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PubMed1998

Neuroendocrine effect of a short-term treatment with DHEA in postmenopausal women.

OBJECTIVES: A progressive decline of plasma dehydroepiandrosterone (DHEA) levels occurs in women during aging related to the reduction of adrenocortical secretion. A specific action of DHEA on the central nervous system (CNS) is suggested by the improvement of psychological and physical well-being in postmenopausal women after DHEA supplementation. The aim of the present study was to investigate the neuroendocrine effects of short-term DHEA supplementation in postmenopausal women, evaluating changes of plasma beta-endorphin (beta-EP) and growth hormone (GH) before and after oral DHEA (100 mg/day) for 7 days in postmenopausal women (n = 6). METHODS: Before and after 7 days of DHEA supplementation, postmenopausal women underwent a neuroendocrine test with clonidine, an alpha 2 presinaptic agonist for adrenergic system (1.25 mg i.v.). Basal plasma DHEA, androstenedione (A), testosterone (T), estrone (E1) and estradiol (E2) levels were evaluated before and after treatment, while plasma beta-EP and GH levels were measured before and 15, 30, 45, 60 and 90 min after clonidine injection. RESULTS: Basal plasma beta-EP and GH levels did not show a significant difference before and after short-term DHEA administration, while circulating A, T, E1 and E2 significantly increased after treatment. The clonidine test induced a significant increase of plasma beta-EP levels in women after receiving DHEA supplementation but not before; conversely, plasma GM levels increased both before and after treatment. CONCLUSIONS: The present study indicates that short-term DHEA supplementation in postmenopausal women is able to restore the impaired response of pituitary beta-EP to clonidine, an alpha 2 presinaptic agonist. According to these data it is possible to hypothesize that DHEA could play a role in the psychological and physical well-being of postmenopausal women acting via a restoration of neuroendocrine control of antero-pituitary beta-EP secretion.

Administration, Oral↗

PubMed1997

Changes in bone collagen markers and in bone density in hormone treated and untreated postmenopausal women.

OBJECTIVE: This study aims to compare bone mineral density measurements (BMD), pyridinium crosslink levels and pyridinium crosslink levels in untreated and hormone treated postmenopausal women. METHODS: A cross-sectional study comparing biophysical (BMD) and biochemical (pyridinium crosslink and PCICP) parameters in a group of untreated postmenopausal women (n = 145) to a group of postmenopausal women on hormone replacement therapy (HRT) (n = 92). RESULTS: Untreated postmenopausal women compared to postmenopausal women on HRT had higher Osteoblastic and Osteoclastic activity. Procollagen I C-end terminal peptide (PCICP) was 11.3% lower in the women on HRT compared to controls whilst crosslinks were 27.2% lower than in controls. This seems to indicate that women on HRT had a bone balance that was higher compared to the control group (15.9%). The difference in bone density of L2-L4 between the two groups was (16.1%). CONCLUSIONS: This study seems to indicate that postmenopausal women receiving HRT readjust their bone remodelling so that although osteoblastic function is reduced, there is a much greater deduction in osteoclastic function and this results in an overall higher bone mass observed in the BMD of women on HRT.

Aged↗

PubMed1998

T score of trabecular and cortical bone in normal postmenopausal women.

