PubMed · 14951985
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J UFER. 1952. [Hyperfolliculinism].. https://pubmed.ncbi.nlm.nih.gov/14951985/
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Oral contraceptive (OC) use, hormonal contraceptive use and multiparity are potential risk factors for cervical precancer, cervical intraepithelial neoplasia 3 (CIN3), but a limited number of studies have adequately accounted for possible confounding effect of oncogenic human papillomavirus (HPV) infection. To examine the relationships of these factors with CIN3, we conducted an analysis of women (n = 5,060) with minimally abnormal Pap smears who were enrolled in the ASCUS and LSIL Triage Study (ALTS), a clinical trial to evaluate management strategies. Cervical specimens collected at enrollment were tested for HPV DNA using 2 methods. Multivariate logistics regression models were used to assess associations (odds ratio [OR] with 95% confidence intervals [CI]) of the potential risk factors (e.g., OC use and parity) with testing oncogenic HPV positive among controls (<CIN2) (n = 4,114) and with rigorously reviewed cases of CIN3 identified throughout the study (n = 499) among women with oncogenic HPV (n = 3,126). Only former oral contraceptive use (OR = 1.3, 95% CI = 1.0-1.7) was associated marginally with having an oncogenic HPV infection among controls. Restricted to women with oncogenic HPV, current injectable hormonal contraceptive users were at an elevated risk of CIN3 (OR = 1.6, 95% CI = 1.2-2.1) compared to women who never used them. Similarly, restricted to women with HPV16 infection, current users of injectable contraceptives were at a marginally elevated risk of CIN3 (OR = 1.5, 95% CI = 1.0-2.3) compared to women who never used them. Oral contraceptive use, Norplant (implantable hormonal contraceptive) use, a history of pregnancy, age at first pregnancy, lifetime numbers of pregnancies and lifetime numbers of live births were not associated with CIN3. We conclude that only current injectable hormonal contraceptive use slightly elevated the risk (approximately 50%) of CIN3 in this young and low parity population of women with oncogenic HPV and minimally abnormal Pap smears but further confirmation of this relationship is needed.
Sleep disturbances in peri- and postmenopausal women may result from hormonal changes, vasomotor symptoms, and possibly psychological factors. Hormone replacement therapy (HRT) seems to diminish the disruption of sleep in climacteric women. The aim of this study was to determine the effects of a low dose of conjugated equine estrogens (CE) in combination with different progestins (LD-HRT) and evaluate differences between regimens on sleep in symptomatic postmenopausal women. Postmenopausal women were recruited and assigned to calcium-vitamin (control group) or to LD-HRT with 0.3mg of CE associated with a daily administration at bedtime of a progestin (2.5 mg MPA, CE + MPA, n = 20), or 100 mg natural micronized progesterone (CE + P, n = 20). Subjective symptoms were evaluated by the Greene climacteric scale, and by a visuanalogic graduated scale (0-10) at baseline and after 4, 8, and 12 weeks of study. Greene's scores for the control group were similar to those in LD-HRT group at baseline, and showed no significant modification at all subsequent measurements. Conversely, in LD-HRT group, a significant (P < 0.05) reduction in the scores of all Greene's domains was evident versus corresponding baseline and control group values. Conversely, in LD-HRT group, a significant (P < 0.05) reduction in the scores of all Greene's domains was evident with no difference in the scores of the two treated group. Both CE + MPA and CE + P significantly (P = 0.05) reduced the HF and sleep visuanalogic score in comparison to the control group. The score of sleep was significantly (P = 0.05) lower in the CE + P group in comparison to that measured in the CE + MPA group. No significant correlation between sleep and vasomotor score was found. In conclusion, low estrogen dose may have a value in the treatment of menopausal women in which sleep disturbances may be a symptom of estrogen deprivation. Low-dose estrogen associated with low-dose micronized progesterone may especially benefit women who complain of disturbed sleep.
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