ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Most perimenopausal women suffer from vasomotor symptoms. Changes in central opioid activity have been proposed to be involved in the mechanisms of hot flushes after menopause. Because acupuncture increases central opioid activity, it may affect postmenopausal hot flushes. The aim was to study if and to what extent two different kinds of acupuncture affected postmenopausal hot flushes, urinary excretion of certain neuropeptides, and quality of life in a group of postmenopausal women. Twenty-four women with natural menopause and hot flushes were included. Twenty-one women completed the study. One group was randomized to electroacupuncture at 2 Hz, whereas the other group was treated with another form of acupuncture (i.e., superficial needle insertion) for a total of 8 weeks. All women daily registered the number and severity of flushes from 1 month before to 3 months after treatment. They completed Quality of Life questionnaires before, during, and after treatment. Twenty-four-hour urine was sampled before, during, and after treatment and analyzed for neuropeptides using radioimmunoassay methods. The number of flushes decreased significantly by >50% in both groups and remained decreased in the group receiving electroacupuncture, whereas in the superficial-needle-insertion group, the number of flushes increased again during the 3 months after treatment. The Kupperman Index decreased significantly in both groups during and after treatment. The excretion of the potent vasodilating neuropeptide calcitonin gene-related peptide-like immunoreactivity decreased significantly during treatment. Acupuncture significantly affects hot flushes and sweating episodes after menopause, with effects persisting at least 3 months after the end of treatment. Changes in calcitonin gene-related peptide, which is a very potent vasodilator, could be involved in the mechanisms behind hot flushes.

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Whole cerebral and cerebellar flow (CBF and Cb1BF) measurements with single-photon emission computed tomography were performed on 14 postmenopausal women 4 weeks after the discontinuation of hormone replacement therapy. After the first brain blood flow measurements, nine subjects received 0.625 mg of conjugated equine estrogens (CEE) orally twice a day continually for 3 weeks (study group). The remaining five did not receive CEE (control group). The second brain blood flow measurements were performed on all 14 subjects between 2 and 3 weeks after the first ones. The mean whole CBF value (&OV0335; ±; SE) in the study group was significantly increased from 45.9 ±;3.4 to 58.8 ±; 5.5 ml/100 g/min during estrogen replacement therapy (ERT) (p = 0.0382). The mean whole Cb1BF value was also significantly increased from 47.7 ±; 3.4 to 61.0 ±; 5.6/100 g/min during ERT (p = 0.0382). In the control group, there were no significant differences between the first and second flow measurements either in the mean whole CBF values (46.6 ±; 2.5 versus 44.6 ±; 5.4 ml/100 g/min) or in the mean whole Cb1BF values (46.3 ±; 2.2 versus 44.2 ±; 5.2 ml/100 g/min). The mean percent changes were 29.5 ±; 10.2% in CBF and 29.3 ±; 10.4% in Cb1BF. These results suggest that ERT significantly increases the whole cerebral and cerebellar blood flows in postmenopausal women.

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

We report the data concerning postmenopausal women treated either with a calcium supplement (500 mg/day, group l, n = 13) or with cyclic conjugated estrogens (0.625 mg/day) and dydrogesterone (5 mg/day) for 21 days with a 7-day free interval (n = 27, group 2) for 24 months. Withdrawal bleeding was regular, starting 1–2 days after the last treatment day and defined as light or mild. No sign of endometrial hyperstimulation was found by hysteroscopy and endometrial biopsy performed after 24 months of treatment. In group 1, constant levels of both urinary excretion of hydroxyproline and plasma osteo-calcin were observed, along with a significant (p < 0.05) decrease in vertebral bone mineral density. In group 2, both urinary excretion of hydroxyproline and plasma osteocalcin levels were significantly (p < 0.05) decreased and vertebral bone density showed a slight but significant (p < 0.05) increase. In group 1, a significant (p < 0.05) increase in serum low-density lipoprotein (LDL)-cholesterol levels was observed, whereas no modification in total cholesterol, high-density lipoprotein (HDL)-cholesterol and triglycerides was found. In group 2, total cholesterol and LDL-cholesterol levels significantly (p < 0.05) decreased, whereas triglycerides levels were stable throughout the study. In this group, HDL-cholesterol levels showed a significant (p < 0.05) increase. In conclusion, the regimen for cyclic combined estrogen-progestogen therapy attenuates bleeding disturbances and results in a low dropout rate. Thus, the clinical and metabolic actions, as well as the protective effects on the endometrium, make this treatment of potential interest. Further studies are required to confirm the long-term beneficial effects of this formula on cardiovascular protection and fracture rate.

