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Biomedical subjects

R Lindgren

Publications and source records attributed to R Lindgren.

At least 19 recordsLinked to original sources
PubMed1997

[Estrogen and natural products in the treatment of postmenopausal complaints. Oral contraceptives prepare the way for hormonal substitution].

To chart current and previous use of hormone replacement therapy (HRT) and alternative remedies in a postmenopausal population, in relation to previous oral contraceptive (OC) usage, all 1,323 55-56-year-old women living in Linköping in 1995 were sent a questionnaire concerning health status and climacteric symptoms, and previous and/or current use of HRT, OCs and alternative remedies. Current HRT was more common among previous OC users than among those who had never used OCs (41.4 vs. 23.1 percent). As compared with non-HRT users, HRT users were characterised by greater physical activity but less strenuous occupations, and a higher prevalence of hysterectomy. Of the series as a whole, 35 per cent were currently on HRT, half of them having been so for at least two years, and only 5 per cent had abandoned HRT after trying it for some time. Alternative remedies were used by 5 per cent of the women as therapy for climacteric complaints, but about four times as many women had tried such therapy and abandoned it. The sole characteristic feature of alternative remedy usage was that it was less common among hysterectomised women. Of women treated for breast cancer, none used HRT and few used alternative remedies. Thus, in this postmenopausal population, the prevalence of HRT was high, as was the level of compliance. Previous OC usage was probably a determinant of current attitudes toward HRT.

Aged↗
PubMed1996

Effects of hormonal replacement therapy on the postural balance among postmenopausal women.

OBJECTIVE: To establish whether hormone replacement therapy affects postural balance in postmenopausal women. METHODS: Nineteen healthy postmenopausal women with vasomotor symptoms were included. Median age was 54 years, median time since menopause was 3 years. They underwent dynamic posturography before and after 4 and 12 weeks of transdermal estrogen treatment (17 beta-estradiol 50 micrograms/day) as well as after 2 additional weeks of combined estrogen-progestagen treatment. The dynamic posturography method quantifies the amplitude, frequency, and pattern of body sway and tests the visual, vestibular, and somatosensory systems, which together maintain balance. The two most difficult tests either cancel visual and distort somatosensory inputs or give distorted information from both the visual and somatosensory systems. RESULTS: Hormone replacement therapy increased static balance performance assessed by dynamic posturography. A highly significant improvement was seen in the two most difficult tests between the pretreatment test and the test performed after 4 weeks of estrogen therapy (P < .01, P < .001, respectively). This improvement was sustained after 12 weeks and also during the 14th week, with the women on combined estrogen-progestagen treatment. CONCLUSION: Estrogen treatment increased balance performance measured by dynamic posturography, indicating that the beneficial effects from estrogens on postmenopausal fracture risk may include central nervous system effects on balance. Two weeks' addition of gestagen to the treatment regimen did not counteract the estrogen effects.

Estradiol↗
PubMed1996

Hormone replacement therapy and previous use of oral contraceptives among Swedish women.

OBJECTIVES: To assess the current and previous use of hormone replacement therapy (HRT) and alternative remedies in a postmenopausal population and to relate HRT use to previous use of oral contraceptives. MATERIAL AND METHODS: All 1323 women living in Linköping of 55 or 56 years old during 1995 were sent a questionnaire asking for data with relation to health and climacteric symptoms as well as to previous and current use of HRT, oral contraceptives and alternative remedies. RESULTS: Current use of HRT was more common among women who previously used oral contraceptives (41.3%) than among women who had never used oral contraceptives (23.1%). HRT users were also more often physically active, had undergone hysterectomy and had lighter occupation than non-users. Of all women 35% were current users of HRT, half of them for at least 2 years, whereas only 5% had tried HRT and abandoned therapy. Alternative remedies were used by 5% of the women as therapy for climacteric complaints, and about four times as many women had tried such therapy but abandoned it. The only characteristic about use of alternative medicines was that they were used less often by women who had been hysterectomized. No women treated for breast cancer used HRT and only few of them used alternative remedies. CONCLUSIONS: The prevalence of HRT use, as well as compliance, was high. Previous use of oral contraceptives probably affected the attitude towards using HRT.

