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Biomedical subjects

Woraluk Somboonporn

Publications and source records attributed to Woraluk Somboonporn.

7 recordsLinked to original sources

PubMed2006

Testosterone therapy for postmenopausal women: efficacy and safety.

The treatment of postmenopausal women with a variety of androgen formulations is increasing, despite the lack of clear guidelines regarding the diagnosis of androgen insufficiency. This review summarizes evidence on the efficacy and safety of adding testosterone to hormone therapy in postmenopausal women. Fair to good evidence exists that the use of testosterone in combination with hormone therapy has both benefits and risks. The benefits are an improvement in sexual function with various regimens of testosterone use (good evidence), an improved sense of well-being with transdermal testosterone (fair evidence), and a reduction in triglyceride levels with methyl testosterone (fair evidence). The most consistent risk is a reduction in high-density lipoprotein (HDL) cholesterol, particularly with methyl testosterone (good evidence). There has been insufficient reporting of other side effects; hence, testosterone therapy should be used with caution. The use of testosterone may be justified in specific clinical circumstances and should be limited to short-term use; long-term studies are not available. Close surveillance for HDL cholesterol and other side effects is necessary.

Androgens↗

PubMed2006

Androgen and menopause.

PURPOSE OF REVIEW: Androgen therapy is being increasingly used in the management of postmenopausal women. The most common indication is to improve sexual function. The aim of this review is to evaluate current knowledge pertaining to testosterone and sexual function in postmenopausal women. RECENT FINDINGS: The change of testosterone levels during the menopause transition remains controversial. A correlation of endogenous testosterone levels and sexual function is still inconclusive. A Cochrane Review and recent randomized control trials have, however, consistently demonstrated that short-term testosterone therapy in combination with traditional hormone therapy regimens improves sexual function in postmenopausal women, particularly surgically menopausal women with hypoactive sexual desire disorder. An adverse effect on the lipid profile has been identified which appears to be mostly associated with oral methyltestosterone. Data for other effects of testosterone and long-terms risks are lacking. Testosterone may act in a variety of ways in different tissues. This is, however, an area that requires further investigation. SUMMARY: Testosterone therapy is a promising option for treating women with hypoactive sexual desire disorder after surgical menopause. Two remaining questions need to be answer: who is most likely to benefit from testosterone therapy and what are the long-term health risks?

Anabolic Agents↗

PubMed2004

Postmenopausal testosterone therapy and breast cancer risk.

BACKGROUND: Testosterone therapy is being increasingly used in the management of postmenopausal women. However, as clinical trials have demonstrated a significantly increased risk of breast cancer with oral combined estrogen-progestin therapy, there is a need to ascertain the risk of including testosterone in such regimens. OBJECTIVE: Evaluation of experimental and epidemiological studies pertaining to the role of testosterone in breast cancer. DESIGN: Literature review. SETTING: The Jean Hailes Foundation, Research Unit. MAIN OUTCOME MEASURES: Mammary epithelial proliferation, apoptosis and breast cancer. RESULTS: In experimental studies, testosterone action is anti-proliferative and pro-apoptotic, and mediated via the AR, despite the potential for testosterone to be aromatized to estrogen. Animal studies suggest that testosterone may serve as a natural, endogenous protector of the breast and limit mitogenic and cancer promoting effects of estrogen on mammary epithelium. In premenopausal women, elevated testosterone is not associated with greater breast cancer risk. The risk of breast cancer is also not increased in women with polycystic ovary syndrome who have chronic estrogen exposure and androgen excess. However, in postmenopausal women, who are oestrogen deplete and have increased adipose aromatase activity, higher testosterone has been associated with greater breast cancer risk. CONCLUSION: Available data indicate the inclusion of testosterone in estrogen-progestin regimens has the potential to ameliorate the stimulating effects of hormones on the breast. However, testosterone therapy alone cannot be recommended for estrogen deplete women because of the potential risk of enhanced aromatisation to estrogen in this setting.

Animals↗

PubMed2004

Testosterone effects on the breast: implications for testosterone therapy for women.

