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PubMed2002

Genital and subjective sexual arousal in postmenopausal women: influence of laboratory-induced hyperventilation.

The current study was aimed at comparing genital and subjective sexual arousal in pre- and postmenopausal women and exploring the effects of heightened sympathetic nervous system (SNS) activity on these parameters. Seventy-one women (25 young and premenopausal, 25 postmenopausal, and 21 age-matched premenopausal women) participated in two counterbalanced sessions consisting of genital arousal assessment with vaginal photoplethysmography and subjective arousal assessment with self-report questionnaires. SNS activity was enhanced using laboratory-induced hyperventilation. Results demonstrated no significant differences between pre- and postmenopausal women on genital and subjective measures of arousal in response to neutral and erotic films. SNS manipulation increased genital excitement only in young, premenopausal women. These data suggest that prior SNS enhancement can differentiate pre- from postmenopausal genital arousal. Data also revealed significant correlations between genital and subjective sexual arousal in older pre- and postmenopausal women, but not in young premenopausal women. These data are the first to directly compare genital-subjective correlations between pre- and postmenopausal women.

Adult↗

PubMed2004

Evaluation of the effect of tibolone and transdermal estradiol on triglyceride level in hypertriglyceridemic and normotriglyceridemic postmenopausal women.

The objective of the present study was to quantify the magnitude of the association between the change in triglycerides and high-density lipoprotein (HDL) cholesterol levels with the use of tibolone and transdermal estrogen in postmenopausal women with hypertriglyceridemia and normotriglyceridemia. This prospective randomized study enrolled 140 postmenopausal women who had all been hysterectomized for almost a year or more. All subjects completed the 3-month follow-up. The 140 patients were divided into two groups: 70 were given transdermal 17beta-estradiol 0.05 mg/day, and 70 were given tibolone 2.5 mg/day. We compared the effects of tibolone and transdermal 17beta-estradiol on lipids and dimacteric symptoms of the patients. To evaluate the effects of tibolone and transdermal estrogens on triglycerides and HDL cholesterol in postmenopausal women with normotriglyceridemia and hypertriglyceridemia, the women were assigned to five groups according to triglyceride levels (0-100, 101-200, 201-300, 301-400 and > or = 401 mg/dl). We compared changes in the triglyceride and HDL cholesterol levels of each group after treatment. All 140 postmenopausal women completed the trial. No significant differences were found in baseline characteristics of the patients. The tibolone group showed a 22.6% decrease whereas the transdermal estrogen group had a 10.9% decrease in the mean triglyceride levels after 3 months of treatment. The mean decrease of triglyceride level with transdermal estradiol was approximately 11% in normotriglyceridemic and hypertriglyceridemic postmenopausal women. The mean decrease of triglyceride level was 17% in the normotriglyceridemic group and 22-30% in the hypertriglyceridemic groups with tibolone. While the mean HDL cholesterol level increased in the transdermal estrogen group (3.6%), it decreased in the tibolone group (9.3%). We found that tibolone decreased triglyceride levels much more than did transdermal estradiol. However, HDL cholesterol was decreased by tibolone and increased by transdermal estradiol. Tibolone had a more marked decreasing effect in postmenopausal women who had higher initial triglyceride levels. It is suggested that the beneficial effect of tibolone on the cardiovascular system might be greater in women with a high level of triglycerides.

Administration, Cutaneous↗

PubMed2003

Postmenopausal hormone therapy and migraine headache.

