ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Aging is associated with loss of height, which is thought to be caused, at least in part, by vertebral osteoporosis. Estrogen replacement therapy prevents osteoporosis in postmenopausal women, and it has been shown to protect against height loss in some, but not all, prior studies. We took advantage of the availability of information on height measured under standardized conditions 20 years ago among women who participated in the Walnut Creek Contraceptive Drug Study to assess the relationship between height loss and long-term postmenopausal estrogen replacement therapy. Subjects were 36 long-term estrogen users (mean duration of use 17.2 years) and 34 nonusers who were age 45–54 years at entry to the Walnut Creek Study in 1969–1971. These women had their height remeasured in 1992 and completed a detailed questionnaire about risk factors for osteoporosis. After 21–23 years of follow-up, height loss among estrogen users was 0.77 in (95% C.I. 0.50, 1.04); among nonusers, height loss was 0.94 in (95% C.I. 0.71, 1.17). The difference in mean height loss between estrogen users and nonusers was 0.17 in (95% C.I. — 0.18, 0.52), which was not statistically significant (p = 0.32). After adjustment for factors related to osteoporosis and baseline height, the difference in height loss between estrogen users and nonusers was still 0.17 in (95% C.I. — 0.29, 0.62), a difference that was still not statistically significant (p = 0.46). Height loss was highly variable in both estrogen users and nonusers. Median height change and the distribution of height change were essentially identical between estrogen users and nonusers. Our findings do not contradict the protective effect of postmenopausal estrogen replacement therapy against spinal bone loss. They suggest that estrogen may not prevent biologically important differences in height loss up to age 70.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We investigated the effect of nafarelin monotherapy and nafarelin/ norethisterone combination therapy on bone turnover and bone mass. A total of 49 premenopausal women with endometriosis confirmed by laparoscopy were randomized to double-blind treatment for 6 months with 400 μg nafarelin (n = 12), 200 μg nafarelin (n = 12), or 200 μg nafarelin combined with 1.2 mg norethisterone (n = 25). All were followed for another 6 months without treatment and 47 women completed the whole study period. Parameters for bone formation (plasma bone Gla protein and serum total alkaline phosphatase) and bone resorption (fasting urinary hydroxyproline and calcium corrected for creatinine excretion) were determined at baseline and every 3 months. Bone mass was measured at baseline and every 6 months in the forearm and the spine. A significant increase in the parameters of bone resorption was observed after treatment with nafarelin monotherapy, whereas these parameters remained unchanged after combination therapy with norethisterone. A delayed increase in markers of bone formation was observed in all groups, but the response was less pronounced in the combination therapy group. In the 400 μg nafarelin group we observed a delayed 1% (p < 0.05) decrease in the bone mineral content of the forearm; no changes were observed in this region in the 200 μg nafarelin groups. Bone mineral density of the spine decreased 2–3% (p < 0.05–0.001) in all groups. In the nafarelin monotherapy groups, a significant increase in serum total cholesterol, LDL-C, and triglycerides was found. Combination therapy with norethisterone decreased this negative effect on the lipid profile. We conclude that combined nafarelin/norethisterone treatment has a less deleterious effect on bone and lipid metabolism than treatment with nafarelin alone.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Postmenopausal hormone therapy to prevent osteoporosis is commonly started during menopause and often discontinued within 5–10 years. This approach may preserve bone density during use, but there is evidence that it does not preserve bone density or protect against osteoporotic fractures that occur late in life. We used data on the effects of hormone therapy on bone density and the association of bone density and fracture risk to estimate and compare the expected benefits of beginning therapy at menopause and continuing for the remainder of life, beginning therapy at menopause and stopping at age 65, and beginning hormone therapy at age 65 and continuing for the remainder of life. Compared to never users, women who use estrogen continuously beginning at menopause are predicted to have about 22% higher mean bone density between ages 75 and 85 and to reduce their risk of fracture about 73%. In contrast, women who begin therapy at menopause but stop at age 65 are predicted to have only about 8% higher mean bone density and to reduce their risk of fractures about 23% compared to never users. Those who start using estrogen at age 65 are predicted to have 14–19% higher mean bone density than never users and to reduce fracture risk 57–69%. Beginning hormone therapy later in life may provide almost as much protection against osteoporotic fractures as starting at menopause and would halve the period of hormone exposure, reducing the potential risks of very long-term estrogen therapy.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We have previously shown that estradiol-17β (E2) will induce a pituitary luteinizing hormone (LH) surge in postmenopausal women. The current study was designed to evaluate dose response of progesterone (P) on the initiation, augmentation, or inhibition of pituitary LH release in postmenopausal women. Nine healthy postmenopausal women were administered transdermal E2, 0.05 mg per day for 1 week, followed by 0.20 mg per day for 3 days. In a random assignment, the volunteers each were given one of the three doses of P (12.5, 25.0, and 50.0 mg intramuscularly) daily during the 0.20-mg estrogen administration. There was a washout period of 2 weeks between each of the three P treatment regimens. A pituitary LH surge was induced in five volunteers with all three regimens. The mean time to the initiation of the LH surge was 0.55 ± 0.32 days, the peak LH value was found after 0.99 ± 0.39 days, and the duration of the surge was 1.40 ± 0.56 days. These data suggest that P advances the LH surge following estrogen priming in postmenopausal women. The dose of administered P did not result in any other changes in pituitary LH release.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Depression is twice as common in women as in men, with three peaks of occurrence coinciding with major hormonal changes—premenstrual, postnatal, and climacteric. The following review covers studies of all three peaks and the hormonal treatments used.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The North American Menopause Society (NAMS) sponsored a Gallup Organization survey of 833 women aged 45–60 to determine attitudes and experience with menopause and various forms of hormone replacement therapy (HRT). The results of this survey are presented herein.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The etiology for breast cancer remains elusive. The epidemiologic and in vitro evidence for the role played by exogenous ovarian hormones shows no consistent trend for or against causation. This review will look at three aspects of this problem. Many breast cancers are hormone independent, potentially driven by proto-oncogenes and genetic alterations. The breast has the ability to make its own endogenous estrogen, irrespective of exogenous hormone use. Progesterone plays an important role in normal breast homeo-stasis, one which may continue to be needed in the postmenopausal era.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We present the case histories of two women diagnosed with endo-metrial adenocarcinoma during continuous combined hormonal replacement therapy (HRT). Although these findings do not necessarily favor a causal association, they remain of concern. In the absence of a well-designed study evaluating the long-term safety of continuous combined HRT, closer monitoring of the endometrium with baseline and routine periodic histologie evaluation may be necessary. The occurrence of uterine bleeding in women receiving this mode of HRT warrants a thorough investigation.

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1072-3714    

出版商:OVID    

年代:1994

数据来源: OVID