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Our objective is to illustrate the bias introduced in assessing factors associated with age at menopause when the population sample has been selected using restricted criteria, i.e. number of years since menopause, by using a cross-sectional analysis of baseline data from a population-based randomized clinical trial. The participants were women who participated in the Postmenopausal Estrogen/Progestins Intervention (PEPI) trial, had not had a hysterectomy, were between 45 and 64 years old, and were menopausal for at least 1 but not greater than 10 years. The outcome measures were self-reported age at menopause and factors thought to be associated with it, including smoking, alcohol use, oral contraceptive use, number of pregnancies, education, income, body mass index, waist-hip ratio, thigh girth, and systolic and diastolic blood pressures. At entry, the mean age of the 601 women was 56.2 years. Mean age at menopause was 51.0 years. Chronologic (current) age was strongly correlated with age at menopause (r = 0.74, p = 0.0001). In bivariate analyses, factors associated with younger age at menopause were ever-use of cigarettes, former oral contraceptive use, and higher thigh girth; factors associated with later age at menopause were greater number of pregnancies, higher waist-hip ratio, and higher systolic blood pressure. After stratification by 5-year age intervals, these associations were no longer statistically significant. Because of restricted sampling, an artificial association was observed between chronologic age and age at time of menopause. This artifact made it difficult to distinguish between factors associated with chronologic age and those that may be independently associated with menopause. Failure to recognize this bias could lead to erroneous conclusions.

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

In a large group of unselected postmenopausal women, we investigated the predictive value of climacteric complaints for future bone loss. We reviewed data on 143 healthy, early postmenopausal women, who had participated in two placebo-controlled trials of the effects of different hormonal replacement regimens on bone mass, receiving either continuous estradiol valerate (E2V) and cyproterone acetate or sequential E2V and levonorgestrel, medroxyprogesterone acetate, or desogestrel. Follow-up examinations were done every 3 months, and 118 women (85%) completed the 2-year study. Bone mass was measured in the distal forearm (BMCarm) and the lumbar spine by photon and x-ray absorptiometry; bone turnover was estimated by measurements of plasma bone Gla protein, serum alkaline phosphatase, and fasting urinary hydroxyproline and calcium corrected for creatinine (FuHPr/Cr). Menopausal complaints were scored according to the Kupperman index and flush scores separately. At baseline, levels of serum estradiol and bone turnover parameters were independent of the Kupperman index and flush score. A slight negative relationship was seen between menopausal complaints and HPr/ Cr only (r = - 0.18; p < 0.05). In the placebo group there was no relationship between the spontaneous rates of bone loss during the 2 years and either the initial Kupperman index or flush score. The responses in both bone compartments to hormone replacement therapy (HRT) were also unrelated to the initial level of menopausal complaints. After 2 years the responses to HRT in bone turnover parameters and BMCarm were independent of menopausal complaints. We conclude that there is no evidence of a relationship between the severity of menopausal complaints and the rate of bone loss or the response to HRT. Women with severe menopausal complaints are a target group for HRT because of the symptom relief, but those requiring HRT for prevention of osteoporosis must be identified by other means.

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A new transdermal therapeutic system has been developed, in which estradiol is dispersed in the adhesive matrix. Gynecologists from 10 Swedish cities recruited 265 healthy women >50 years of age with climacteric complaints into a randomized trial. The objectives of the study were to compare the effects of treatment with the new matrix system and a registered reservoir system. Both patches administer 50 μg/day of 17-beta-estradiol transdermally. Significantly fewer women on the new patch noted erythema, itching, rubbing of the patch on clothes, rustling of the patch, and problems removing the protective lining. The matrix patch also adapted better to the skin and fell off in significantly fewer cases than the reservoir patch. The physician was unaware of the treatment allocated to the patient. Clinic visits were scheduled during treatment-free periods. Patch sites were examined by a study nurse, independently of the clinician. Overall assessment of effectiveness by the investigators favored the new matrix patch, even though efficacy variables suggested equivalence.

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:1995

数据来源: OVID