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PubMed1992

Development and evaluation of an index to predict early postmenopausal bone loss.

An index to predict individual postmenopausal bone loss is presented. The index is developed by means of data from a 10-year prospective Norwegian study in which bone mass of the distal forearm was measured annually in 73 women. All the women were 47 years old and premenopausal at inclusion. Independent risk factors for postmenopausal bone loss were identified by applying multivariate regression analysis on anthropometric, biochemical, nutritional, and life-style variables measured at menopause. The analysis identified low body weight, reduced renal phosphate reabsorption, and smoking as significant independent risk factors, and by means of these three factors a predictive index for postmenopausal bone loss was developed. This index was validated by using data from a 10-year longitudinal Dutch study, in which bone mass of the proximal radius was measured annually in 86 women, aged between 49 and 57 years and perimenopausal at inclusion. We defined women with the highest index score as "high-risk persons." According to this definition approximately 25% of the perimenopausal women were classified as high-risk persons, and the estimated sensitivity/specificity/positive predictive power were 36%, 89%, and 74%, respectively, when used to select women with a postmenopausal bone loss above average. We conclude that the index may be helpful in identifying healthy perimenopausal women in whom bone mass measurements should be considered.

Female↗

PubMed1979

Ultrastructural effects of estrogen replacement on postmenopausal endometrium.

Endometrial adenocarcinoma occurs almost exclusively in postmenopausal women, and excessive or unopposed estrogen stimulation is suspect as a causative factor in its pathogenesis. Furthermore, the incidence of endometrial adenocarcinoma has increased in women undergoing estrogen replacement therapy. In the present study, the cellular response of premenopausal and postmenopausal endometrium to estrogenic stimulation was compared with endometrial adenocarcinoma by the electron microscope. Tissues were obtained at hysterectomy, endometrial biopsy, or endometrial curettage and were processed routinely for light and electron microscopy. Ultrastructurally the endometrium from postmenopausal patients undergoing estrogen replacement therapy was similar to normal cyclic endometrium in the late proliferative phase. At least three features of the estrogen-treated postmenopausal tissue resembled those observed in adenocarcinoma of the endometrium: accumulation of lipid droplets, irregular nuclei, and perinuclear whorls of microfibrils.

Adenocarcinoma↗

PubMed1978

The prevention of endometrial cancer in postmenopausal women with progestogens.

Due to adverse publicity alleging an increased risk of endometrial cancer with estrogen therapy, a prospective study was begun in 1976 to determine the incidence of this disease in postmenopausal women. During 5,025 patient-years of observation in 1976-1977, 6 adenocarcinomas of the endometrium were diagnosed for an incidence of 1.2:1,000 postmenopausal women per year. No endometrial malignancies were detected in 2,552 patient years of therapy with estrogens and progestogens. In 1,028 patient-years of observation where estrogens only was the therapy, there were 3 endometrial cancers for an incidence of 2.9:1,000. Adenocarcinoma of the endometrium was found in 2 of the untreated group, which gave an incidence of 3.0:1,000. The sixth endometrial cancer occurred in a patient using estrogen vaginal cream. During this same period, 139 perimenopausal and postmenopausal women were treated with progestogens for endometrial hyperplasia. The hyperplasia was reversed to normal endometrium in 133 patients (95.7%). Hyperplasia is a precancerous lesion and should be treated with either progestogens or hysterectomy. All postmenopausal women with a uterus should be given the Progestogen Challenge Test and the progestogen continued each month as long as bleeding follows. These methods will prevent most endometrial cancers.

Adenocarcinoma↗

PubMed1992

The role of estrogen in the TSH and prolactin responses to thyrotropin-releasing hormone in postmenopausal as compared to premenopausal women.

