ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

There is an increasing public interest in foods and dietary supplements containing phytoestrogens for the maintenance of health. A workshop was convened to assess evidence for the potential benefits of phytoestrogen-containing foods or supplements on diseases or conditions affecting older populations. Preclinical, clinical, and epidemiologic data on the cardiovascular system, various cancers, bone diseases, and menopausal symptoms were the focus of the discussions. Research on the basis of consumer food choices as well as a presentation from the FDA regarding approval of the use of soy foods to reduce the risk of cardiovascular disease were also presented. Based on the information presented, isoflavone-containing soy foods may have favorable effects on the cardiovascular system, but major knowledge gaps still exist regarding effects of phytoestrogen supplements on bone diseases, various cancers, menopausal symptoms, and cognitive function.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveWhether phytoestrogen-containing soy supplements have beneficial effects on hot flashes of postmenopausal women and how those effects, if any, compare to estrogen replacement therapy has been uncertain. It is possible that the uncertainty is due to the low doses of soy isoflavones (30–60 mg per day) used in the studies. We used ovariectomized retired breeder rats and a higher dose of soy phytoestrogens to approach these uncertainties experimentally.DesignThe treatment groups were as follows: (1) Control group fed a casein/lactalbumin-based diet; (2) Soy(−) group fed alcohol-washed soy protein isolate with the phytoestrogens extracted; (3) Soy(+) group fed phytoestrogen-containing soy protein (equivalent to a woman's dose of 144 mg isoflavones per day)—a dose two to three times higher than that in most studies with women; and (4) E2group fed oral micronized estradiol (E2) at a dose equivalent to a woman's dose of 1 mg per day. A temperature-transponder was taped to the surface of the tail to measure temperature. Tail skin temperature was significantly increased within a week after ovariectomy. The animals were pair-fed during the last 21 days of treatment for daily temperature measurement.ResultsSoy(−) had no effect on skin temperature. E2had a large effect on skin temperature (about 1.4°C reduction from Control). Soy(+) was intermediate between the E2treatment and no treatment (about 0.8°C reduction from Control).ConclusionsSoy phytoestrogens have a modest effect on average skin temperatures, being about half that of E2, even at high doses in the rat model.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveRecent studies suggest that ovarian volume and antral follicle numbers may be sensitive, specific, and early indicators of menopausal status. The accuracy of these markers, however, has not been compared directly to more traditional markers [age and follicle-stimulating hormone (FSH) levels]. Thus, the purpose of this study was to test whether ovarian volume and antral follicle counts are more sensitive and specific markers of menopausal status than age or FSH levels.DesignPremenopausal (n= 34) and postmenopausal (n= 25) women between 40 and 54 years old received a transvaginal ultrasound for determination of ovarian volume and antral follicle numbers, provided blood for measurement of FSH levels, and completed a questionnaire. FSH levels, age, ovarian volume, and antral follicle numbers were compared usingttests. Receiver operating characteristic curves were generated to evaluate the sensitivity and specificity of each marker.ResultsPostmenopausal women had significantly higher FSH levels (p≤ 0.0001), smaller ovarian volumes (p≤ 0.002), and fewer antral follicles (p≤ 0.002) than premenopausal women. Ovarian volume and antral follicle numbers had similar sensitivity (27.3–100%) and specificity (3.4–92.9%) in indicating postmenopausal status as FSH levels and age.ConclusionThese data suggest that ovarian volume and antral follicle numbers may be useful indicators of menopausal status.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveSimilar to the circadian rhythm of core body temperature, hot flashes have been found to exhibit a circadian rhythm in healthy, naturally postmenopausal women, with a peak in frequency at 18:25 h. However, to date, no studies have evaluated whether this same pattern is found among breast cancer survivors reporting hot flashes.DesignDaily hot flash frequencies were measured among 21 postmenopausal breast cancer survivors using validated 24-h sternal skin conductance monitoring.ResultsHot flashes were noted in all women, ranging in frequency from 1 to 30 per 24-h period. A majority of the sample (86%) experienced ≥ 1 nighttime hot flash, with 48% exhibiting ≥ 3 but ≤ 7 nighttime hot flashes. For the total sample, a modest circadian rhythm was noted with a peak in hot flash frequency occurring at 16:10 h. However, significant variability was observed across individual women, and, as a whole, breast cancer survivors demonstrated distorted to obliterated rhythms.ConclusionsData suggest that hot flashes in postmenopausal breast cancer survivors do not follow the same circadian pattern as previously seen in healthy, naturally postmenopausal women. Findings have implications for (1) understanding the potential for sleep disturbances and fatigue in breast cancer survivors experiencing hot flashes, and (2) future research examining circadian rhythms of core body temperature and hot flashes in breast cancer survivors.