OBJECTIVE: The T score of the cortical and trabecular bone compartments (T score of BMDTrab and T score of BMDCorti) was calculated in healthy postmenopausal women to determine which bone compartment loses more bone mass. MATERIAL AND METHODS: A total 134 healthy postmenopausal women (mean age 55.1 +/- 6.4 years) and 67 healthy premenopausal women (mean age 36.0 +/- 8.6 years) were studied. Determinations were made using peripheral quantitative computed tomography (pQCT) of the nondominant forearm. The postmenopausal women were divided into groups by years since menopause (YSM): two early postmenopausal groups: < 5 YSM and 6-10 YSM; and two late postmenopausal groups: 11-20 YSM and > 20 YSM. RESULTS: There was a significant correlation between the T score of BMDTrab and the T score of BMDCorti (P < 0.0001). Both correlated negatively and significantly with age (P < 0.001 and P < 0.0001, respectively) and neither correlated with weight. The Wilcoxon test showed no significant differences between the trabecular and cortical T scores in the overall group of women. By YSM, only the > 20 YSM group showed significant differences (P < 0.005). The ANOVA post hoc Bonferroni/Dunn test showed a significant difference in the T score of BMDTrab by YSM only in the < 5 YSM versus 11-20 YSM groups (P = 0.007) and in the < 5 YSM versus > 20 YSM groups (P < 0.0001). The T score of BMDCorti by YSM differed significantly only between the < 5 YSM versus 11-20 YSM groups (P < 0.0001) and between the 11-20 YSM and > 20 YSM groups (P < 0.005). CONCLUSION: In contrast with what has been postulated in recent studies, our results showed that postmenopausal bone loss was similar in the cortical and trabecular bone compartments in the first 20 years after menopause. Trabecular bone loss was greater than cortical bone loss in late menopause (> 20 years).

Adult↗

PubMed1998

Results of the colposuspension operation in pre and postmenopausal incontinent women.

OBJECTIVE: To compare the results of Burch colposuspension in premenopausal and postmenopausal women with urinary stress incontinence (USI). METHODS: A total of 85 women with urodynamic diagnosis of genuine urinary stress incontinence were divided into two groups, according to their menstrual status (premenopausal and postmenopausal group). All of them underwent the Burch colposuspension procedure. Clinical and urodynamic data were compared preoperatively and postoperatively and between the two groups. RESULTS: Cure rate was significantly higher after Burch colposuspension in the premenopausal as compared to the postmenopausal patients (90.9 vs 73.1%, respectively, P < 0.01). A significant reduction of the diurnal and nocturnal frequency and urgency was noted in both groups postoperatively. The reduction of urgency was more prominent in the premenopausal women (P < 0.001). There were no statistically significant differences between the preoperative and postoperative values of bladder capacity, residual volume, maximal voiding pressure, peak flow rate, absolute urethral length, functional urethral length, urethral pressure and maximum urethral closure pressure both preoperatively and postoperatively within the groups and between the two groups. Comparing the two groups postoperatively, the pressure transmission ratios in the postmenopausal women were found to be significantly lower in the middle two quarters of the urethra as compared to the premenopausal patients (P < 0.001). CONCLUSION: Burch colposuspension for urinary stress incontinence has better cure rate in premenopausal than in postmenopausal women. Nevertheless, the above procedure remains an acceptable method for treatment of USI in postmenopausal patients.

Adult↗

PubMed2000

The effect of hormone replacement therapy on metabolism of lipoprotein remnants in postmenopausal women.

OBJECTIVE: The measurement of remnant-like particles reflects chylomicron and very low density lipoprotein remnants which are most likely atherogenic particles. We investigated the effects of menopausal status and postmenopausal hormone replacement on metabolism of remnant lipoprotein-cholesterol. METHODS: We measured remnant lipoprotein-cholesterol by an immunoseparation assay in 20 premenopausal, 40 postmenopausal, and 30 bilaterally oophorectomized women. Of 70 postmenopausal subjects, 21 surgically menopausal women (with total hysterectomy) were started on hormone replacement with conjugated equine estrogen, 0.625 mg/day, and 36 naturally postmenopausal women were begun on a combination of conjugated equine estrogen 0.625 mg/day, plus medroxyprogesterone acetate, 2.5 mg/day. Plasma levels of remnant lipoprotein-cholesterol and other common lipids were measured after 6 and 12 months of treatment. RESULTS: Plasma remnant lipoprotein-cholesterol levels in postmenopausal and surgically menopausal women were significantly higher than in premenopausal women (P < 0.005). Plasma total and low-density lipoprotein cholesterol levels decreased and high-density lipoprotein cholesterol increased significantly (P < 0.01) in both treatment groups, respectively. Plasma triglyceride levels were not changed by treatment; however, remnant lipoprotein-cholesterol levels decreased in both treatment groups (estrogen group; P = 0.07, estrogen-progestin group; P < 0.05). No side effects of therapy were consistently reported. CONCLUSIONS: We confirmed that remnant lipoprotein-cholesterol increases after menopause. Hormone replacement therapy improves disordered lipoprotein metabolism and exerts a favorable effect on lipoprotein remnant metabolism in postmenopausal women.