BACKGROUND: Estrogen withdrawal has been described as a trigger for migraine headache, and some studies suggest that estrogen and progestin may exacerbate migraine. No population-based studies have examined the association between hormone therapy (HT) and migraine among postmenopausal women. METHODS: To examine the association between HT and migraine headache in postmenopausal women, we used self-report of HT use, HT characteristics, and migraine headache within the past year among 17,107 postmenopausal female health professionals enrolled in the Women's Health Study. RESULTS: Analyses were restricted to the 17,107 of 21,788 postmenopausal women who were postmenopausal at baseline and who were never (38.5%) or current (61.5%) users of HT. Of these, 1,909 (11.2%) experienced migraine headache within the last year. Women with migraine headache were significantly younger, had a younger age at menopause, were more likely to have had a surgical menopause, and were more likely to be current users of HT. After adjusting for age, race, smoking, alcohol use, ever use of oral contraception, age at menopause, and menopause type, the odds ratio (OR) for migraine headache was 1.42 (95% CI 1.24-1.62) for women who were current users of HT compared with never users. ORs were similar for users of estrogen alone (OR 1.39, 95% CI 1.14-1.69) and users of both estrogen and progestin (OR 1.41, 95% CI 1.22-1.63). CONCLUSIONS: In this cross-sectional study, current HT use was associated with higher rates of migraine headache than nonuse. Clinical trials are needed to determine if HT increases the incidence of migraine in postmenopausal women.

Aged↗

PubMed2005

Effect of anovulation factors on pre- and postmenopausal ovarian cancer risk: revisiting the incessant ovulation hypothesis.

Risk factors for ovarian cancer may differ between pre- and postmenopausal women. The authors used data from a multiethnic, population-based, case-control study, conducted between 1993 and 1999 in Hawaii and Los Angeles, California, to examine whether menopause modified the effect of ovulation on ovarian cancer risk. A structured questionnaire was administered to 558 histologically confirmed epithelial ovarian cancer cases and 607 population controls. Lifetime ovulatory (log)years were significantly associated with an increased risk of ovarian cancer (odds ratio = 1.78, 95% confidence interval: 1.24, 2.57), particularly among premenopausal women (odds ratio = 2.49) but not among postmenopausal women (odds ratio = 0.88) (p(interaction) = 0.006). Factors that induced anovulation, including oral contraceptives, pregnancy, and breastfeeding, were associated with a reduced risk of ovarian cancer. Among anovulation factors, prolonged oral contraceptive pill use provided a greater protective effect against premenopausal ovarian cancer than against postmenopausal ovarian cancer (for > or =5.4 years of use vs. never use: odds ratio = 0.28, 95% confidence interval: 0.15, 0.52 vs. odds ratio = 0.58, 95% confidence interval: 0.31, 1.08, respectively), but the difference was not significant (p(interaction) = 0.20). Association of breastfeeding and pregnancy with ovarian cancer risk was also similar between pre- and postmenopausal women (respective p(interaction) = 0.72 and 0.43). The authors' data support the hypothesis that lifetime ovulation is involved in the pathogenesis of pre- but not postmenopausal ovarian cancer, while the protective effects of anovulation factors persist from pre- to postmenopausal women.

Adult↗

PubMed1997

Plasma fibrinogen levels in healthy postmenopausal women: physical activity and hormone replacement status.

BACKGROUND: Fibrinogen is a major component of the coagulation system and a powerful independent risk factor for cardiovascular disease in postmenopausal women. Regular physical activity has been recommended as an effective clinical approach to lowering plasma fibrinogen levels; currently, however, there are little or no data to support a relationship between habitual exercise status and plasma fibrinogen levels in healthy postmenopausal women who either use or do not use hormone replacement therapy (HRT). METHODS: Plasma fibrinogen levels were measured in 20 physically active (56 +/- 1 yr) and 31 sedentary (58 +/- 1 yr) healthy postmenopausal women. Nine (45%) physically active and 15 (48%) sedentary women had been using HRT for > 1 year; the others were nonusers of HRT. RESULTS: Plasma fibrinogen levels were approximately 15% lower (p = .001) in the physically active women (2.48 +/- .08 g/L) than the sedentary controls (2.92 +/- .06 g/L) and approximately 7% lower (p = .04) in the users (2.65 +/- .08 g/L) versus nonusers (2.84 +/- .08 g/L) of HRT. Moreover, the lower (0.4 g/L) plasma fibrinogen levels associated with regular physical activity were evident in both the users (2.39 +/- .11 vs 2.80 +/- .08 g/L, p = .001) and nonusers (2.56 +/- .11 vs 3.03 +/- .08 g/L, p = .006) of HRT. Stepwise multiple regression analysis revealed that percent body fat was the primary determinant of plasma fibrinogen levels, accounting for 30% of the variability. CONCLUSIONS: Regular physical activity is associated with lower plasma fibrinogen levels in postmenopausal women; the lower plasma fibrinogen levels associated with regular physical activity are evident in both users and nonusers of HRT; and plasma fibrinogen levels are positively related to percent body fat in postmenopausal women differing in physical activity and HRT status. Lower plasma fibrinogen levels in physically active postmenopausal women may contribute to their lower risk of cardiovascular disease.