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo identify sociobehavioral factors and side effects associated with the discontinuation of postmenopausal hormone therapy in a clinical practice settingDesignA total of 816 women aged 45–59 who began hormone therapy between July 1993 and June 1995 in a Massachusetts health maintenance organization were followed for 2 years from the day they received a prescription for estrogen. This cohort has been previously studied for health, treatment, and demographic determinants of hormone therapy discontinuation. In March 1999, these women were mailed a questionnaire containing closed and open-ended questions. A total of 449 women (55%) completed the survey. Discrete-time hazards models were used to identify determinants of discontinuation, controlling for medical predictors of survey nonresponse.ResultsWomen separated from their partners when they initiated hormone therapy (relative risk [RR] of discontinuation = 3.42; 95% confidence interval [CI] = 1.09, 10.73) and women with a body mass index greater than 29.0 (RR = 1.62; 95% CI = 1.18, 2.23) were more likely to discontinue. Women who had ever used oral contraceptives were less likely to discontinue hormone therapy (RR = 0.70; 95% CI = 0.51, 0.98). After women began using hormone therapy, those who experienced irregular bleeding (RR = 1.58; 95% CI = 1.08, 2.31), edema (RR = 2.18; 95% CI = 1.42, 3.34), or abdominal cramps and pelvic pain (RR = 2.42; 95% CI = 1.46, 4.02) while using hormones were more likely to discontinue. The effect of edema and abdominal cramps on the rate of discontinuation was greatest during the first 6 months of use. Women who adjusted their progestin schedule on their own were four times more likely than other women to discontinue hormones (RR = 4.18; 95% CI = 2.20, 7.94). The use of alternative therapies was not statistically associated with discontinuation.ConclusionsWomen who report therapeutic benefits from hormone therapy are more likely to continue using hormones long-term. The experience of certain side effects, especially during the first few months of hormone use, strongly affects whether women continue using hormone therapy.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo compare serum estrone sulfate (E1S) levels in postmenopausal women during long-term treatment with commonly prescribed doses of oral and transdermal estradiol (E2).DesignA retrospective study performed in a University setting in the United States involving 33 healthy postmenopausal women. Two groups of postmenopausal women were studied: group 1 (n= 10) received 1 mg oral micronized E2daily for 16 months; blood was drawn at 0, 7, and 15 months. Group 2 (n= 23) was randomized into three subgroups. Two of the subgroups (n= 8;n= 7) received E2delivered at a rate of 0.05 mg/day and 0.1 mg/day, respectively, by transdermal patch, changed twice weekly; the third subgroup received a placebo (without E2) patch for 9 continuous months. Blood samples were drawn at 0, 6, and 9 months. Serum E1S and E2were quantified by specific radioimmunoassays. Statistical analysis was performed by analysis of variance.ResultsAfter oral E2treatment, E1S levels increased significantly (p< 0.01) from baseline, reaching an average level of 38.8 ng/mL at 15 months. After transdermal E2treatment, E1S levels increased significantly, yet to a much lesser extent, reaching levels of 1.8 ng/mL and 3.2 ng/mL after 9 months of treatment with the 0.05 mg/day and 0.1 mg/day patches, respectively.ConclusionsMarkedly elevated levels of E1S were found after long-term oral estrogen treatment. In comparison to the increase in E1S levels after long-term oral estrogen treatment, there was only a small increase in E1S levels after transdermal E2therapy. This difference may be attributed to the higher dosage of oral E2that is required because of the low bioavailability compared with the transdermal dosages.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo test the effect of female sex hormone depletion and replacement on the distensibility and geometry of the saphenous vein in female rats.DesignTwenty Sprague-Dawley rats were pharmacologically ovariectomized by triptorelin. Ten of these animals received combined hormone replacement with estradiol and medroxyprogesterone acetate. The rest were given vehicle. Ten animals kept parallel without pharmacological ovariectomy served as controls. After 3 months of treatment, a segment of the saphenous vein was dissected. Pressure-diameter curves were recorded in relaxed, contracted, and control states using a microangiograph.ResultsPharmacological ovariectomy lowered venous wall distensibility measured in contraction (at P=8 mm Hg: 4.41 ± 1.21*10−3m2/N vs. control: 0.79 ± 0.14*10−3m2/N;p< 0.05). Hormone replacement partially restored this value (1.8 ± 0.49*10−3m2/N). No alterations in distensibility were found in the relaxed state.After adjusting for body weight, we found that pharmacological ovariectomy lowered venous inner radius significantly compared with control (p< 0.05), whereas hormone replacement increased it compared with pharmacological ovariectomy (p< 0.05) and more significantly compared with control (p< 0.01).ConclusionSex hormone depletion induces significant alterations in venous distensibility, presumably by inducing initial remodeling of the venous wall. Hormone dependency of distensibility differed in relaxed and contracted states of the vein, so some alterations of contractile elements of the wall may be hypothesized. Lower distensibility of the venous wall found after pharmacological ovariectomy could be part of the mechanism of predisposition for postmenopausal hypertension. This can be reversed by female sex hormone replacement.

ISSN:1072-3714    

出版商:OVID    

年代:2001

数据来源: OVID