Lifetime endogenous estrogen exposure and electrocardiographic frontal T axis changes in postmenopausal women.

Maturitas. 2009 Jun 29; Atsma F, van der Schouw YT, Grobbee DE, Kors JA, Bartelink MLOBJECTIVE: The protective effect of endogenous estrogens in cardiovascular disease may in part originate from effects of circulating estrogens on the electrophysiological properties of the myocardium. The aim of this study was to investigate the relation between reproductive factors and the electrocardiographic frontal T axis in postmenopausal women. DESIGN: Cohort study. SETTING: The study was conducted at the University Medical Center Utrecht. PATIENTS: In total, 998 postmenopausal women were included. MAIN OUTCOMES: Information of women's reproductive life was obtained by a questionnaire. Electrocardiographic frontal T axes were categorized as normal (25-65 degrees ) or abnormal (-180 degrees to 24 degrees...

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Use of a Gonadotropin-releasing Hormone Agonist to Manage Perimenopausal Women With Symptomatic Uterine Myomas.

Taiwan J Obstet Gynecol. 2009 Jun; 48(2): 133-7Wang PH, Lee WL, Cheng MH, Yen MS, Chao KC, Chao HTOBJECTIVE: To determine the acceptability and effectiveness of a gonadotropin-releasing hormone (GnRH) agonist for the treatment of perimenopausal women with symptomatic uterine myomas. MATERIALS AND METHODS: The participants included 43 women with symptomatic myomas who wished to retain their uteri. All the women were older than 45 years old, agreed to use the GnRH agonist for menopause induction, and were without any underlying malignancy. They were treated with six courses of GnRH agonist between 2004 and 2005. The definition of re-intervention included: (1) surgical intervention, such as hysterectomy, myomectomy or laparoscopic uterine vessel occlusion, or (2) modification of GnRH agonist...

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What Can We Learn from Design Faults in the Women's Health Initiative Randomized Clinical Trial?

Bull NYU Hosp Jt Dis. 2009; 67(2): 226-9Design faults resulted in the inability of the Women's Health Initiative (WHI) randomized clinical trial to test the level of cardioprotection conferred by timely hormone treatment of women seeking help for menopausal complaints. Adopting a design constructed around the avoidance of symptomatic subjects and recruitment of older subjects who were more likely to manifest cardiovascular events during the life of the WHI resulted in recruitment of older, sicker subjects than are normally treated for complaints around the time of menopause. The lack of cardioprotection in subjects that began treatment a decade or more after menopause diluted ardioprotection in subjects starting treatment close to the menopausal transition. As a result, despite having the...

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Ovarian status in healthy postmenopausal women: follow-up 12 months after transvaginal ultrasound.

Menopause. 2009 Jul 1; Bell RJ, Healy DL, Robertson DM, Jobling T, Oehler MK, Edwards A, Shekleton P, Oldham J, Piessens S, Teoh M, Mamers P, Taylor N, Walker FOBJECTIVE:: We have previously reported on the point prevalence of ovarian lesions detected by transvaginal ultrasound (TVU) in 515 asymptomatic women at least 5 years postmenopause. The aims of this study were to report, in the same women, on the repeatability of visualization of the ovaries (TVU) and the natural history of ovarian lesions seen at baseline but not treated surgically and to assess whether any women developed new ovarian abnormalities 12 months later. METHODS:: The study involved a cohort of 515 postmenopausal women recruited from the community, at least 5 years past their last period. They were assessed at baseline...

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Lower bone mineral density of forearm in postmenopausal patients with radiographic hand osteoarthritis.

Rheumatol Int. 2009 Jul 8; Kim SK, Park SH, Choe JYThe association between clinical parameters and forearm bone mineral density (BMD) in postmenopausal females with radiographic hand OA has not been determined. We investigated the difference in forearm BMD between radiographic hand OA and non-radiographic hand OA, and also the association between clinical parameters of patients and the level of forearm BMD. A total of 180 postmenopausal patients with hand OA were enrolled in this study. We classified them into two groups according to the Kellgren-Lawrence (K-L) radiological grade, one with radiographic hand OA (K-L grade >/= 2) and the other with non-radiographic OA (K-L grade < 2) as controls. The number of nodal joints, swollen joints and tender joints were determined in the physical...

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Vaginal symptoms in postmenopausal women: self-reported severity, natural history, and risk factors.