Aged↗

PubMed1999

Differences in urinary excretion patterns of the hLH beta core fragment in premenopausal, perimenopausal, and postmenopausal women.

OBJECTIVE: The heterodimeric luteinizing hormone beta core fragment (hLH beta cf) is a highly stable urinary analyte reflective of circulating hLH. It is measured easily because of its high molar content and has none of the multiple isoforms and subunit dissociation problems of LH urinary measurements. As part of a long-term effort to develop new biochemical assays to stage women during the perimenopausal transition, we have examined the patterns of urinary excretion of this metabolite of hLH in premenopausal, perimenopausal, and postmenopausal women. DESIGN: We measured the concentration of the hLH beta cf in 10 consecutive first morning void urine specimens from premenopausal, perimenopausal, and postmenopausal women. Day 1 of collection was the first day of menses in the cycling women. RESULTS: Postmenopausal women exhibited a widely fluctuating pattern of LH beta core fragment excretion, which is not correlated with hLH measured by immunofluorometric assay or with follicle-stimulating hormone measured by immunofluorometric assay. The postmenopausal group was easily distinguished from premenopausal women on the basis of an area-under-the-curve concentration function. Perimenopausal women displayed intermediate hLH beta cf concentrations; some clearly were in postmenopausal ranges, and others were in the premenopausal ranges. CONCLUSIONS: The pattern of excretion and concentrations of the hLH beta cf is significantly different between premenopausal and postmenopausal women. Perimenopausal women exhibited intermediate changes. The capability to measure this type of stable urinary metabolite as a reflection of changes in dynamics of its parent circulating hormone offers new possibilities in the development and application of large-scale testing that does not require blood sampling.

Adult↗

PubMedDate not supplied

Serum leptin levels in postmenopausal women: effects of transdermal hormone replacement therapy.

OBJECTIVE: To evaluate serum leptin levels in postmenopausal women who are receiving hormone replacement therapy (HRT) and postmenopausal women who are not receiving HRT with similar body mass index (BMI) to determine whether estrogens exert effects on leptin secretion. DESIGN: Cross-sectional, prospective study comparing serum leptin levels in premenopausal women, postmenopausal women who were not receiving HRT (group A), and postmenopausal women who were receiving HRT (group B). RESULTS: Serum leptin levels were significantly higher in group A in comparison to group B and control women (15.82 +/- 6.6 ng/ml, 8.14 +/- 4.17 ng/ml, and 10.12 +/- 5.48 ng/ml, respectively; p < 0.05). Total fat mass (FM) was found to be significantly higher in untreated postmenopausal women in comparison to the other two groups (22.66 +/- 2.79 kg vs. 19.14 +/- 3.39 kg vs. 18.98 +/- 3.82 kg; p < 0.05). No significant difference was observed in weight, height, BMI, blood pressure, or glucose levels among the three groups. A linear correlation between BMI and serum leptin levels as well as between total FM and serum leptin levels was observed in all groups. No correlation was found between serum leptin levels and months from menopause and months of HRT. CONCLUSIONS: Our results show that serum leptin is increased in untreated postmenopausal women, possibly as a consequence of the increase in FM, and that HRT reduces serum leptin levels to premenopausal values. These data need further investigation by a broader longitudinal study.