The basal and TRH (Thyrotropin-Releasing Hormone) stimulated TSH (Thyrotropin) and PRL (Prolactin) responses (incremental area; IA) to 200 micrograms TRH was studied in 13 pre- and 13 postmenopausal women of 60 years of age. Both groups consisted of healthy women, none had goiter and all were negative for thyroid autoantibodies. The serum levels of TSH, T3, T4 and SHBG (sex hormone-binding globuline) were in the normal range and did not differ significantly between the groups. There were no differences in basal TSH (1.3 +/- 0.5 vs 1.4 +/- 0.5 mIU/l) or PRL (6.4 +/- 2.7 vs 6.6 +/- 2.5 micrograms/l) or for PRL IA (498 +/- 126 vs 584 +/- 165) between pre- and postmenopausal women. However, for TSH IA there was a slight decrease (15%), but not significant, in the postmenopausal group compared to the premenopausal group (1630 +/- 598 vs 2067 +/- 893). In conclusion, a weak but not significant decrease in the TSH response to TRH in postmenopausal women may be explained by the lower endogenous estradiol level.

Adult↗

PubMed1979

Sex hormone binding globulin capacity and postmenopausal hormone replacement therapy.

The sex hormone binding globulin (SHBG) capacity was measured in 26 normal untreated postmenopausal women and 10 postmenopausal women taking different types of hormone replacement therapy. The patients on hormone replacement therapy had significantly higher levels of SHBG than postmenopausal women (p less than 0.001) and also significantly higher levels than 52 normal ovulating women studied previously (Pogmore and Jequier, 1979; p less than 0.02). This suggests that postmenopausal women on hormone therapy are being overtreated.

Adolescent↗

PubMed1992

Concordant suppression of serum immunoreactive luteinizing hormone (LH), follicle-stimulating hormone, alpha subunit, bioactive LH, and testosterone in postmenopausal women by a potent gonadotropin releasing hormone antagonist (detirelix).

The purposes of the current study were 2-fold: 1) to assess the effects of a new antagonistic analog of GnRH [N-Ac-D-Nal(2)1, D-pC1-phe2, D-Trp3, D-hArg (Et2)6, D-Ala10] GnRH, or detirelix (Syntex Research) on gonadotrope function as reflected by serum levels of immuno- and bioassayable LH, and immunoactive FSH and alpha-subunit concentrations in postmenopausal, hypergonadotropic women; and 2) to determine if androgen production in the postmenopausal ovary is gonadotropin dependent. Six normal postmenopausal women were studied. Each volunteer received doses of 1, 5, and 20 mg detirelix sc in a random order separated by at least a 1-week interval. Serum LH, FSH, and alpha-subunit were measured by RIA at frequent intervals for 72 h after each injection. Bioactive LH levels were measured at 0, 24, 48, and 72 h after injection by a mouse Leydig cell bioassay, to permit comparison of biological with immunological LH activity. The steroids testosterone (T) and dehydroepiandrosterone sulfate were measured before injection and 12 (T only), 24 and 48 h after injection of the 20 mg dose. Immunoactive levels of serum LH and FSH were both suppressed in a dose-dependent manner, but LH suppression was greater than that of FSH. Maximum LH suppression (mean +/- SEM) after the 1, 5, and 20 mg doses was 40.2 +/- 7.0%, 63.2 +/- 3.4%, and 75.8 +/- 2.2%, respectively. For the same doses, maximum FSH suppression was 18.0 +/- 6.0%, 25.6 +/- 4.6%, and 39.6 +/- 2.7%. LH levels remained suppressed below baseline for up to 72 h after the 20 mg dose. Bioactive LH changes closely paralleled those of immunoactive LH. Mean LH suppression (area under the serum concentration curve) during the first 24 h after injection was 23.5 +/- 6.2% for the 1-mg dose, 47.2 +/- 4.7% for the 5-mg dose, and 61.0 +/- 2.1% for the 20-mg dose. Mean percent FSH suppression during the first 24 h, calculated in the same manner, was 6.8 +/- 3.9% (1 mg), 14.5 +/- 2.9% (5 mg), and 18.2 +/- 2.6% (20 mg). Serum alpha-subunit concentrations were significantly suppressed by 1 h after dosing with the 5- and 20-mg doses (P less than 0.05), and remained suppressed throughout the 72-h sampling period. Gonadotropin dependence of steroidogenesis in the postmenopausal ovary was suggested by a significant suppression of serum T concentrations after the 20-mg dose of detirelix.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

PubMed1992

Sex hormones and bone metabolism in postmenopausal rheumatoid arthritis treated with two different glucocorticoids.

