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PubMed2004

The effects of hormone replacement therapy combined with vitamins C and E on antioxidants levels and lipid profiles in postmenopausal women with Type 2 diabetes.

BACKGROUND: Recent studies have demonstrated that oxidative modification of low-density lipoprotein (LDL) involving the formation of lipid peroxides (MDA), exerts several biological effects that may contribute to the onset and progression of cardiovascular diseases in postmenopausal women with Type 2 diabetes (DPMW). Therefore, the aim of our study was to evaluate the effect of hormone replacement therapy (HRT), vitamin C and E (VCE) treatments on lipid profiles, glucose and MDA levels as well as antioxidant vitamins and enzymes in plasma and red blood cells (RBC) in diabetic or non-diabetic postmenopausal women (PMW). METHODS: Oral HRT and VCE supplementation for 6 weeks were compared with HRT treatment in 40 non-diabetic PMW and 40 DPMW. RESULTS: In the 40 postmenopausal women (PMW) and 20 postmenopausal women with DPMW who received oral HRT and 20 DPMW who received HRT plus VCE, there was a significant fall in MDA, total cholesterol, LDL-cholesterol and triglyceride values. Glycated haemoglobin (HbA1c) in the DPMW was significantly improved with oral HRT and VCE although no significant change in white blood cell counts, vitamin A and HDL values occurred. Additionally, a fall in plasma glucose, HbA1c and platelet values also occurred in the PMW and DPMW groups by oral HRT and VCE treatments. There was a significant increase in plasma vitamin E and beta-carotene concentrations, catalase, glutathione peroxidase and reduced glutathione levels in RBC and plasma in DPMW by treatments with HRT and/or VCE. CONCLUSIONS: Daily VCE and HRT administrations both in PMW and DPMW seem to produce significant improvement in antioxidants concentrations, and the metabolic control of lipids and glucose. The HRT and VCE supplementations may strengthen the antioxidant defense system due to reducing blood glucose and lipid metabolites, and they may play a role in preventing cardiovascular diseases in postmenopausal women with Type 2 diabetes.

Aged↗

PubMed2006

Once-monthly ibandronate for postmenopausal osteoporosis: review of a new dosing regimen.

BACKGROUND: Ibandronate, a nitrogen-containing bisphosphonate, was approved by the US Food and Drug Administration (FDA) in May 2003 as a daily oral regimen for the treatment and prevention of post-menopausal osteoporosis. In March 2005, the FDA approved once-monthly dosing with ibandronate for the same indications. OBJECTIVE: The purpose of this article was to review the efficacy and tolerability of ibandronate 150 mg once monthly in the treatment and prevention of post-menopausal osteoporosis. METHODS: A search of MEDLINE (1966-September 2005) and International Pharmaceutical Abstracts (1971-September 2005) for articles relating to the efficacy and tolerability of once-monthly ibandronate in the treatment of postmenopausal osteoporosis was conducted using the terms ibandronate and ibandronic acid. Additional searches were conducted to identify publications relevant to compliance and pharmacoeconomic considerations using the terms bispbospbonate, compliance, cost, and pharmacoeconomics. The reference lists of identified articles and presentations from recent scientific meetings also were reviewed. Selected safety information from the manufacturer was incorporated. RESULTS: Ibandronate 2.5 mg/d and intermittent ibandronate (20 mg QOD for 12 doses every 3 months) have been shown to effectively reduce the incidence of vertebral fractures; after 3 years of therapy in a placebo-controlled clinical trial, the relative risk reductions for new vertebral fractures with daily and intermittent ibandronate were 62% and 50%, respectively (both, P<0.001 vs placebo). Once-monthly ibandronate has been evaluated in 2 clinical trials: a Phase I dose-ranging trial in 144 healthy postmenopausal women and a Phase III noninferiority trial in 1609 women with postmenopausal osteoporosis who were randomized to receive ibandronate 2.5 mg/d or 1 of 3 monthly ibandronate regimens: 50/50 mg (50 mg given on 2 consecutive days) once monthly; 100 mg once monthly; and 150 mg once monthly. The primary end point of the Phase III trial was the change from baseline in lumbar spine bone mineral density (BMD). After 1 year of therapy, patients who received ibandronate 150 mg once monthly had a significantly greater increase from baseline in lumbar spine BMD compared with those who received ibandronate 2.5 mg/d (4.9% vs 3.9%, respectively; P=0.002). The overall adverse-event profile was similar between the daily and monthly regimens. Drug-related adverse events were reported in 32.4% of patients receiving ibandronate 2.5 mg/d and 36.9% of patients receiving ibandronate 150 mg monthly. Upper gastrointestinal adverse events occurred in a respective 22.8% and 22.5% of the 2 groups. After 1 year of therapy, patients receiving ibandronate 150 mg monthly reported more flulike symptoms (8.3%) compared with those receiving ibandronate 2.5 mg/d (2.8%). In a crossover study comparing preference for and convenience of monthly ibandronate and weekly alendronate in 342 ambulatory women with postmenopausal osteoporosis, significantly more patients preferred the monthly ibandronate regimen to the weekly alendronate regimen (71.4% vs 28.5%, respectively; P<0.001). CONCLUSION: Once-monthly ibandronate is an effective and well-tolerated treatment option for postmenopausal osteoporosis.