Adult↗

PubMed2000

Difference in the effect of adiposity on bone density between pre- and postmenopausal women.

OBJECTIVES: Elevated bone mineral density (BMD) in obese women is partially attributable to the higher circulating estrogen levels derived from extraglandular aromatization in adipose tissue. However, it remains unclear whether there is an effect of overall adiposity on BMD in both pre- and postmenopausal women. The difference in the effect of overall adiposity on BMD between pre- and postmenopausal women was investigated. MATERIALS AND METHODS: Subjects were 296 premenopausal women with regular menstruation and 233 postmenopausal women. Age, age at menarche, years since menopause (YSM, in postmenopausal women), weight, height, and body mass index were recorded. Total fat mass amount, lean mass amount, and percentage of body fat were measured by whole body scanning with dual-energy X-ray absorptiometry (DEXA). Lumbar spine BMD (L2-L4) was measured by DEXA. In each group, significant determinants of BMD were investigated using univariate and stepwise multiple regression analysis. RESULTS: In postmenopausal women, YSM, lean mass amount, total fat mass amount, and height were significant determinants of BMD (R(2)=0.273, P<0.001). In premenopausal women, only two variables including lean mass amount and age at menarche were significant determinants of lumbar spine BMD (R(2)=0.110, P<0.001), but total fat mass amount and percentage of body fat were not significant determinants of BMD. CONCLUSION: The effect of overall adiposity on BMD is more prominent in postmenopausal women than in premenopausal women.

Absorptiometry, Photon↗

PubMed2001

Blunted nighttime blood pressure dipping in postmenopausal women.

Blunting of the normal drop in blood pressure (BP) from day to night is emerging as a strong prognostic indicator of cardiovascular morbidity and mortality. This study evaluated the effects of natural menopause on BP dipping in African American and white women. A total of 112 women (62 premenopausal and 50 postmenopausal) took part in the study. Pre- and postmenopausal groups were comparable in terms of clinic BP, body mass index, and ethnic composition. Ambulatory BP was recorded over 24 h during a typical workday, with measurements programmed to be taken every 15 min during waking hours and every 30-minutes during sleeping hours. Nocturnal BP dipping was defined as the difference between waking and sleep BP. Waking BP did not differ by menopausal status. However, nocturnal systolic BP (SBP) and diastolic BP (DBP) dipping were attenuated in postmenopausal women, with both SBP (P < .05) and DBP (P < .05) higher during nighttime sleep in postmenopausal than in premenopausal women. Ethnicity was also related to BP dipping, with African American women tending to show blunted SBP dipping (P = .055) compared with white women; BP dipping was most blunted in postmenopausal African American women. These observations suggest that blunted nighttime BP dipping may contribute to increased cardiovascular disease risk in postmenopausal women.

Black People↗

PubMed2002

Association between a functional interleukin-6 gene polymorphism and peak bone mineral density and postmenopausal bone loss in women: the OFELY study.