To investigate the effect of low doses of 2 different glucocorticoids on bone mass, sex hormone status and bone metabolic indices, a study was undertaken in 16 postmenopausal women with rheumatoid arthritis (RA) receiving < 15 mg/day of deflazacort and in 16 patients with RA matched for age, years postmenopause and disease duration, receiving < 10 mg/day of prednisone. Sixteen healthy postmenopausal women and 16 nonsteroid treated patients with RA were also studied as control groups. Vertebral bone density (vBMD) was lower (mean +/- SD: 0.65 +/- 0.07 vs 0.73 +/- 0.09 g/cm2; p < 0.02) in prednisone treated patients than in deflazacort treated patients, whose vBMD values were similar to those of nonsteroid treated RA. No significant difference was found as for radial bone mineral content. Circulating levels of estradiol, dehydroepiandrosterone sulfate, androstenedione and progesterone were low in all patient groups with RA when compared with healthy controls. The prednisone treated patients showed significantly lower values of all sex hormones with respect to deflazacort treated patients. Osteocalcin values were also lower (3.0 +/- 1.4 vs 3.9 +/- 1.6 ng/ml; p < 0.05) in prednisone treated patients with respect to deflazacort treated group. Glucocorticoid treated patients showed a direct correlation (r2 = 0.39) between vBMD and plasma estradiol levels, while no correlation was found with osteocalcin values. In conclusion, our postmenopausal patients with RA treated with low dose prednisone had reduced levels of sex hormones and osteocalcin and reduced vertebral bone mass. Comparable doses of deflazacort showed only a mild inhibitory effect on sex hormones and osteocalcin, and did not show any detectable effect on bone mass.

Adult↗

PubMed1976

Ovarian and adrenal contributions to peripheral steroid levels in postmenopausal women.

Serum levels of cortisol (F), pregnenolone (delta5-P), 17-hydroxypregnenolone (17-delta5-P), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), progesterone (P), 17-hydroxyprogesterone (17-P), androstenedione (A), testosterone (T), dihydrotestosterone (DHT), androst-5-ene-3beta, 17beta-diol (delta5-diol), estrone (E1), and estradiol-17beta (E2) were measured in 10 postmenopausal and 5 premenopausal women before (control) and after 7 days of Dexamethasone (post-dex). Control and post-dex levels of delta5-P, P, DHT, T, and F were not different (P greater than 0.05) in premenopausal versus postmenopausal women, while the control levels of 17-P, DHEA, DHEA-S, A, delta5-diol, and E2 were lower in the postmenopausal women (P less than 0.05). Assuming post-dex levels equal ovarian contribution, the ovarian contribution of 17-delta5-P, 17-P, DHEA, delta5-diol, A, E1, and E2 and the adrenal contribution (control-post-dex) to DHEA, DHEA-S, 17-P, A, and delta5-diol was significantly lower (P less than 0.05) in postmenopausal subjects.

Adrenal Cortex Hormones↗

PubMed1992

Effect of human corticotropin-releasing hormone on gonadotropin secretion in cycling and postmenopausal women.

OBJECTIVE: To test the hypothesis that corticotropin-releasing hormone (CRH) is linked to stress-associated reproductive dysfunction in the human by determining if the administration of human corticotropin-releasing hormone (hCRH) results in an inhibition of gonadotropin secretion. DESIGN: Twenty-four-hour prospective study with frequent (every 10 minutes) blood sampling. SETTING: University Clinical Research Center. INTERVENTIONS: Sequential 8-hour infusions of normal saline, hCRH (1 to 5 micrograms/kg per hour), and hCRH plus naloxone (2 mg/h). SUBJECTS: Four normal cycling women and four postmenopausal women. MAIN OUTCOME MEASURES: Plasma luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), and adrenal and ovarian steroids. RESULTS: In response to hCRH, a prompt and sustained rise in cortisol (F) was noted in both normal cycling women and postmenopausal women. No inhibition of LH or FSH was noted during either the hCRH or hCRH plus naloxone infusion in either group of women. Unexpectedly, elevations in the mean LH peak amplitude and the transverse mean LH concentration were noted in the postmenopausal women during the infusion of hCRH as compared with saline. The infusion of hCRH had no apparent effect on concentrations of PRL, FSH, and gonadal and adrenal steroids (except for F). CONCLUSIONS: Under these conditions, intravenously administered hCRH has no inhibitory effect on gonadotropin secretion in either premenopausal or postmenopausal women. The mechanism by which stress exerts its deleterious effect on reproductive function in the human remains unknown.