Climacteric↗
PubMed1995

The climacteric among South-American women, who immigrated to Sweden and age-matched Swedish women.

Forty-nine immigrated South-American (SA) and 48 Swedish women, aged 42-67 years, were studied in a comparative semi-structured interview survey, concerning the climacteric and its treatment. The mean age at natural menopause was 47 for the South-American women and 50 for the Swedish women. The prevalence of moderate to severe vasomotor symptoms at the time of the survey did not differ significantly between the non-treated, non-operated, postmenopausal South-American and Swedish women (36% and 21%; N.S.). One reason for the trend towards a higher prevalence among South-American women could be that a greater number of Swedish women used hormone replacement treatment compared to South-American women (11 vs. 4). The general attitude to hormone replacement therapy was more positive among South-American women, although they did not use hormone therapy, as could be expected from their symptoms. These results are probably an illustration of the difficulties in getting access to treatment for the immigrated SA women.

Adult↗
PubMed1995

Transdermal hormonal replacement therapy with transdermal progestin every second month.

OBJECTIVES: Unopposed estrogen therapy may induce endometrial hyperplasia. To protect the endometrium, estrogen replacement therapy should be combined with a progestin in menopausal women with an intact uterus. The aim of this open non-comparative study was to evaluate the effects on bleeding control and endometrium of 'spacing-out' the 14-day progestin therapy to every second month during transdermal combined hormonal replacement therapy. METHODS: Sixty-eight healthy women, previously treated with sequential combined transdermal hormonal replacement therapy every month for 3 years, were treated for the following 2 years in cycles with 6 weeks of transdermal estradiol 50 micrograms/daily (Estraderm, Ciba-Geigy), followed by 2 weeks of combined norethisterone acetate 0.25 mg/day and 50 micrograms estradiol per day. RESULTS: Annual endometrial biopsies diagnosed hyperplasia in one woman during the second year whereas most biopsies showed a secretory endometrium. Vaginal ultrasound showed no correlation to either bleeding-pattern or histopathological diagnosis. Most women had a regular bleeding-pattern. CONCLUSIONS: Transdermal progestin every second month might be an alternative to regular monthly sequential hormonal replacement therapy.

Administration, Cutaneous↗
PubMed1994

[Acupuncture against climacteric disorders? Lower number of symptoms after menopause].

Vasomotor symptoms are very common among perimenopausal women, but also among orchidectomized men. The cause of the symptoms is not the low steroid concentrations per se, but probably changes in central neuropeptide activity. Twenty-four healthy women with natural menopause, suffering from hot flushes, were included in the study and randomly assigned to either of two groups, one group received treatment with electrostimulated acupuncture (EA), the other with superficial needle position (SNP) acupuncture. Treatment was given for totally of eight weeks, twice a week during the first two weeks, and then once a week for the remaining six weeks. As recorded in logbooks kept by the participants, the frequency of flushes decreased significantly by more than 50 per cent in both groups, and remained decreased in the EA group, whereas in the SNP group it increased slightly again over the three months after treatment. Values for the Kupperman Index decreased in both groups during treatment, changes still evident at three-month follow-up, whereas the self-rated general climacteric symptoms (VAS) decreased significantly in the EA group only. The PGWB (Psychological General Well-Being) index did not change significantly in either group during treatment.

Acupuncture Therapy↗
PubMed1993

A Swedish version of the Women's Health Questionnaire. A measure of postmenopausal complaints.

We wanted to provide details on the psychometric documentation of the Swedish version of the Women's Health Questionnaire (WHQ), a patient based measure of postmenopausal complaints. The results of two clinical trials in Sweden in which the WHQ had been used as one out of several measurement tools were used to document the reliability, the validity and the responsiveness to change of the WHQ. More than 350 women suffering from postmenopausal complaints were included in the two trials. A factor analysis, using the baseline values of all women in each study, showed that the Swedish version of the WHQ was very close to the English original. The internal consistency reliability was excellent. The clinical validity was confirmed by a significant correlation between change in E2 levels and change in the WHQ during estrogen therapy. A high construct validity was established by the agreement between the WHQ and other quality of life scales. For use in clinical trials the WHQ was sensitive to treatment-induced changes, and added important information to the clinical effect variables.