Genetic factors play an important role in determining bone mass and several genes are involved in this process. Interleukin-6 (IL-6) is a candidate gene for regulation of bone mineral density (BMD) and it has been suggested recently that novel IL-6 -174 G/C allelic variants may be associated with peak BMD in young men and with bone resorption in elderly women. In this study, we assessed the relationships between IL-6 gene polymorphism, peak BMD, rate of postmenopausal BMD loss, and bone turnover in women. BMD was measured by dual-energy X-ray absorptiometry in 255 healthy premenopausal women, aged 31-57 years. BMD loss at the forearm was measured over 4 years in 298 healthy untreated postmenopausal women, 50-88 years (mean 64 years). We also measured levels of serum osteocalcin, bone alkaline phosphatase, and N-propeptide of type I collagen for bone formation and three markers of bone resorption, including urinary and serum C-terminal cross-linking telopeptide of type I collagen and urinary N-terminal telopeptide of type I collagen, in both pre- and postmenopausal women at baseline. In premenopausal women we found a significant association between IL-6 genotypes and BMD at the whole body (analysis of variance [ANOVA], p = 0.03), femoral neck (p = 0.03), trochanter (p = 0.014), Ward's triangle (p = 0.03), and total hip (p = 0.006), with subjects having the CC genotype showing 3%-7% higher BMD levels than their GG counterparts. However, after matching women with CC and GG genotypes for body height the differences decreased (2%-4%), and were no longer significant (p = 0.10-0.23). In postmenopausal women the mean rate of loss at the ultradistal radius was significantly associated with IL-6 genotypes (ANOVA, p = 0.049), with women having the CC genotype showing a significantly greater rate of bone loss (p < 0.05) compared with their GC and GG counterparts. After adjustment for weight changes, the difference in the rate of ultradistal radius bone loss between genotypes decreased and was not significant (p = 0.06 for CC vs. GG). A similar trend was observed for distal radius bone loss (p = 0.10, ANOVA), but not for the middle radius. We found no significant association between genotypes, bone turnover markers in premenopausal women, and either bone turnover or BMD in postmenopausal women. We conclude that this new functional IL-6 polymorphism was weakly associated with level of peak BMD and the rate of forearm trabecular postmenopausal bone loss in this cohort of healthy French women. IL-6 genotypes accounted only for a small proportion of the interindividual variation of both peak BMD and rate of bone loss and were not significant after adjustment for height and changes in body weight, respectively, suggesting that part of the effect may have been due to the differences in body size. Larger long-term studies are necessary to assess adequately the relationships between IL-6 genotype, rate of bone loss, and risk of fracture.

Adult↗

PubMed2002

Body mass index, height, and postmenopausal breast cancer mortality in a prospective cohort of US women.

OBJECTIVE: Epidemiologic evidence suggests a positive association between body mass, adult height, and postmenopausal breast cancer. However, most studies have not been large enough to examine the association across a very wide range of body mass or height, and few studies have assessed the relationship between body mass or height and postmenopausal breast cancer mortality. METHODS: The relation between body mass index (BMI) and height and postmenopausal breast cancer mortality was examined in the American Cancer Society's Cancer Prevention Study II (CPS-II), a large prospective mortality study of US adults enrolled in 1982. After 14 years of follow-up, 2852 breast cancer deaths were observed among 424,168 postmenopausal women who were cancer-free at interview. Cox proportional hazards modeling was used to estimate relative risks and to control for potential confounding. RESULTS: Breast cancer mortality rates increased continually and substantially with increasing BMI (rate ratio (RR) = 3.08, 95% confidence interval (CI) = 2.09-4.51 for BMI > 40.0 compared to BMI 18.5-20.49). If causal, the multivariate-adjusted RR estimates in this study correspond to approximately 30-50% of breast cancer deaths among postmenopausal women in the US population being attributable to overweight. Breast cancer mortality also increased with increasing height up to 66 inches with RR= 1.64, (95% CI = 1.23-2.18) in women 66 inches tall compared to those <60 inches. CONCLUSIONS: Postmenopausal obesity is an important and potentially avoidable predictor of fatal breast cancer in this study. These results underscore the importance of maintaining moderate weight throughout adult life.

Adult↗

PubMed2002

Obesity, body size, and risk of postmenopausal breast cancer: the Women's Health Initiative (United States).