Adult↗

PubMed1975

Effect of exogenous estrogen on serum pregnenolone, cortisol, and androgens in postmenopausal women.

Previous studies from this laboratory have included reports on the serum concentrations of the following steroids in premenopausal and postmenopausal women: pregnenolone, 17-hydroxypregnenolone, progesterone, 17-hydroxyprogesterone, cortisol, corticosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, testosterone, dihydrotestosterone, estone, and estradiol 17-beta. In general the steroid levels were lower in postmenopausal subjects, and this difference was significant at P smaller than 0.05 for 8 of the steroids. The significantly decreased peripheral level of steroids in the postmenopausal state can be explained by decreases either in ovarian secretion of steroids or in ovarian stimulation of the adrenal cortex. Since the contribution of the adrenal cortex to the peripheral levels of dehydroepiandrosterone sulfate (DHEA-S) is greater than 95% in premenopausal women, a plausible explanation for the marked drop observed in peripheral DHEA-S levels after menopause is that the ovary influences the steroidogenic activity of the adrenal cortex. In such cases a decrease in the stimulation of the adrenal cortex by some ovarian steroids would be expected. Estrogen therapy in 10 postmenopausal women resulted in significant increases in the serum levels of 3 of the steroids compared to those in untreated subjects, confirming the postulate that ovarian estrogens stimulate the secretion of adrenal androgens.

Adrenal Cortex↗

PubMed2026

Implementing a novel digital health platform for self-management of postmenopausal osteoporosis: A qualitative study of user experiences, perspectives and implementation outcomes.

BACKGROUND: Osteoporosis self-management requires scalable support, and digital health platforms may meet this need. This study aimed to characterise the experiences and perspectives of postmenopausal women who participated in a 12-month randomised controlled trial (RCT) of a digital voice assistant (DVA) delivered osteoporosis self-management intervention, and to assess key implementation outcomes. METHODS: This was a qualitative analysis of interviews with postmenopausal women from the intervention arm (DVA group) of the RCT. The DVA program broadcast education videos, medication reminders, home-based exercise, nutrition advice and monthly quizzes through a DVA device. Semi-structured interviews were recorded, transcribed and managed in NVivo through reflexive thematic analysis, guided by the Practical Planning for Implementation and Scale-Up and Proctor's implementation outcome taxonomy frameworks. Evidence weighting summarised participant coverage and code density. RESULTS: Twenty-two of 25 (88%) DVA group participants completed semi-structured interviews. Thematic analysis identified seven themes mapped to Proctor's implementation outcomes. Evidence weighting indicated strong support for the intervention's appropriateness and acceptability, moderate support for its adoption, fidelity, feasibility and sustainability, and limited support for costs. Participants valued clear audiovisual guidance, conversation-based interactions with natural language, and flexible home-based access to self-management. CONCLUSION: Digital health platforms for osteoporosis self-management appear feasible, acceptable and sustainable among postmenopausal women. Findings indicate that these platforms are approaching readiness for evaluation in implementation-focused settings, contingent on streamlined content, reliable delivery modalities, accessible user support, clear privacy regulations and pragmatic pricing models.

Humans↗

PubMed1992

Minimal levels of serum estradiol prevent postmenopausal bone loss.

Biochemical parameters reflecting bone resorption [urinary calcium/creatinine (Ca/Cr) and hydroxyproline/creatinine (OH/Cr)] were related to serum estrogens [estrone (E1) and estradiol (E2)] in 262 healthy women including 158 patients receiving estrogen replacement therapy (ERT) for at least 6 months, 49 eugonadal women, and 55 untreated postmenopausal women. A significant (P < 0.001) correlation exists between serum E2 and Ca/Cr: Ca/Cr (mg/dl) = -0.00044 E2 (pg/ml) + 0.129 (n = 262; r = -0.37), serum E2 and OH/Cr: (OH/Cr (mg/g) = -0.049 E2 (pg/ml) + 18.76 (n = 262; r = -0.36), serum E1 and Ca/Cr: Ca/Cr (mg/dl) = -0.0003 E1 (pg/ml) + 0.127 (n = 261; r = -0.28) but not between serum E1 and OH/Cr. Women with circulating levels of E2 between 60 and 90 pg/ml have a significant (P < 0.01) reduction of Ca/Cr and OH/Cr when compared with those with lower levels of E2. Higher values of E2 do not provide additional benefit. We conclude that in postmenopausal women receiving an estrogen replacement therapy (ERT), a significant reduction of bone resorption is achieved when circulating levels of estradiol reach a value (60 pg/ml) corresponding to the one measured, in eugonadal women, during the last days of the early follicular phase of the menstrual cycle. We suggest that oral or percutaneous ERT should induce a minimal value of 60 pg/ml to prevent postmenopausal bone loss.

