Substantial relief of myopathic disability by progesterone therapy.
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Activities of Daily Living↗
Biomedical subjects
M Sator
Publications and source records attributed to M Sator.
Hysterectomy is associated with postmenopausal body composition characteristics.
The impact of hysterectomy without oophorectomy and with no malignant purpose on body composition and postmenopausal weight gain was tested in 184 Viennese females aged between 47 and 57 years (mean 52.9). Hysterectomized women were significantly heavier than those who experienced a spontaneous menopause (controls). The amount of fat tissue, especially in the abdominal region, was significantly higher in hysterectomized women. Furthermore, they were reported to have experienced a significantly higher weight gain since menopause (9.1 versus 6.0 kg). No significant differences in bone mass were found. Psychological stress factors and hormonal changes following hysterectomy are discussed as possible causes of these differences.
Absorptiometry, Photon↗
Postmenopausal weight status, body composition and body fat distribution in relation to parameters of menstrual and reproductive history.
OBJECTIVES: In the present study the association between menstrual and reproductive history patterns and weight status, fat distribution and body composition during postmenopause was tested. METHODS: In 106 healthy postmenopausal women ranging in age from 48 to 58 years (x = 53.7 year) the weight status was classified according to the recommendations of the WHO. Additionally body composition was estimated by dual energy X-ray absorptiometry and fat distribution was calculated using the fat distribution index. Weight status, body composition and fat distribution were correlated with self-reported parameters of menstrual and reproductive history (age at menarche, average cycle length, number of births, age at first and last birth, average pregnancy weight gain, age at menopause). RESULTS: It was shown that number of births, age at first birth and pregnancy weight gain were related significantly to the postmenopausal weight status, body composition and fat distribution. CONCLUSION: An early first birth a low number of births and a high weight gain during pregnancies can be assumed as risk factors for overweight, a higher amount of adipose tissue, android fat patterning and therefore for the development of the metabolic syndrome during postmenopause. In contrast no adverse effect of menstrual and reproductive parameters on postmenopausal bone mass was found.
Adipose Tissue↗
Efficacy, tolerability, and rare side effects of tibolone treatment in postmenopausal women.
OBJECTIVE: The purpose of this study was to assess the tolerability and side effects of tibolone (Livial, Organon), a synthetic steroid analogue for the treatment of postmenopausal symptoms, in a large population of patients. METHOD: 1189 postmenopausal patients were included in this study. The patients' blood pressure, body weight, general complaints, and the severity of their climacteric complaints were documented at baseline and after 4 months of tibolone treatment. RESULTS: Tibolone significantly relieved all of the classical menopausal complaints. The proportion of patients with bleeding problems dropped significantly from 15.9% to 6.8%. Other complaints, such as headache, vertigo, nervousness, breast tenderness, and hirsutism were also significantly less frequent than before treatment. Only few women reported other rare side effects, and only 14.4% of women discontinued treatment prematurely. CONCLUSION: Tibolone provides an efficient and safe means of treating the postmenopausal syndrome in every-day practice.
Antineoplastic Agents, Hormonal↗
Impact of the age at menarche on adult body composition in healthy pre- and postmenopausal women.
The present study focuses on the impact of age at menarche on body composition development during adulthood. With 459 healthy middle-class women between 18 and 67 years (x = 41.5) the association between age at menarche and body composition was tested. Body composition, described by absolute and relative amount of fat mass, lean body mass, and bone mass, was estimated by means of dual energy x-ray absorptiometry. In order to exclude the influence of the menopausal transition on body composition, pre- and postmenopausal females were examined separately. The absolute amount of body fat was significantly lower within the group of women whose menarche occurred later. However, postmenopausal females exhibit less significant relations between the two trait systems than premenopausal women. This may be due to the impact of menopausal transition which affected the hormone levels and body composition development independently from the adolescent hormonal transition. While in both proband groups the quantitative amount of body fat was significantly related to menarcheal age, a significant relation between menarcheal age and adult body fat distribution could not be verified.
Adolescent↗
Estrogen therapy in keratoconjunctivitis sicca.
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Administration, Topical↗
The impact of nutritional status on body fat distribution patterns in pre- and postmenopausal females.
This study examines the impact of nutritional status, classified by body mass index, on sex specific fat distribution patterns dependent on menopausal status in 467 pre-, peri- or postmenopausal females. Absolute and relative amounts of upper and lower body fat were estimated by means of dual energy X-ray absorptiometry. It was found that low weight, independent of menopausal status, leads to the typical gynoid pattern of fat distribution while excess weight and obesity result in the android pattern of distribution in pre- and postmenopausal women.
Adipose Tissue↗
Membrane thickness and PROM--high-frequency ultrasound measurements.