OBJECTIVE: Body size is an important modifiable risk factor for breast cancer. Although obesity has generally been found to be associated with increased risk for postmenopausal breast cancer, there remain questions concerning the role of body fat distribution, lifetime weight history, and effects within specific subgroups of women. METHODS: We assessed the relationship of several anthropometric measures and risk of postmenopausal breast cancer in 85,917 women aged 50-79 at entry in the Women's Health Initiative Observational Study. Women were enrolled during 1993-1998 at 40 clinics in the US and 1030 developed invasive breast cancer by April 2000. Upon entry, trained clinical center staff measured each woman's height, weight, and waist and hip circumference. RESULTS: Anthropometric factors were not associated with breast cancer among women who had ever used hormone replacement therapy (HRT). Among HRT non-users, heavier women (baseline body mass index (BMI) >31.1) had an elevated risk of postmenopausal breast cancer (relative risk (RR) = 2.52; 95% confidence interval (CI) = 1.62-3.93), compared to slimmer women (baseline BMI < 22.6). The elevation in risk associated with increasing BMI appeared to be most pronounced among younger postmenopausal women. Change in BMI since age 18, maximum BMI, and weight were also associated with breast cancer in HRT non-users. While both waist and hip circumference were associated with breast cancer risk, their ratio, a measure of fat distribution, was not (RR = 1.33; 95% CI = 0.88-2.01). CONCLUSIONS: Our study confirms previously reported findings that generalized obesity is an important risk factor for postmenopausal breast cancer, but only among women who have never taken HRT. Lifetime weight gain is also a strong predictor of breast cancer. Waist to hip ratio, a measure of weight distribution, does not appear to be related to postmenopausal breast cancer risk.

Aged↗

PubMed2000

Different circulatory response to melatonin in postmenopausal women without and with hormone replacement therapy.

In young men and women, melatonin influences vascular reactivity and reduces blood pressure and norepinephrine levels. Herein, we investigated whether these effects are conserved in postmenopausal women without and with hormone replacement therapy (HRT). Oral melatonin (1 mg) or placebo was randomly and in double blind fashion administered to 18 untreated and 13 postmenopausal women who were treated continuously with transdermal estradiol (50 microg/day) plus cyclic medroxyprogesterone acetate (5 mg/day x 12 days every 28 days). Internal carotid artery pulsatility index (PI), an index of downstream resistance to blood flow, blood pressure and catecholamine levels were evaluated. In untreated postmenopausal women, melatonin was ineffective, while in HRT-treated women, studied during the only estrogenic phase, melatonin reduced, within 90 min, systolic (-8.1 +/- 9.9 mmHg; P = 0.054), diastolic (-5.0 +/- 7.0 mmHg; P = 0.049) and mean (- 6.0 +/- 6.6 mmHg; P = 0.037) blood pressure. Norepinephrine (-50.1 +/- 66.7 pg/mL; P = 0.019), but not epinephrine levels, were also significantly reduced. Similarly, resistance to blood flow in the internal carotid artery, as evaluated by the PI, decreased (-0.190 +/- 0.15; P = 0.0006) in a way that was linearly related to pre-existing PI values (r2 = 0.5; P = 0.0059). These data show that the circulatory response to melatonin is conserved in postmenopausal women on HRT but not in untreated postmenopausal women. Possible physiological and pharmacological implications of these data on the cardiovascular risk of postmenopausal women can be envisioned.

Antioxidants↗

PubMed2007

Association of eating frequency with body fatness in pre- and postmenopausal women.