Androgens have important physiological effects in women. Postmenopausal androgen replacement, most commonly as testosterone therapy, is becoming increasingly widespread. This is despite the lack of clear guidelines regarding the diagnosis of androgen insufficiency, optimal therapeutic doses, and long-term safety data. With respect to the breast specifically, there is the potential for exogenous testosterone to exert either androgenic or indirect estrogenic actions, with the latter potentially increasing breast cancer risk. In experimental studies, androgens exhibit growth-inhibitory and apoptotic effects in some, but not all, breast cancer cell lines. Differing effects between cell lines appear to be due primarily to variations in concentrations of specific coregulatory proteins at the receptor level. In rodent breast cancer models, androgen action is antiproliferative and proapoptotic, and is mediated via the androgen receptor, despite the potential for testosterone and dehydroepiandrosterone to be aromatized to estrogen. The results from studies in rhesus monkeys suggest that testosterone may serve as a natural endogenous protector of the breast and limit mitogenic and cancer-promoting effects of estrogen on mammary epithelium. Epidemiological studies have significant methodological limitations and provide inconclusive results. The strongest data for exogenous testosterone therapy comes from primate studies. Based on such simulations, inclusion of testosterone in postmenopausal estrogen-progestin regimens has the potential to ameliorate the stimulating effects of combined estrogen-progestin on the breast. Research addressing this is warranted; however, the number of women that would be required for an adequately powered randomized controlled trial renders such a study unlikely.

Androgens↗

PubMed2002

Knowledge-attitude-practice of sexual intercourse of post-menopausal women using hormone replacement therapy.

OBJECTIVE: To study knowledge, attitude, practice and concern related to sexual intercourse of post-menopausal women using hormone replacement therapy. MATERIAL AND METHOD: One hundred and thirty subjects were included in the study from the 1st of May 2000 to the 31st of August 2000 at the Menopause Clinic, Srinagarind Hospital, Khon Kaen. All subjects were interviewed by a researcher with structured questionnaires. RESULTS: Sixty seven per cent of the subjects had an acceptable level of knowledge, whereas, 87.7 per cent thought that they could have sexual intercourse similar to what they had in their pre-menopausal period. It was found that 85.4 per cent and 88.5 per cent of the subjects had either less or absent sexual desire and less sexual activity, respectively. In terms of their concern, 73.9 per cent of the subjects were not worried about sexual intercourse. CONCLUSION: The majority of the post-menopausal women using hormone replacement therapy had a good level of knowledge and attitude concerning sexual intercourse. Although most of them had decreased sexual desire and activity, this sexual activity did not cause them concern.

Aged↗

PubMed2002

Comparison of the accuracy of ultrasonic fetal weight estimation by using the various equations.

OBJECTIVE: To compare the accuracy of ultrasonic fetal weight estimation using the Hadlock's, Shepard's, Tongsong's and Hansmann's equations. MATERIAL AND METHOD: The analytical-cross sectional study was conducted on 102 pregnant women who were admitted for delivery in the Labor Room at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University between January 1, 1999 and June 30, 1999. The fetal parameters, including biparietal diameter, abdominal circumference, transverse trunk diameter and femur length, were measured by ultrasound. The estimated fetal weight was calculated by those four equations. The mean absolute error was calculated from the absolute of the difference between the estimated fetal weight and the actual birth weight. RESULTS: The mean absolute error and standard deviation of the estimated fetal weight by the Hadlock's, Shepard's, Tongsong's and Hansmann's equations were 8.09 +/- 4.18, 7.94 +/- 4.63, 7.77 +/- 3.70 and 7.83 +/- 4.35 per cent respectively and there were no statistically significant differences at 95 per cent confidence interval (p>0.05). CONCLUSION: Apart from having comparable accuracy in the estimation of fetal weight to those of Hadlock, Shepard and Tongsong, Hansmann's equation employed at Srinagarind Hospital was more convenient to use than the others.

Adolescent↗

PubMed2002

Effectiveness of intravenous meperidine for pain relief in the first stage of labour.

OBJECTIVE: To determine the effectiveness and side effects of intravenous meperidine in labour pain relief. MATERIAL AND METHOD: A double blind, randomized controlled trial was conducted in 84 parturients, using normal saline as control. Visual analogue scale, postpartum parturients' opinion of effectiveness, sedative scores, nausea/vomiting, dizziness, delivery method, Apgar scores, and naloxone prescription were assessed. RESULT: There were no statistically significant differences between the mean and median of visual analogue scale of meperidine and control group. In addition, the sedative scores, nausea/vomiting and dizziness in the meperidine group occurred more than those in the control group significantly. Even mean of the pain increment in the meperidine group was less than those in the control group (p < 0.05). The parturients' opinion on the effectiveness of pain relief during labor within 24 hours of the first postpartum day was only 23.80 per cent in the meperidine group, however, it was statistically significantly different when compared to 7.10 per cent in the control group. CONCLUSION: Intravenous meperidine exhibited the effectiveness of pain relief of only 23.80 per cent of the subjects, in addition, it may cause many side effects.

Adult↗