England↗
PubMed1993

Hormonal replacement therapy and sexuality in a population of Swedish postmenopausal women.

All women (n = 2465) living in the community of Linköping, Sweden, aged 55, 57, 59 and 65 years were studied in a cross-sectional trial concerning the prevalence of vasomotor symptoms, hormonal replacement therapy (HRT) and sexual activities. After one reminder, answers were received from 1867 (76%) women. In all, 51% of the women reported vasomotor symptoms. Ten percent of the women used HRT at the time of the survey. Another 10% of the women had previously used oral HRT but had abandoned treatment. One third of these women reported no vasomotor symptoms when they abandoned treatment. One fifth ceased treatment after recommendation from their physician and another fifth because of 'fear' of hormonal treatment. Sixty-two percent of the women reported sexual activity. The most common reasons for not having a regular sex-life were lack of partner or lack of desire.

Adult↗
PubMed1992

Plasma lipid and lipoprotein effects of transdermal administration of estradiol and estradiol/norethisterone acetate.

To evaluate the effect of transdermal sequential treatment with estradiol and estradiol/norethisterone acetate on lipoprotein metabolism, 25 postmenopausal women received treatment for 12 cycles of 4 weeks each (2 weeks estradiol 50 micrograms/day and 2 weeks a combined patch delivering norethisterone acetate 0.25 mg/day and estradiol 50 micrograms/day). Blood samples for lipoprotein analyses were drawn before treatment and in estrogen and combined phases in cycles 3 and 12. Plasma total cholesterol, low (LDL) and high (HDL) density lipoprotein were all significantly reduced in both estrogen and combined phases. Eighteen of the women continued the treatment for 36 cycles. In this group the HDL-cholesterol had returned to baseline values in combined phase in cycle 24. Plasma cholesterol and LDL-cholesterol values remained significantly reduced throughout the whole study compared to the pre-trial values. The present study by transdermal sequential hormonal treatment results in a lipid and lipoprotein pattern with reduced total cholesterol and LDL cholesterol in postmenopausal women.

Administration, Cutaneous↗
PubMed1992

Endometrial effects of transdermal estradiol/norethisterone acetate.

The efficacy of transdermal norethisterone acetate in sequence with transdermal estradiol has been investigated in a multicenter study of 136 post-menopausal women to determine the incidence of endometrial hyperplasia, the effects on the vaginal cytology and the control of bleeding. Treatment consisted of 12 cycles of 4 weeks each (2 weeks estradiol 50 micrograms/day followed by 2 weeks of a new combined patch delivering norethisterone acetate 0.25 mg/day and estradiol 50 micrograms/day). Endometrial histology was assessed by two pathologists. Of the 136 pre-treatment biopsies 89% provided no material, an inadequate sample or an inactive (atrophic or non-secretory) endometrium. Of the post-treatment biopsies from 110 women who completed the study: 65% showed secretory, 3% proliferative and 24% inadequate material or inactive endometrium. Hyperplasia was found in two biopsies (2%); in one of these focal atypical hyperplasia was agreed by both pathologists, in another a hyperplastic endometrial polyp was diagnosed by one pathologist. The bleeding was regular in 80% of the 1195 cycles and irregular in 11%. No bleeding occurred in 9% of the cycles. Vaginal cytology showed a significant shift towards increased maturation during treatment.

Administration, Cutaneous↗
PubMed1992

Long-term effect of transdermal hormonal therapy on aspects of quality of life in postmenopausal women.