Menopause. 2009 Jul 1; Huang AJ, Moore EE, Boyko EJ, Scholes D, Lin F, Vittinghoff E, Fihn SDOBJECTIVE:: This study aimed to examine factors other than estrogen deficiency influencing the development and persistence of vaginal dryness, itching, and painful sexual intercourse after menopause. METHODS:: We analyzed data from a 2-year, population-based cohort of 1,017 postmenopausal women aged 55 to 75 years. Vaginal symptoms were assessed by interviewer-administered questionnaire, and vaginal swabs were performed to assess vaginal pH and microbial flora at baseline, 12 months, and 24 months. Generalized estimating equations were used to identify characteristics associated with symptoms. RESULTS:: Half of the women (n = 471) reported problematic vaginal dryness, a third (n = 316) reported itching,...

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Effects of alendronate treatment on serum levels of osteoprotegerin and total receptor activator of nuclear factor kappaB in women with postmenopausal osteoporosis.

Menopause. 2009 Jul 1; Reyes-García R, Muñoz-Torres M, García DF, Mezquita-Raya P, García Salcedo JA, de Dios Luna JOBJECTIVE:: Bisphosphonates are potent inhibitors of bone resorption that are used as effective therapeutic agents for the management of osteoporosis and other bone diseases. The osteoprotegerin (OPG)-receptor activator of nuclear factor kappaB (RANKL) system plays an important role in the regulation of bone metabolism and vascular biology. The effects of bisphosphonate treatment in OPG-RANKL system have not been fully elucidated. The aims of the study were to evaluate the effects of alendronate treatment (70 mg once/wk) on serum concentrations of OPG, total RANKL, and biochemical markers of bone turnover in untreated women with postmenopausal osteoporosis and to determine...

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Coronary heart disease and menopause management: The swinging pendulum of HRT.

Atherosclerosis. 2009 Jun 6; Stevenson JC, Hodis HN, Pickar JH, Lobo RAThe Women's Health Initiative comprised a randomized placebo-controlled clinical trial of therapeutic and dietary interventions influencing postmenopausal women's health. One arm evaluated hormone replacement therapy and its effects on major health outcomes. Initial publication of the preliminary results suggested overall harm from hormone replacement therapy, leading to a dramatic worldwide decrease in its use, and concerns from clinicians and regulatory authorities. Subsequent publications with more detailed analyses appear to have countermanded these initial concerns. Analyses of the studies have not been adherent to those specified in the original published protocol. Nominal confidence intervals should have been used...

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Transdermal Nitroglycerin Therapy May Not Prevent Early Postmenopausal Bone Loss.

J Clin Endocrinol Metab. 2009 Jun 23; Wimalawansa SJ, Grimes JP, Wilson AC, Hoover DR, Context: Osteoporosis is common among postmenopausal women; pilot studies support the concept of nitric oxide (NO) donors reducing bone mineral density loss. Objective: Evaluate if NO donor, nitroglycerin prevents postmenopausal bone loss. Design: Three-year randomized, blinded, single-center, placebo-controlled clinical trial. Setting: Single-center study at the University of Medicine and Dentistry - Robert Wood Johnson Medical School, New Brunswick, New Jersey. Participants: 186 postmenopausal women aged 40 to 65 years, with lumbar bone mineral density (BMD) T-scores of 0 to -2.5. Intervention: Women, stratified by lumbar T-score (< -1.50 and >/= -1.50) and years since menopause (5 years), were...

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Influence of gender on serum growth hormone, insulin-like growth factor-I and its binding protein-3 during aging.

Yonsei Med J. 2009 Jun 30; 50(3): 407-13Lin CM, Huang YL, Lin ZYPURPOSE: The serum concentrations of insulin-like growth factors-I (IGF-I), insulin-like growth factor binding protein-3 (IGFBP-3) and growth hormone (GH) are related to body composition, function and metabolism, and are influenced by the aging process. This study was to investigate the influence of gender on serum concentrations of IGF-I, IGFBP-3 and GH in middle and old age subjects. MATERIALS AND METHODS: Sixty healthy volunteers (male 35, female 25, 36-70 years) were divided into < or = 50 and > 50 years groups, based on gender. Women > 50 years were post-menopause. IGF-I, IGFBP-3, and GH were determined by immunoradiometric assay. RESULTS: IGF-I was shown to be negatively correlated with age (women r = -0.62, p...

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Association of Polymorphism of Estrogen Receptor-alpha Gene with Circulating Levels of Adiponectin in Postmenopausal Women with Type 2 Diabetes.