Premature rupture of the membranes (PROM) is still an unsolved problem in obstetrics. Neither prevention nor diagnosis nor therapy is readily available. The amniotic sac is stabilized mechanically by a dense network of collagenous fibres; in the event of PROM, the collagenous mesh is dissolved and the thickness of the amniotic sac is reduced. In a prospective study involving 32 patients, we measured the thickness of the membranes in vitro by high-frequency ultrasound and by light microscopy of histological sections, between gestational weeks 28 and 32. We compared 18 patients with premature rupture of the amnio-chorionic membrane with 14 patients following induction of labour, with intact membranes at the same gestational age in vitro. We were able to show that the membrane in the PROM group (0.54 +/- 0.9 mm) was markedly thinner with fewer collagenous fibres than in the control group (0.74 +/- 1.01 mm). The application of high-frequency ultrasound in vivo in PROM may become helpful for the prediction of PROM; further studies are therefore desirable.
Amnion↗
Endometrial volume change during spontaneous menstrual cycles: volumetry by transvaginal three-dimensional ultrasound.
OBJECTIVE: At present, only limited data are available on endometrial volume during the menstrual cycle. Most of these studies deal with animal models and use magnetic resonance imaging for volume measuring. The application of three-dimensional ultrasound in endometrial volume estimation is the subject of this study. SETTING: Patients visiting the outpatient unit of the division of endocrinology and reproductive medicine of a university hospital. PATIENT(S): Twenty patients with a history of a normal menstrual cycle were selected. INTERVENTION(S): Ultrasound examinations were performed during a single menstrual cycle in addition to routine laboratory tests. MAIN OUTCOME MEASURE(S): Uterus-endometrial volume ratio. RESULT(S): Data from 18 patients could be evaluated. In 81 examinations the endometrium volume could be determined. Mean endometrial volume measured by three-dimensional ultrasound was 1.23 cm3. Mean uterus volume was 48.93 cm3. The change of the uterus-endometrial volume ratio showed a good correlation with the day of menstrual cycle. Quadratic regression analysis of volume and cycle length was R2 = 0.432. CONCLUSION(S): Three-dimensional ultrasound allows assessment of volume data of the female internal genitalia. In this study changes of the endometrial volume in menstrual cycles were measured. Additional studies are required to give information on the clinical impact of this new technique of endometrial volume estimation.
Endometrium↗
[The neurotropic effect of progesterone].
Neurological diseases are frequently observed in perimenopausal women and can be characterised through their gender-specific occurrence. These observations raise the question, whether sexual steroids are also involved in neurologic diseases. Epidemiological data have shown, that in Austria in the year 1993 the prescription-rate of psychopharmaca, hypnotics, and analeptics for women between the age of 50 to 55 increased over 300% compared to other age-groups. In males of the same age an increase of the prescription-rate was not observed. Molecular research during the last ten years has found that sexual steroids may interact with the central nervous system via the GABA-receptor. These observations confirm the epidemiological data, that neurologic and psychological functions may be directly influenced by sexual steroids.
Adult↗
[The significance of progesterone and gestagens in climacteric].
Progesterone is the first ovarian hormone to decrease with the onset of menopause. Its deficiency is mainly involved in metro-menorrhagias as well as edemas, body weight problems and psychovegetative symptoms. Hormone replacement therapy with progesterone or one of its derivatives should be perfectly adapted to the women's needs. It is necessary to offer each patient an individual dose. In order to choose the most suitable way of application, the metabolism for each individual should be carefully considered.
Climacteric↗
MRI of microadenomas in patients with hyperprolactinaemia.
MRI is a sensitive tool for the investigation of pituitary microadenomas but cannot be used as a screening investigation. To establish a strategy for the use of MRI in patients with hyperprolactinaemia we investigated 74 women with serum prolactin levels above 52 ng/ml for the presence of microadenomas. We examined 55 premenopausal and 19 postmenopausal women, using a 1.5 T unit. We used T1-weighted spin-echo sequences, with coronal and sagittal images before and after intravenous gadolinium. We found microadenomas in 38 patients (51.3%), macroadenomas in 6 (8.1%) and an infundibular glioma in 1;29 patients had a normal pituitary gland (39.2%). The size of the adenomas was related to the prolactin level, and the mean level in patients with MRI evidence of adenomas was higher than in patients without microadenomas (155.72 +/- 131.01 ng/ml versus 110.14 +/- 80.86 ng/ml). The probability of the presence of an adenoma increased with rising serum prolactin levels. We suggest MRI in patients with prolactin levels more than 100 ng/ml. In patients on oestrogen therapy MRI should be performed with only slightly elevated prolactin levels. Evidence of a microadenoma should be considered in planning further therapy, especially concerning the use of hormone replacement therapy or of bromocriptine.