Analysis of Variance↗

PubMed2025

Evaluation of the gut microbiome and sex hormones in postmenopausal women with newly diagnosed hormone receptor-positive breast cancer versus healthy women: a prospective case-control study.

PURPOSE: The functional composition and diversity of the gut microbiome may affect breast cancer risk by modulation of systemic sex hormones. Gut bacteria with β-glucuronidase enzymatic activity may deconjugate estrogens, leading to increased estrogen reabsorption into the circulation thereby increasing breast cancer risk. We investigated the relationship between the gut bacterial microbiome and endogenous estrogens and related sex hormones in women with hormone receptor-positive breast cancer compared to healthy control women. The goal was to determine if the estrobolome (i.e., bacteria capable of modulating the body's circulated estrogen levels) was altered in those with breast cancer compared with controls. METHODS: In this prospective case-control study, postmenopausal women (n = 46) with newly diagnosed stage I-III estrogen and/or progesterone receptor-positive breast cancer were compared with healthy postmenopausal female controls (n = 22). Bacterial composition of the gut microbiome was analyzed by 16S rRNA gene sequencing from fecal specimens. Plasma and urine sex hormones were quantified using high-performance liquid chromatography/mass spectrometry. RESULTS: We found evidence that some β-glucuronidase positive bacteria were enriched in the breast cancer patients compared to healthy controls, whereas abundances of some β-glucuronidase negative bacteria were reduced. There was also a wide distribution of prevalence of β-glucuronidase positive taxa in both breast cancer subjects and healthy controls, as well as higher probability of breast cancer subjects having higher average β-glucuronidase levels. Significant differences were found in endogenous progesterone levels between the breast cancer patients and healthy controls. CONCLUSION: This pilot study showed differences in the gut microbiome and endogenous progesterone levels among postmenopausal women with hormone receptor-positive breast cancer compared with healthy controls. These interesting findings may have implications for breast cancer risk and prevention and warrant further exploration.

Humans↗

PubMed2026

Bridging the gap: multi-omic insights into exercise responses in postmenopausal women.

Postmenopausal women represent the fastest-growing demographic at risk of sarcopenia and cardiometabolic disease, yet exercise biology research remains disproportionately derived from male or hormone-replete phenotypes. Menopause constitutes a chronic endocrine perturbation characterized by sustained reductions in estrogen and progesterone, and altered androgen balance, superimposed on the acute and chronic perturbations induced by exercise. This hormonal shift modifies substrate metabolism, inflammation, redox balance, and recovery capacity, factors that shape molecular responses to exercise across tissues and time. Here, we synthesize current evidence on exercise responses in postmenopausal females across genomics, epigenomics, transcriptomics, proteomics, and metabolomics/lipidomics. Across omics layers, direct data in postmenopausal cohorts remain limited, with frequent underreporting of menopausal status, hormone therapy exposure, circulating hormone concentrations, medication use, and biosampling timing relative to exercise and hormone dosing. We outline a menopause-aware framework for exercise-omics that prioritizes endocrine stratification, repeated sampling across exercise and recovery, and integrative multi-omics approaches linking molecular responses to functional outcomes. We also outline minimum reporting standards to improve reproducibility, inclusivity, and translational relevance. Advancing menopause-aware exercise-omics will be essential for developing precision exercise strategies that improve health span and functional independence in later life.

Humans↗

PubMed1992

Body weight and/or endogenous estradiol as determinants of cortical bone mass and bone loss in healthy early postmenopausal women.