Body Mass Index↗

PubMedDate not supplied

Fatty acid composition of serum phospholipid of premenopausal women and postmenopausal women receiving and not receiving hormone replacement therapy.

OBJECTIVE: To compare the fatty acid composition of serum phospholipid of premenopausal women with that of postmenopausal women receiving and not receiving hormone replacement therapy (HRT). DESIGN: Women between the ages of 43 and 70 were recruited for two separate case-comparison studies. Participants were grouped as either premenopausal, postmenopausal receiving HRT, or postmenopausal not receiving HRT. All participants were required to complete a 3-day dietary record before providing a 12-h fasting blood sample. Fatty acid composition of phospholipids and lipid concentrations was determined from serum samples. RESULTS: The postmenopausal women receiving HRT had significantly higher concentrations of palmitic acid (16:0), palmitoleic acid (16:1), and di-homo-gamma-linolenic (20:3n-6) and significantly lower levels of docosapentaenoic acid (22:5n-3) than the other groups in both studies. In addition, the postmenopausal women receiving HRT had lower levels of behenic (22:0), lignoceric (24:0), and nervonic acid (24:1) in comparison with the postmenopausal women not receiving HRT. CONCLUSION: The results of this study indicate that the fatty acid composition of serum phospholipids in women is influenced by menopausal status and hormone use. These results are of interest because high levels of 20:3n-6 and low levels of docosapentaenoic acid have been associated with increased myocardial infarction plus stroke mortality from cardiovascular disease.

Adult↗

PubMedDate not supplied

Androgens, insulin-like growth factor-I (IGF-I), and carrier proteins (SHBG, IGFBP-3) in postmenopause.

OBJECTIVE: To determinate the profile of androstenedione (A), total (T), and free testosterone (FT), dehydroepiandrosterone (DHEA), DHEA-sulphate (DHEAS), sex hormone-binding globulin (SHBG), insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 (IGFBP-3) in non-smoking, postmenopausal women of normal weight and to search for correlations between hormones and carrier proteins and chronological age, number of years of postmenopause and age of onset of menopause. DESIGN: A group of 149 postmenopausal women aged 49 to 74 years were divided into three groups based on the number of years of postmenopause: 2-4 years (group A), 9-12 years (group B), and 19 years or more (group C). Seventy-two women aged 21 to 35 years were the controls. Hormones and carriers were assessed in all groups. RESULTS: A, DHEA, DHEAS, and IGF-I were significantly lower than controls in all groups, whereas T, FT, SHBG, and IGBFP-3 were lower only in groups B and C. All hormones and carriers were negatively correlated with the number of years of postmenopause; DHEA and T also showed a positive correlation with the age of onset of menopause. CONCLUSIONS: Androgens, SHBG, and IGF-I/IGFBP-3 show a diversified decline in postmenopause that is involved in the physiological aging process. Thus, a modification, in excess or deficiency, could favor the development of central symptoms or pathologies.

Aged↗

PubMedDate not supplied

Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies.

OBJECTIVE: To investigate the effect of glucosamine sulfate on long-term symptoms and structure progression in postmenopausal women with knee osteoarthritis (OA). DESIGN: This study consisted of a preplanned combination of two three-year, randomized, placebo-controlled, prospective, independent studies evaluating the effect of glucosamine sulfate on symptoms and structure modification in OA and post-hoc analysis of the results obtained in postmenopausal women with knee OA. Minimal joint space width was assessed at baseline and after 3 years from standing anteroposterior knee radiographs. Symptoms were scored by the algo-functional WOMAC index at baseline and after 3 years. All primary statistical analyses were performed in intention-to-treat, comparing joint space width and WOMAC changes between groups by ANOVA. RESULTS: Of 414 participants randomized in the two studies, 319 were postmenopausal women. At baseline, glucosamine sulfate and placebo groups were comparable for demographic and disease characteristics, both in the general population and in the postmenopausal women subset. After 3 years, postmenopausal participants in the glucosamine sulfate group showed no joint space narrowing [joint space change of +0.003 mm (95% CI, -0.09 to 0.11)], whereas participants in the placebo group experienced a narrowing of -0.33 mm (95% CI, -0.44 to -0.22; P < 0.0001 between the two groups). Percent changes after 3 years in the WOMAC index showed an improvement in the glucosamine sulfate group [-14.1% (95%, -22.2 to -5.9)] and a trend for worsening in the placebo group (5.4% (95% CI, -4.9 to 15.7) (P = 0.003 between the two groups). CONCLUSION: This analysis, focusing on a large cohort of postmenopausal women, demonstrated for the first time that a pharmacological intervention for OA has a disease-modifying effect in this particular population, the most frequently affected by knee OA.