OBJECTIVE: To examine associations between eating frequency (EF) and body fatness in pre- and postmenopausal women, after excluding potential low-energy reporters. RESEARCH METHODS AND PROCEDURES: In this cross-sectional study of 220 free-living women, 64 pre- and 50 postmenopausal non-low-energy-reporting women were further analyzed (age, 24 to 74 years; BMI, 18.5 to 38.6 kg/m2). Anthropometric and body composition measurements (DXA) were performed in all study participants. EF, energy, and macronutrient intake were assessed by 3-day food record. Physical activity level and energy expenditure were assessed by self-reported questionnaire. RESULTS: No association between EF and adiposity indices was detected in premenopausal women. In contrast, EF was positively correlated with percentage body fat in postmenopausal women (r = 0.30, p = 0.03). EF was positively correlated with total energy intake in both groups and with total energy expenditure in premenopausal women only (r = 0.34, p = 0.02). Multivariate analysis revealed that, in postmenopausal women, EF was a significant predictor of body fatness (standardized beta = 0.41, p = 0.01). DISCUSSION: Frequent eating was not found to be related to adiposity in premenopausal women, but it was associated with increased body fat in postmenopausal women. Possible explanations could be that the frequent eating is not associated with a physically active lifestyle in postmenopausal women or that frequent eating predisposes women after menopause to a higher energy intake by increasing food stimuli and rendering it more difficult for them to control energy balance.

Absorptiometry, Photon↗

PubMed2003

Evaluation of gustatory function in postmenopausal women.

OBJECTIVE: The aim of this study is to evaluate the gustatory function in postmenopausal women. SUBJECTS AND METHODS: Whole mouth taste test and spatial taste test were administered to 20 postmenopausal women (Group 1) and 20 age-matched male subjects (Group 2). Further investigations were carried out for subjective assessment of taste alteration and nutritional differences between premenopausal and postmenopausal periods. RESULTS: There was a significant reduction in sucrose perception and in palatal sensitivity in postmenopausal women (p<0.05). Only 7(35%) of the female patients noticed alteration in taste perception during the postmenopausal period. Alteration in dietary habits after menopause was reported by 9 (45%) patients. CONCLUSION: This study demonstrates that taste perception of the tongue does not change, but that there is a disorder in palatal perception in postmenopausal women. Furthermore, there is tendency to preference of sweeter foods during menopause.

Age Factors↗

PubMed2002

Pharmacokinetics of tibolone in early and late postmenopausal women.

AIMS: Tibolone is a tissue-specific compound with favourable effects on bone, vagina, climacteric symptoms, mood and sexual well being in postmenopausal women, without stimulating the endometrium or breast. Since tibolone is used for the treatment of both young and elderly postmenopausal women, its pharmacokinetics were studied to investigate potential differences with age. In addition, the bioequivalence of the 1.25 and 2.5 mg tablets was evaluated. METHODS: Single doses of 1.25 or 2.5 mg of tibolone were given in a double-blind, randomized, two-way cross-over study to women aged between 45 and 55 years or between 65 and 75 years of age. RESULTS: Age did not have a significant effect on C(max), t(max), and t(1/2) of tibolone and its metabolites and on the body weight standardized oral clearance (CL/F kg(-1)) of the 3alpha- and 3beta-hydroxy tibolones. In early postmenopausal women, significantly lower values were found for the AUC(0,16 h), and AUC(0, infinity ) of 3alpha-hydroxy tibolone 24.6+/-6.6 vs 29.2+/-4.9 and 27.1+/-6.9 vs 32.3+/-6.5 ng ml(-1) h for the 1.25 mg tablet, respectively, and 45.4+/-13.9 vs 55.7+/-14.1 and 49.6+/-14.6 vs 62.6+/-17.3 ng ml-1 h for the 2.5 mg tablet, respectively. When these values were adjusted for the significantly higher body weight of the early postmenopausal women, the differences disappeared. No significant differences between early and late postmenopausal women were found for the AUC(0,8 h), and AUC(0, infinity) of 3beta-hydroxy tibolone. The rate of absorption of tibolone and the rates of absorption or formation of the 3alpha- and 3beta-hydroxy tibolones were significantly higher after the 1.25 mg dose than after the 2.5 mg tablet, resulting in increases of 32%, 27% and 17% for the dose normalized-C(max) of tibolone and the 3alpha- and 3beta-hydroxy tibolones, respectively. tmax for tibolone and its metabolites was 12-27% less after 1.25 mg compared to 2.5 mg, which was statistically significant. The two formulations were bioequivalent with respect to the dose-normalized AUC(0, infinity) and the AUC(0,t(fix)) values for the 3alpha-hydroxy tibolone (ratio point estimate [90%, confidence limits]: 1.08 [1.04, 1.14] and 1.08 [1.03, 1.13], respectively) and for the 3beta-hydroxy tibolone (1.07 [1.01, 1.14] and 1.04 [0.96, 1.12], respectively). Both formulations were also bioequivalent with respect to CL/F kg(-1) and t(1/2). CONCLUSIONS: The pharmacokinetics of tibolone are similar in early (age 45-55 years) and late (65-75 years) postmenopausal women. The 2.5 and 1.25 mg tablets are bioequivalent with respect to the extent of absorption. The rate of absorption or formation of the metabolites of tibolone were not bioequivalent, but these differences are considered to have no clinical relevance in view of the chronic administration of tibolone.

