provider is associated with greater knowledge about HRT. (Menopause2000;7:266‐272. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:The aim of this study was to delineate the use of hormone replacement therapy (HRT) among women who were born between December 2, 1935, and December 1, 1945, and living in the Lund area of southern Sweden and to analyze factors that contribute to the acceptance and continuation of HRT.Methods:All women received a generic questionnaire pertaining to demographic background, lifestyle, health behavior, and climacteric symptoms and underwent a personal interview. An interim analysis was carried out on 3,900 women. We mailed a hormone questionnaire to the women who were using HRT (n= 1,875). This hormone questionnaire covered, for example, menopausal status, complaints, and alterations in and efficacy of HRT use, as well as the reasons for discontinuing HRT use.Results:A total of 1,415 (76%) women answered the hormone questionnaire. Forty‐eight percent were HRT ever users, and 32% were current users. Mean duration of HRT use was 47 months. The most common incentives for HRT use were alleviation of menopausal symptoms (72%) and prevention of bone loss (50%) and/or cardiovascular disease (31%). Forty‐seven percent of HRT users reported that they had changed regimens at least once. HRT users had higher education, full‐time work, and a higher consumption of alcohol but less consumption of cigarettes. They reported higher frequencies of climacteric symptoms, past histories of premenstrual syndrome, use of oral contraceptives, and hysterectomy. They also had a higher consumption of healthcare resources. A total of 177 women withdrew from therapy. The most common reasons for discontinuation of HRT were weight gain, anxiety of cancer, bleeding, breast tenderness, and emotional problems. Compared with current users, past users had less positive as well as fewer negative effects of HRT. Several variables contributed to compliance, including education, full‐time work, regular exercise, low frequency of persistent climacteric symptoms, and alteration of regimens.Conclusion:Education, working conditions, lifestyle, interest in prevention, and severity of the climacteric symptoms are determinants for both acceptance of and compliance with HRT. (Menopause2000;7:273‐281. © 2000, The North American Menopause Society.)

ISSN:1072-3714    

出版商:OVID    

年代:2000

数据来源: OVID