Dietary Supplements↗

PubMedDate not supplied

Comparison of intranasal and transdermal estradiol on nasal mucosa in postmenopausal women.

OBJECTIVE: To compare nasal symptomatology and function and local concentrations of estradiol (E2), estradiol receptor (ERalpha), vasoactive intestinal peptide (VIP), substance P (SP) and neuropeptide Y (NPY) in nasal biopsies of 20 postmenopausal women complaining of paradoxical nasal stuffiness before and after treatment with intranasal or transdermal E2. DESIGN: Twenty healthy postmenopausal women willing to start hormone therapy (HT) were allocated to one of two groups, using a computer-generated randomization list. Ten postmenopausal women were treated with transdermal 17beta-estradiol 50 microg daily plus nomegestrole acetate 5 mg/day for 12 days per 28-day cycle for 6 months (Group A). Ten postmenopausal women were treated with intranasal 17beta-estradiol 300 microg/day (one spray delivery of 150 microg per nostril) plus nomegestrole acetate 5 mg/day for 12 days per 28-day cycle for 6 months (Group B). Fourteen fertile women undergoing nasal mucosa biopsy during plastic surgery were used as controls for the immunohistochemical evaluation (Group C). All women in groups A and B underwent evaluation of nasal stuffiness score, mucociliary transport time, rhinoscopy, and active anterior rhinomanometry at the beginning of the study and after, VIP, SP, and 6 months of HT. Nasal biopsies and evaluation of local concentrations of E2, ERalpha NPY were performed in groups A and B before and after 6 months of HT and in group C. RESULTS: Both intranasal and transdermal HT improve nasal symptomatology and nasal mucosa appearance and reduce mean mucociliary transport time. The effectiveness of intranasally administered therapy at improving nasal function is significantly better than transdermal therapy. In comparison with premenopausal controls, untreated postmenopausal women of group A and B showed significantly decreased immunopositivity for E2, ERalpha, and SP. HT induced a significant increase in E2, ERalpha, VIP, and SP and a decrease in NPY immunopositivity. Intranasal therapy was associated with a significantly higher immunopositivity for VIP and SP. CONCLUSIONS: HT improves nasal function and symptomatology in postmenopausal women with paradoxical nasal stuffiness, modulating nasal mucosa function through an action on cholinergic, adrenergic, and sensory peptides. Intranasally administered HT is more effective at improving nasal function than transdermal HT.

Estradiol↗

PubMedDate not supplied

Differences between middle cerebral artery blood velocity waveforms of young and postmenopausal women.