Administration, Oral↗

PubMed1996

Transvaginal sonography of the endometrium in a representative sample of postmenopausal women.

The aim of this study was to assess endometrial thickness using transvaginal sonography in a representative sample of postmenopausal women and to evaluate whether the technique can be used for screening of endometrial cancer. A random sample (n = 1000) of the total population of women aged 45-80 years resident in the city of Göteborg in 1993 was invited to attend for transvaginal sonography. The only exclusion criterion was hysterectomy. Transvaginal sonography was performed in 827 women. An endometrium of < or = 4 mm was not investigated further. Women with an endometrium of 5-7 mm and non-measurable cases were re-assessed 1 year later, and women with an endometrial thickness of > or = 8 mm were investigated directly with hysteroscopy and/or dilatation and curettage. A total of 559 women were postmenopausal and 183 were taking some form of hormonal substitution (33%). One case of endometrial cancer (endometrial thickness 19 mm), 23 cases of polyps without atypia (endometrial thickness 8-18 mm) and no cases of endometrial hyperplasia were diagnosed. Endometrial thicknesses were as follows (mean +/- SEM; respectively grouped as < or = 4 mm, 5-7 mm and > or = 8 mm): total population of postmenopausal women (3.4 +/- 0.1 mm, 82%, 13% and 6%); postmenopausal women without estrogens (3.0 +/- 0.1 mm, 90%, 7% and 3%); postmenopausal women on medium-potency estrogens + gestagen (5.1 +/- 0.3 mm, 49%, 40% and 11%) and women with low-potency estrogens only (3.6 +/- 0.3 mm, 85%, 6% and 9%). The prevalence of endometrial cancer was 0.2% and for benign polyps 3.2% in this representative sample of postmenopausal women. Our results do not support generalized endometrial screening with transvaginal sonography.

Aged↗

PubMed2003

Pharmacokinetics of oral micronized beta-estradiol in postmenopausal women receiving maintenance hemodialysis.