Adenoma↗
[Measuring amniochorionic membrane thickness with high frequency ultrasound].
The postpartal thickness of the amniochorionic membrane was measured by means of 20 MHz ultrasound after 28 inconspicuous deliveries in the course of a prospective study. The aim of our investigation was to determine the thickness of the amniochorionic membrane using high frequency ultrasound and to evaluate the results for a statistical correlation with fetal and maternal parameters. The data obtained were compared with histological sections for measurement accuracy using a linear regression analysis method. Membrane thickness of the total study group was 0.83 +/- 0.11 mm (0.72-1.08 mm). Based on a statistical comparison with the histological sections, the high frequency ultrasonographic examination was shown to be highly reliable with a correlation coefficient of r = 0.96 (p < 0.0001). Results obtained by ultrasonography were correlated with maternal (gestational age, patient age, parity) and neonatal (size and weight at birth, sex, placental weight, Apgar 1/5/10) parameters by means of linear regression analysis. There was a statistically significant correlation between parity and membrane thickness (r = 0.485, p < 0.05). There was also a correlation of Apgar scores at 5 minutes post partum (r = 0.485, p < 0.05). We were able to demonstrate that the measurement of membrane thickness by ultrasound is an objective and reliable method and may be a gain to prenatal diagnostics when used in vivo.
Adolescent↗
The effects of hormone substitution in depot form on the uterus in a group of 50 perimenopausal women--a vaginosonographic study.
The aim of our study was to examine the effects of hormone replacement on the size of the uterus and the development or increase of myomatas. Fifty perimenopausal women were included in the study (53.8 +/- 5.0 years). Patients received a substitution therapy composed of a combination of 4 mg estradiovalerate and 200 mg prasteronenantate (Gynodian Depot cartridges) given as a muscular injection in 6-10 week intervals (mean 7 weeks +/- 4 days). Prior to the onset of therapy with Gynodian and after a period of 12 months (+/- 13 days) vaginosonography was performed. Measurements taken were length, thickness, height of endometrium, size of ovaries and of myomas. Data obtained were correlated with baseline findings. Within 1 year, significant increases in uterus length from 73.4 mm to 88.2 mm, in uterus thickness from 33.9 mm to 43.5 mm and in endometrium height from 4.1 mm to 6.7 mm were observed (median values). There was an increase in both the number (from 2.2 to 3.5) and the size of the myomatas (29.4-35.0 mm diameter). A statistical analysis conducted by means of the Wilcoxon matched pairs signed-rank sum test showed P < 0.001. No significant change occurred in the size of the ovaries. Our study shows that hormone substitution may have an impact on uterus growth and that therefore vaginosonographical monitoring can be recommended.
Dehydroepiandrosterone↗
[Measuring skin thickness in perimenopausal women. Correlation with bone density and hormone parameters].
AIM: To evaluate the connection between alterations in skin-thickness and bone density in menopause. METHOD: In 231 perimenopausal women the skin thickness was measured with ultrasound and correlated with the results of bone densitometry and the hormonal parameters. RESULTS: The correlation between skin thickness and bone densitometry showed a statistical significance of p < 0.0001. Thus we could demonstrate that not only the bone but also the skin is a hormone-dependent organ which responds enormously to a decrease of C19 and C18 steroids. CONCLUSION: Ultrasound skin measurement is a very simple method which can be used for a more differentiated diagnosis and therapy in menopausal women.
Bone Density↗
[Correlation of skinfold thickness with bone density and estradiol, FSH and prolactin level in a sample of 231 women].
Skin thickness was measured by means of ultrasound and correlated with the results of bone densitometry and hormonal parameters. Skin thickness and bone density were significantly correlated (p < 0.0001). These results indicated that not only bone, but also skin is a hormone-dependent organ, which responds to the menopausal decrease in sexual steroids. Hence, skin ultrasound, just like bone densitometry, can be useful implemented in the differential diagnostic procedure, as well as the therapy of the menopausal syndrome. Additionally, the estrogen-dependent postmenopausal decrease in collagen tissue can be assessed by ultrasound and a successful therapeutic outcome achieved by optimizing the dosage of estrogen substitution.
Bone Density↗
[Placebo-controlled study of melbrosia in treatment of climacteric symptoms].
In a placebo controlled randomized trial we evaluated the efficacy of melbrosia in women who suffered from severe menopausal symptoms. We could show that there was hardly no difference in the change of biochemical parameters, but we found out that the decrease of menopausal symptoms (headache, urinary incontinence, dry vagina, decreasing vitality) was significant in women who did undergo melbrosia medication compared to those who just took placebo. Due to our investigations we reasoned that melbrosia is especially appropriate to women who do not want and who do not need hormone replacement therapy, but who do suffer from menopausal symptoms.
Adult↗