OBJECTIVE: We characterized middle cerebral artery (MCA) blood flow velocity waveforms measured by transcranial Doppler ultrasonography in premenopausal (26.6 +/- 6.1 years, mean +/- SD) and postmenopausal (54.0 +/- 3.6 years) women, of whom six were receiving hormone therapy (PM-HT) and seven were not (PM-non-HT). We hypothesized that feature points on MCA waveforms are altered in postmenopausal women compared with those in young women. DESIGN: A short protocol involved maintaining end-tidal PO2 at euoxia (88 mm Hg) and end-tidal PCO2 at 1.5 mm Hg above eucapnic values using a dynamic end-tidal forcing system. Doppler data for the velocity spectral outline (Vp) were collected every 10 ms, and velocity waveform analyses were done on a beat-by-beat basis. Waveform features were identified over each cardiac cycle, including the average Vp (VCYC), maximum acceleration (AMAX), and the ratio of the velocity at the reflected wave and the velocity at peak systole (VR:VMAX). RESULTS: VCYC was unchanged between premenopausal and postmenopausal women (69.4 +/- 9.6 and 67.5 +/- 11.1 cm/s, respectively). AMAX was significantly higher (P = 0.007) in premenopausal women (987.9 +/- 280.7 cm/s) compared with postmenopausal women (743.1 +/- 100.3). Conversely, VR:VMAX was significantly smaller (P < 0.001) in premenopausal women (0.90 +/- 0.09) compared with postmenopausal women (1.11 +/- 0.05). In postmenopausal women, the reflected wave is higher than the maximum velocity at peak systole, suggesting the presence of a shoulder in the MCA waveform. CONCLUSIONS: Further investigations are required to assess whether this waveform analysis can provide insight into pathophysiologic changes in cerebral hemodynamics with aging.

Adult↗

PubMedDate not supplied

Urogenital symptoms of postmenopausal women in Turkey.

OBJECTIVE: The objective of this study was to collect data on the prevalence and risk factors of urogenital symptoms in postmenopausal women in Turkey. DESIGN: The study was performed with the participation of 510 postmenopausal women who presented to previously defined clinics for reasons other than urogenital complaints. Women completed a questionnaire including questions about their demographic properties and their urogenital symptoms. Data were analyzed by SPSS 10.0. The chi-square test was the statistical test of choice. RESULTS: The mean age of participants was 58.64 +/- 8.14 years. The mean age of menopause was 47.21 +/- 4.36 years. Urinary frequency was found to be the most common postmenopausal urogenital symptom (16.5%), followed by stress incontinence (10.4%), dyspareunia (10%), and vaginal dryness (9.6%). Risk factors investigated were found not to affect the prevalence of the vaginal symptoms in postmenopausal women. Dysuria was found to be more common in women with diabetes mellitus (P = 0.022) and in women who had given birth to more children (P = 0.018). Stress incontinence was more common in those 60 years of age or older (P = 0.03), in those who had been in the postmenopausal period for more than 20 years (P = 0.01), and in those who had more than three pregnancies (P = 0.047) or who had given birth to more than three children (P = 0.011). Diabetes mellitus (P = 0.001) and use of hormone therapy (P = 0.001) significantly increased the prevalence of urinary frequency. CONCLUSIONS: Urogenital symptoms observed in our population were found to be fewer than reported previously. Symptoms that appear in the postmenopausal period may be related to several factors such as age, number of births, time elapsed since menopause, presence of diabetes mellitus, and use of hormone therapy, but this topic requires further study.

Adult↗

PubMed2004

Population pharmacokinetic modelling of Emfilermin (recombinant human leukaemia inhibitory factor, r-hLIF) in healthy postmenopausal women and in infertile patients undergoing in vitro fertilization and embryo transfer.