BACKGROUND: Although 11% of postmenopausal women with end-stage renal disease (ESRD) are prescribed hormone replacement therapy (HRT), the appropriate use remains poorly explored. Although there remains controversy surrounding the benefits of HRT, it may be of particular interest in this population, which has a high risk of bone loss and a fourfold increase in fracture risk compared to the general population. However, the appropriate dose of estrogen for use in postmenopausal women with ESRD is not known. The objective of this study was to evaluate the steady-state pharmacokinetics of oral micronized beta-estradiol in postmenopausal women with ESRD compared with postmenopausal women with normal renal function in order to determine equivalent dosing. METHODS: Six postmenopausal women with ESRD receiving maintenance hemodialysis and 6 healthy postmenopausal controls received 14 days of micronized beta-estradiol (1.0 mg for control, 0.5 mg for ESRD). Blood, urine, and dialysate samples were obtained during a dosage interval on day 14. Estradiol, estrone, albumin, and sex-hormone binding globulin (SHBG) concentrations were determined. Free estradiol concentrations were calculated using a previously described method. RESULTS: Women with ESRD had significantly lower serum albumin (610 +/- 31 micromol/L vs. 684 +/- 83 micromol/L) and SHBG (78 +/- 17 vs. 118 +/- 13 nmol/L) than control subjects. Total clearance of estradiol was not significantly different. Due to difference in binding, free estradiol concentrations were significant higher in ESRD women (53.2 +/- 17.7 pg/mL) than control women (43.5 +/- 8.7 pg/mL), despite receiving 50% of the dose. There was no significant difference in estrone concentrations. Clearance of both estradiol and estrone in the dialysate was minimal. CONCLUSION: Women with ESRD should receive approximately 50% of the dose typically prescribed to women without ESRD.

Administration, Oral↗

PubMed2003

Effects of low-dose 17-beta-estradiol plus norethisterone acetate and tibolone on fasting plasma homocysteine levels in postmenopausal women.

BACKGROUND: Many postmenopausal women currently receive hormone replacement therapy. The use of low-dose 17beta-estradiol plus norethisterone acetate and tibolone for hormone replacement therapy is not uncommon in postmenopausal women. Homocysteine, which is known to be an independent risk factor for the development of cardiovascular disease, is found in increased levels postmenopause. This study compared the effects of low-dose 17beta-estradiol plus norethisterone acetate and tibolone on the fasting plasma homocysteine level in healthy postmenopausal women. METHODS: Healthy postmenopausal women (n = 44) were enrolled in the study. Women randomly assigned received 1 mg of 17beta-estradiol plus 0.5 mg of norethisterone acetate or 2.5 mg tibolone during a period of 12 weeks. Fasting plasma homocysteine levels were measured at baseline, the 4th week, and the 12th week of therapy. RESULTS: In the 4th week there were no significant changes in plasma homocysteine levels in both groups (p > 0.05). However at the end of the 12th week the plasma homocysteine levels were reduced significantly in both groups (p < 0.05). CONCLUSION: Low-dose 17beta-estradiol plus norethisterone acetate and tibolone lower the fasting plasma homocysteine levels in healthy postmenopausal women.

Dose-Response Relationship, Drug↗

PubMed2003

Increased serum inhibin B levels in postmenopausal women with altered thyroid function.

Hyper- and hypothyroidism have significant effects on the female reproductive system. However, little in the way of data is available on the relationship between ovarian paracrine control and thyroid function. This study was aimed at characterising the serum levels of inhibin B in relation to altered thyroid function. Serum inhibin B and FSH levels were measured in 91 women (51 regularly cycling and 40 postmenopausal). The mean serum concentration of inhibin B in euthyroid cycling women (0.025 +/- 0.018 microg/l) was similar to that observed in hyper- and hypothyroid patients (0.022 +/- 0.015 and 0.018 +/- 0.014 microg/l, respectively, p=ns). Inhibin B levels were obviously reduced (-72%) in euthyroid postmenopausal women. In contrast, in hyper- and hypothyroid postmenopausal women, inhibin B levels remained substantially at the premenopausal level. So far, serum inhibin B appeared to be significantly increased in both hyperthyroid patients (0.025 +/- 0.014 microg/l; p<0.0001) and in hypothyroid patients (0.016 +/- 0.006 microg/l; p=0.0006). Altered thyroid function did not affect FSH levels at fertile age. However, a significant decrease of FSH levels was observed in hyper- and hypothyroid (-52% and -43%, respectively) postmenopausal women. Nevertheless, these FSH levels remained in the postmenopausal range. These results indicate that an altered thyroid function affects serum inhibin B levels in postmenopausal women.

Adult↗