The objective was to study the independent relationships of body mass index and endogenous estradiol to cortical bone mineral density and the rate of cortical bone loss at the radius in healthy early postmenopausal women. Fifty-one healthy early postmenopausal women (aged 58-66 years) participated. The women were a subset of a population participating in a 10-year longitudinal study to elucidate the influence of dietary calcium on the rate of cortical bone loss. Cortical bone mineral density at the radius, body weight and body height were measured annually (1979-89). Concentrations of sex steroids were measured in serum samples collected during the last year of follow-up (1989). Endogenous estradiol levels, although significantly positively correlated with body mass index, were not independently related to bone mass indices of the radius. Body mass index, on the other hand, was found to be positively related to cortical bone mineral density and negatively to the rate of bone loss, even after adjustments had been made for confounding factors. Our results suggest that the level of total estradiol is not an important determinant of cortical bone mass indices in healthy early postmenopausal women. Other factors of overweight such as mechanical loading may be important.

Aged↗

PubMed1992

Postmenopausal women. Factors in osteoporosis preventive behaviors.

Osteoporosis is a serious health hazard mainly affecting postmenopausal and elderly women. Osteoporotic fractures are one of the leading causes of morbidity and death in the elderly population. Prevention of further loss of bone mass in postmenopausal women can be achieved if women take estrogen replacement therapy, consume adequate levels of calcium, exercise regularly, and practice healthy lifestyle behaviors. Elderly women need to follow the same strategies as postmenopausal women with more emphasis on prevention of falls.

Aged↗

PubMed1992

Measurement of bone mineral density (BMD) with quantitative computed tomography (QCT) in postmenopausal osteoporosis: effect of estrogen.

UNLABELLED: To determine the efficacy of the estrogen replacement therapy (ERT) on the bone mineral density (BMD) measured with quantitative computed tomography (QCT) in postmenopausal osteoporosis 16 women aged 46-72 were examined. They were divided into two groups: 8 women treated with conjugated estrogens (Group I) and 8 who did not received ERT (Group II). In all 16 patients the serum hormonal concentrations (LH, FSH and estradiol) were measured with radioimmunological methods. The bone densitometry was performed in all of them using the single-energy computed tomography (QCT) with the computer Picker 1200. Bone mineral density was measured in three lumbar vertebra (L1-L3) and expressed in milligrams K2HPO4 per ml. The bone mineral density (BMD) was statistically significantly higher in the estrogen treated group (Group I) in every vertebra compared with that of controls (Group II). The serum FSH concentration was statistically significantly lower in the ERT group (Group I) and a statistically significant correlation between FSH level and average BMD (Lmean) was present. IN CONCLUSION: 1. the ERT is very efficacious in preventing bone loss in postmenopausal women; 2. measurement of BMD in lumbar vertebra L1 or L3 may be a sufficiently reliable and accurate, cost-effective and time-saving method of screening for osteoporosis; 3. the serum FSH determination seems to be useful in monitoring of the estrogen therapy for postmenopausal osteoporosis.

Aged↗

PubMed1992

Bone density in postmenopausal women: high impact vs low impact exercise.

This 1 year study examined the effect of high impact and low impact activities on bone mineral density (BMD) at the lumbar vertebrae (L2-L4) in healthy, sedentary, early postmenopausal women. Fifteen subjects whose postmenopausal status was verified by the blood levels of follicle stimulating hormone (FSH) and estradiol were chosen. These subjects were tested on the following variables: BMD via dual photon absorptiometry, heart rate response to the Balke treadmill test, percent fat via skinfolds, and a 3-d dietary analysis. Subjects were matched and then assigned randomly to one of three groups: (a) a control nonexercising group, (b) a low impact exercise group, and (c) a high impact exercise group. The control nonexercising group experienced a significant linear decrease in BMD during the study (F = 12.63, P = 0.002). Both the low and high impact exercise groups maintained BMD during the study (F = 0.04, P = 0.85; F = 1.08, P = 0.31, respectively). The difference in BMD between the low impact and the high impact exercise groups was not significant (F = 0.36, P = 0.55). In conclusion, 20 min of moderate intensity low impact or high impact exercise 3 d.wk-1 for 1 yr is effective in maintaining BMD in early postmenopausal women.

Absorptiometry, Photon↗