AIMS: The aim of this analysis was to develop a population pharmacokinetic model for Emfilermin (recombinant human leukaemia inhibitory factor, r-hLIF) following subcutaneous administration to healthy postmenopausal women and to infertile patients undergoing in vitro fertilization and embryo transfer (IVF-ET). METHODS: Data from three studies, a single and a repeat dose Phase I study in postmenopausal women as well as a proof of concept study in patients undergoing in vitro fertilization and embryo transfer were combined and analyzed. The structural pharmacokinetic model was developed using the rich data from the Phase I studies and the full pharmacostatistical model was then derived using all the data. RESULTS: The pharmacokinetics of r-hLIF after repeated subcutaneous administration were described by a one-compartment disposition model with a zero order input. The duration of the absorption phase was short (0.8 h) and invariant. The apparent clearance in postmenopausal women was 57 l h(-1) (CV = 17%). In in vitro fertilization and embryo transfer patients, the apparent clearance was decreased by 35% compared with postmenopausal women. The apparent volume of distribution was 235 l (interindividual CV = 28%) and exhibited an interoccasion variability of 23%. It increased (for weight above 62 kg) or decreased (for weight below 62 kg) by 29% for every 10 kg body weight. The median posthoc estimates of apparent clearance and volume of distribution and their variability were consistent with the population estimates. In postmenopausal women, the results were consistent with those obtained by noncompartmental analysis. The residual variability on r-hLIF serum concentrations was 20%. CONCLUSIONS: The pharmacokinetics of r-hLIF after repeated SC administration were described by a one compartment disposition model, with zero order input, in postmenopausal women and those undergoing IVF or intracytoplasmic sperm injection and embryo transfer. Absorption of r-hLIF was rapid as was its subsequent clearance. The apparent volume of distribution of r-hLIF was moderate to high, depended on body weight and showed interoccasion variability.

Administration, Cutaneous↗

PubMed2004

FSH and LH responses to GnRH after ovariectomy in postmenopausal women.

OBJECTIVE: Whether the postmenopausal ovary is still playing a role in the control of gonadotrophin secretion in response to GnRH has not been investigated. The aim of the present study was to test this hypothesis by examining changes in basal and GnRH-induced gonadotrophin secretion in postmenopausal women after bilateral ovariectomy. DESIGN: The responses of LH and FSH to GnRH [10 microg intravenously (i.v.)] were investigated in postmenopausal women from 2 days before to 8 days after total abdominal hysterectomy plus bilateral ovariectomy. PATIENTS: Nine postmenopausal women aged 52-67 years and between 5 and 15 years after menopause. In all cases the ovaries were histologically normal. MEASUREMENTS: Pituitary responses to GnRH were calculated every 12-24 h as the net increases in LH (DeltaLH) and FSH (DeltaFSH) at 30 min above the basal values. Basal values of oestradiol (E2) and testosterone were also measured. RESULTS: Basal values of FSH showed a significant decrease on postoperative days 2 (P < 0.01) and 8 (P = 0.03) as compared to day 0, while at the same time points after the operation LH values were marginally lower than on day 2 (P = 0.05). Serum E2 values showed a gradual increase up to postoperative day 1 (P = 0.04) and a gradual decline thereafter. Basal testosterone concentrations decreased gradually and significantly after ovariectomy and were significantly lower on day 8 than on day 0 (P < 0.01). DeltaFSH and DeltaLH responses to GnRH did not change significantly with time. A temporary increase at 12 h after the operation was not significant. CONCLUSIONS: These results demonstrate for the first time that the removal of the ovaries in postmenopausal women does not affect GnRH-induced gonadotrophin secretion in the short term. It is suggested that the postmenopausal ovary is not a dominant regulator of hypothalamic-pituitary interactions.

Aged↗

PubMed1997

Effects of hormone replacement therapy on sexuality in postmenopausal women in a mideast country.