The long-term effect on aspects of quality of life (QoL) of treatment with transdermal oestrogen for 2 weeks followed by transdermal oestrogen/progestogen norethisterone acetate/oestradiol TTS 0.25/0.05 mg/day for the next 2 weeks was investigated in postmenopausal women within the framework of a 1-year seven-centre trial. Of the 136 women who were included (mean age 53 +/- 4.8 years), 110 completed the study. Aspects of QoL that are of relevance in the perimenopause and postmenopause were evaluated using the Psychological General Well-Being (PGWB) index, the Women's Health Questionnaire (WHQ) and the Sleep Dysfunction Scale before and after 3 and 9 months of therapy in the oestrogen phase. Climacteric complaints were also assessed by means of the Kupperman Index. Improved well-being, i.e. less anxiety and depression, increased vitality and better self-control (P less than 0.0001) were observed, as well as reduced sleep disturbance (P less than 0.0001). The WHQ showed decreased vasomotor and somatic symptoms, and improved sex life, emotions and cognitive function (P less than 0.0001). Improvement was the same at 3 and 9 months. According to the Kupperman Index, climacteric symptoms were alleviated (P less than 0.0001). Relief of vasomotor symptoms was correlated with improvement in the WHQ (r = 0.82), the PGWB index (r = 0.58, P less than 0.0001) and sleep (r = 0.51, P less than 0.0001). Because of the absence of a placebo control group, the results must be regarded with caution until confirmed in a placebo-controlled trial.

Administration, Cutaneous↗
PubMed1990

Does physical exercise influence the frequency of postmenopausal hot flushes?

The frequency of moderate and severe hot flushes was investigated in a group of women (n = 142) who took part in organized physical exercise on a regular basis, and a control group of all women 52 and 54 years old in the city of Linköping, Sweden (n = 1,246). Only women with natural menopause and without a history of hormonal replacement treatment were statistically compared in the study. It appeared that moderate and severe vegetative symptoms with hot flushes and sweatings were only half as common among the physically active postmenopausal women (21.5%) as in the control group (43.8%). Although this could be due to a positive selection of these physically active women, it might also be due to the fact that exercise may affect the mechanisms that elicit hot flushes in peri- and postmenopausal women.

Climacteric↗
PubMed1988

Climacteric symptoms among women aged 60-62 in Linköping, Sweden, in 1986.

By means of a simple postal questionnaire, all women aged 60, 61 and 62 (n = 2015) living in the community of Linköping, Sweden, were screened for vasomotor symptoms and local vaginal complaints. After one reminder, answers were received from 73% of the women. At the time of the survey (April 1986) all the women were post-menopausal, the median period since menopause being 11 yr. Slightly over one in four of the women (27%) were suffering from sweating and hot flushes. Ten percent (10%) of the women who were more than 15 yr post-menopausal still had moderate to severe climacteric symptoms. Vasomotor symptoms were significantly more common among oophorectomized women than among those whose ovaries were intact. Local vaginal symptoms were positively correlated with urinary problems, repeated urinary tract infections and a high risk of disturbance of sexual activity. It was concluded that climacteric symptoms often persist for more than 15 yr after the menopause.

Climacteric↗
PubMed1988

Which fetal growth charts should be used?

Fetal intra-uterine growth charts are generally based on last menstrual period (LMP) data. Such charts may not really be applicable to infants whose gestational age is ultrasonically determined in early pregnancy. 1369 consecutive singleton pregnancies were studied. All fetuses had their gestational age estimated both by ultrasonic measurement of fetal crown-rump length and from registered last menstrual period data. All infants were weighed at birth as a part of the routine care. The age determination according to the two methods differed in 664 out of 1369 cases and in 516 of these 664 cases the age according to LMP was higher than according to CRL--a highly significant difference (p less than 0.001). Mean values for birth weight were found to be larger when correlated to age in terms of CRL determinations than when related to age as calculated from LMP data. Birth weight also showed a significant increase between 40 and 42 weeks when age was determined ultrasonically. This was not the case when age determination was based on LMP data. The explanation of this fact is that age is overestimated in late pregnancy when calculated from LMP data. These facts ought to be considered when future fetal growth charts are constructed.

Birth Weight↗