J Atheroscler Thromb. 2009 Jun 25; Yoshihara R, Utsunomiya K, Gojo A, Ishizawa S, Kanazawa Y, Matoba K, Taniguchi K, Yokota T, Kurata H, Yokoyama JI, Urashima M, Tajima NAim: Menopause is a risk factor for cardiovascular disease (CVD) in women because of the reduction in endogenous estrogen. Recently, single nucleotide polymorphisms (SNPs) of the estrogen receptor alpha (ESR-1) gene (c.454-397T>C) associated with the prognosis of myocardial infarction in postmenopausal women were identified; however, the mechanism by which genetic variation of ESR-1 contributes to the pathogenesis of CVD is unknown. Circulating levels of adipokines and inflammatory cytokines predict CVD risk; hence, this study aimed to investigate whether ESR-1 genotypes (c.454-397T>C) might influence circulating levels...

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Life after a diagnosis with endometriosis - a 15 years follow-up study.

Acta Obstet Gynecol Scand. 2009 Jun 30; 1-6Fagervold B, Jenssen M, Hummelshoj L, Moen MHObjective. Previous studies have elucidated the negative impact of endometriosis on life, but the patient selection may have contributed to a skewed picture. The aim of this study was to investigate longitudinally the consequences of the disease in women diagnosed with endometriosis 15 years ago. Design. Retrospective descriptive. Setting. Trondheim 2007. Sample. One hundred thirty women diagnosed with endometriosis at St. Olav's Hospital in Trondheim between 1991 and 1993. Methods. Questionnaires. Response rate of 60%. Main outcome measures. Consequences of living with endometriosis. Results. Of the women, 19.2% never experienced pelvic pain and 21.8% did not have any further visits to the gynecological...

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Progesterone and ovulation across stages of the transition to menopause.

Menopause. 2009 Jun 29; O'Connor KA, Ferrell R, Brindle E, Trumble B, Shofer J, Holman DJ, Weinstein MOBJECTIVE:: Detailed characterization of progesterone and ovulation across the menopausal transition provides insight into conception risk and mechanisms of reproductive aging. METHODS:: Participants (n = 108, aged 25-58 y) collected daily urine specimens for 6-month intervals in each of 5 consecutive years. Specimens were assayed for pregnanediol glucuronide (PDG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estrone glucuronide (E1G). Reproductive stage was determined using cycle length variance. A hierarchical algorithm was used to identify ovulation. Linear mixed-effects models estimated (1) the frequency and day of ovulation by age and stage; (2) differences in FSH,...

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Thyroid hormones affect recovery from depression during antidepressant treatment.

Psychiatry Clin Neurosci. 2009 Jun; 63(3): 305-13Pae CU, Mandelli L, Han C, Ham BJ, Masand PS, Patkar AA, Steffens DC, De Ronchi D, Serretti AAIMS: The aim of the present study was to evaluate whether thyroid hormonal changes during menopause may affect the development and the course of major depressive disorder. METHODS: Thirty-nine female patients (n = 17 in pre-menopause; n = 22 in post-menopause) with major depressive disorder based on Diagnostic Statistical Manual of Mental Disorders (4th edition) criteria and who were euthyroid and not on hormonal replacement therapy, participated in a prospective, 6-week, open-label naturalistic study. The Hamilton Depression Rating Scale-17 item, the Montgomery-Asberg Depression Rating Scale, the Clinical Global Impression scale and the Cognitive...

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HFE C282Y/H63D compound heterozygotes are at low risk of hemochromatosis-related morbidity.

Hepatology. 2009 Mar 19; 50(1): 94-101Gurrin LC, Bertalli NA, Dalton GW, Osborne NJ, Constantine CC, McLaren CE, English DR, Gertig DM, Delatycki MB, Nicoll AJ, Southey MC, Hopper JL, Giles GG, Anderson GJ, Olynyk JK, Powell LW, Allen KJ, The risk of hemochromatosis-related morbidity is unknown among HFE compound heterozygotes (C282Y/H63D). We used a prospective population-based cohort study to estimate the prevalence of elevated iron indices and hemochromatosis-related morbidity for compound heterozygotes. In all, 31,192 subjects of northern European descent were genotyped for HFE C282Y and H63D. An HFE-genotype stratified random sample of 1,438 subjects, followed for an average of 12 years to a mean age of 65 years, completed questionnaires and gave blood. Clinical examinations were blinded...

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