PubMed Health⌕ Search

Biomedical subjects

Valerie Montgomery Rice

Publications and source records attributed to Valerie Montgomery Rice.

8 recordsLinked to original sources
PubMed2006

Bone mineral density in women aged 25-35 years receiving depot medroxyprogesterone acetate: recovery following discontinuation.

INTRODUCTION: This 7-year, prospective, matched-cohort, clinical study evaluated the effects of intramuscular depot medroxyprogesterone acetate (DMPA) (150 mg/mL) on bone mineral density (BMD) in women aged 25-35 years. METHODS: Bone mineral density changes in new DMPA-IM users (n=248) were compared with those in women using nonhormonal contraception (n=360) for up to 240 weeks of treatment and 96 weeks of posttreatment follow-up (in subjects receiving >or=1 dose). RESULTS: At week 240 of treatment, mean percentage changes from baseline in DMPA-IM vs. nonhormonal subjects were: -5.16% (n=21) vs. +0.19% (n=65), total hip (p<.001); -5.38% (n=33) vs. +0.43% (n=105), lumbar spine (p<.001). At week 96 posttreatment, these values were: -0.20% (n=25) vs. +0.84% (n=43), total hip (p=.047); -1.19% (n=41) vs. +0.47% (n=66), lumbar spine (p=.017). CONCLUSIONS: These results show BMD declines during DMPA-IM use; following discontinuation, significant increases in BMD occur through 96 weeks posttreatment.

Adult↗
PubMed2005

Strategies and issues for managing menopause-related symptoms in diverse populations: ethnic and racial diversity.

Menopause is a naturally occurring "equal opportunity" event that every woman who lives beyond the age of approximately 52 years will experience. During the next 20 years, approximately 3.5 million African American women, 2 million Latinas, and 1 million Asian American women will enter the menopause. How a woman approaches the menopausal transition depends on a number of factors, from educational level to socioeconomic status; health-related factors, including stress; and marital status. Increasingly, the roles of race and ethnicity, as they relate to menopausal symptoms, are being explored. Understanding similarities and differences among women of color in perceptions, attitudes, and expectations surrounding the menopause can help provide culturally appropriate care and promote lifestyles that may decrease symptoms and increase quality of life. For example, minority women are usually the gatekeepers for healthcare for themselves and their families and have a highly developed social support network, often including extended family, a church community, and involvement in sororal or social organizations. In the future, research on menopausal symptoms among women of different racial/ethnic groups should focus on exploring in greater detail the effect of dietary factors and body mass index, additional evaluation of pituitary sensitivity, and use of complementary and alternative medicines in symptom management, with a better understanding of the risks and benefits of such therapies.

Complementary Therapies↗
PubMed2002

Conventional medical therapies for endometriosis.

Endometriosis is a common gynecologic disorder that affects approximately 14% of all women and 30% to 50% of infertile women. Since the most common symptoms of endometriosis--progressive dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility--are also symptoms of multiple disorders, a diagnosis of endometriosis can be elusive and confirmed only by visualization, that is, laparoscopy. Endometriosis is often treated surgically upon diagnosis; however, the rate of recurrence is high, suggesting that a combination of therapeutic approaches might provide better outcomes than any one option alone. The most widely utilized hormonal treatments for endometriosis are GnRH agonists and oral contraceptives; agents indicated by the Food and Drug Administration include GnRH agonists and the androgen, danazol. The majority of evidence in support of medical therapy for endometriosis is largely observational, with the exception of studies of GnRH agonists, danazol, and a few progestins. Conventional treatment approaches for the medical management of endometriosis focus on suspected endometriosis, following a diagnosis of endometriosis, following surgical treatment of endometriosis, long-term management, and retreatment. Although major advances have been made in the treatment of endometriosis in recent decades, lack of randomized clinical trials evaluating the use of agents such as oral contraceptives alone or as add-back therapy for GnRH agonists, or those that examine combined medical and surgical treatments, has hampered the ability of physicians to provide the broadest range of medical therapies for this disorder. Future trials addressing these issues are warranted.

Danazol↗
PubMed2002

Hormone replacement therapy: optimising the dose and route of administration.

Several new products and regimens for estrogen replacement in the postmenopausal woman have recently been introduced, giving physicians and patients greater choice not only in dose but also in route of administration. Estrogen treatment in the postmenopausal woman has several proven benefits for those who have vasomotor symptoms or problems related to urogenital atrophy. However, the most controversial area is in the long-term preventive benefits of estrogen against the development of osteoporosis and cardiovascular disease, particularly in women older than 60 years. It is in these areas that decisions on the dose and optimal route of administration of estrogen replacement therapy (ERT) must be made. Although adding a progestogen to an ERT regimen is mandatory, particularly in a woman with an intact uterus, discussion now focuses on which progestogen least attenuates the beneficial effects of estrogen. Emerging trends suggest that lower doses of estrogen (i.e. ethinylestradiol 5 microg/day, estradiol 0.25 mg/day or conjugated estrogens [CEE] 0.3 mg/day) continuously combined with lower doses of medroxyprogesterone (MPA) are equally effective at relieving vasomotor symptoms as the most commonly prescribed regimen in the US (CEE 0.625mg/MPA 2.5mg daily), with fewer adverse events, leading to greater patient acceptance and likelihood for continuation of therapy. This is especially important when therapy is initiated at an older age.

Administration, Cutaneous↗
PubMedDate not supplied

Optimizing the dose of hormone replacement therapy.

Over the last 5 years we have seen the evolution of several new products and several new regimens for estrogen replacement in menopause. Before this time, the decision surrounding hormone replacement therapy (HRT) mainly focused on whether to take estrogen or not, and if the addition of a progestogen was required. However, with new paradigms we now have several options for HRT, with various doses of estrogen ranging from very low doses of oral estrogen (0.3 mg conjugated equine estrogen [CEE], 0.25 mg 17beta-estradiol), transdermal patches which deliver a minimum of 20 microg of 17beta-estradiol per day, or intranasal methods which deliver 100-400 microg of 17beta-estradiol, to the more commonly prescribed doses of 0.625 mg of CEE or 0.5 mg 17beta-estradiol. The decision to add a progestogen to the regimen of replacement therapy is well accepted, particularly in a woman who has an intact uterus; however, now the controversy has focused on which progestogen least attenuates the lipid benefits received from the estrogen replacement therapy. Estrogen treatment in the postmenopausal woman has several proven benefits. For the woman who has vasomotor symptoms or complaints related to urogenital atrophy, there is little controversy regarding its use. However, a continuing controversial area is that of long-term prevention of osteoporosis and cardiovascular disease. It is in these areas that the decision on the dose and the addition of a progestin to hormone replacement therapy is under review.

Aged↗