OBJECTIVE: During the postmenopausal period, sexual interest and activity seem to decline, as part of the menopausal effect of oestrogen deficiency. The aim of this study was to evaluate other factors that could contribute to sexual dysfunction and the effect of hormone replacement therapy among postmenopausal women in Kuwait. METHOD: Between June 1992, and June 1994, details of sexual history were compiled from 261 postmenopausal women that attended the Menopause Clinic at the Maternity Hospital, Kuwait. The effect of hormone replacement was analysed from the sexual history and the bacteriology of the lower genital tract. RESULTS: About 71% of the 261 postmenopausal women were still sexually active. Among those not sexually active, 38% had loss of interest, 22% because of divorce or death of husband, 20% from loss of interest by husband, and in 13% because the husbands had impotence from medical problems. Of the sexually active women, 41.1% had reduced libido. Contributing factors included vaginal symptoms like dyspareunia and vaginal dryness, vaginal infection, disturbances in the premenopausal menstrual pattern and disharmony with husbands. About 23 to 45% of the postmenopausal women with oestrogen replacement therapy, had significant relief of their symptoms of sexual dysfunction. Vasomotor symptoms had better response compared to sexual dysfunction (p < 0.01). Natural oestrogen gave slightly better relief of symptoms of sexual dysfunction than other forms of oestrogen therapy. Livial gave complete relief of dyspareunia and vaginal dryness in 9.1% and 3.9% respectively, but none of those with libido and vaginal discharge had any relief. CONCLUSION: There is a decline in sexual response and activity in postmenopausal women in Kuwait. This is however, multifactorial in origin. Although oestrogen replacement therapy gives significant relief in symptoms of sexual dysfunction, other contributory factors should always be evaluated.

Adult↗

PubMed1995

Histopathological findings in women with postmenopausal bleeding.

OBJECTIVE: To investigate endometrial histopathology in a geographically defined population of women presenting with postmenopausal bleeding. DESIGN: Prospective study with collection of data during an 18-month period. SETTING: The health care county of Skaraborg, Sweden. SUBJECTS: Dilatation and curettage using general anaesthesia was performed on 457 postmenopausal women suffering from uterine bleeding. Women using hormone replacement therapy for climacteric complaints were not included in the investigation. MAIN OUTCOME MEASURES: The frequency of bleeding was correlated to endometrial histopathology, and in relevant cases to pathological conditions in cervix and ovaries in a defined population of postmenopausal women. RESULTS: The incidence of postmenopausal bleeding decreased with increasing age while the probability of cancer as the underlying cause increased. The peak incidence of endometrial carcinoma was found in women between 65 and 69 years of age. Endometrial histopathology showed: atrophy (50%); proliferation (4%); secretion (1%); polyps (9%); different degrees of hyperplasia (10%); adenocarcinoma (8%); not representative (14%); other disorders (3%). In six women a squamous carcinoma of the cervix was found, and eight proved to have ovarian tumours. CONCLUSIONS: The histopathological finding of endometrial adenomatous hyperplasia or cancer in about 15% of the postmenopausal women with bleeding justifies a thorough examination. The probability of cancer as the underlying cause increased with age. The endometrium was atrophic in 50%. Eight women had ovarian tumours. These findings may imply that transvaginal ultrasound examination should be included in the evaluation of postmenopausal bleeding as occasionally endometrial biopsies of atrophic endometrium could be avoided and ovarian pathology detected.

Aged↗

PubMed1996

Occurrence of fibroadenomas in postmenopausal women referred for breast biopsy.

OBJECTIVE: To examine the occurrence of breast fibroadenomas in postmenopausal patients referred for breast biopsy. DESIGN: A retrospective review of breast biopsy outcome and of patient demographics, including menstrual and hormonal status. SETTING: The Tucson Breast Center, a large outpatient breast cancer detection clinic affiliated with the University of Arizona Health Sciences Center in Tucson, Arizona. PARTICIPANTS: All women seen at the Tucson Breast Center between 1985 and 1990 who were referred for breast biopsy. RESULTS: A total of 100 fibroadenomas were found in 709 breast biopsies whose results were known. Fifty-two of these were in premenopausal women and 44 in postmenopausal women; the menopausal status of four women was unknown. In postmenopausal women, 11 of the 44 patients reported hormone use. Fibroadenomas constituted 20% (39 of 195) of the benign masses and 12% (39 of 339) of all breast masses in postmenopausal women. Fibroadenomas constituted 10% (44 of 447) of all biopsies in postmenopausal women, including those with breast masses, abnormal calcifications, or other lesions. CONCLUSION: Noncalcified fibroadenomas of the breast are not confined to young women and may constitute a small but noteworthy proportion of lesions coming to breast biopsy in postmenopausal women.

Adult↗