Aged↗

PubMed2006

The effect of dosing frequency on compliance and persistence with bisphosphonate therapy in postmenopausal women: a comparison of studies in the United States, the United Kingdom, and France.

OBJECTIVES: The aim of this study was to determine the effect of dose frequency on compliance and persistence with bisphosphonate therapy in postmenopausal women and to compare findings from 3 different health care systems. METHODS: Three independently performed retrospective cohort analyses were performed using observational data sources. In the United States, bisphosphonate-naive postmenopausal women were identified from a database providing information on health plan prescription drug claims; in the United Kingdom and France, bisphosphonate-naive postmenopausal women were identified from a database of medical records supplied by general practice physicians. The women were grouped into 2 cohorts: those who were initiated on a weekly regimen of alendronate 70 mg or risedronate 35 mg and those initiated on a daily regimen of alendronate 5 or 10 mg or risedronate 5 mg. Compliance was measured in terms of the medication possession ratio (MPR), which was defined as the proportion of days in the 12-month follow-up period for which patients were covered by prescriptions for bisphosphonates. Persistence was measured as the number of days from the date of the index prescription to the last day of prescription coverage within the followup period. Women were classified as nonpersistent if the gap between prescriptions was > 30 days. RESULTS: The study included 2741 postmenopausal women with osteoporosis from the United States, 7567 from the United Kingdom, and 5332 from France. The mean (SD) age of the women was 73.0, 71.7, and 69.7 years in the 3 countries, respectively. The overall MPR was 61% in the United States, 74% in the United Kingdom, and 58% in France. In all 3 countries, women on a weekly regimen had a significantly greater MPR than women on a daily regimen (69% vs 58%, respectively, in the United States; 76% vs 64% in the United Kingdom; and 59% vs 53% in France; all, P < 0.001). Women on a weekly regimen of bisphosphonates persisted with treatment significantly longer than women on a daily regimen (227 vs 185 days, respectively, in the United States; 249 vs 208 in the United Kingdom; and 179 vs 155 in France; all, P < 0.001). A significantly greater proportion of the women on a weekly regimen persisted with treatment for 12 months compared with those on a daily regimen (44% vs 32%, respectively, in the United States; 52% vs 40% in the United Kingdom; and 51% vs 44% in France; all, P < 0.001). CONCLUSIONS: In all 3 countries, postmenopausal women prescribed a weekly regimen of bisphosphonates had significantly greater rates of compliance than women prescribed a daily regimen, and they persisted longer with treatment. However, compliance and persistence rates were suboptimal for both regimens.

Cohort Studies↗

PubMed2006

[Raloxifene in postmenopausal women].

Since the diffusion of the WHI's trial and MWS results, which reported a negative risk/benefit balance of hormone therapy, the management of postmenopausal women has deeply changed over the last 2-3 years. In particular, for the prevention of osteoporosis, the use of other efficient agents tends now to be more widely recommended rather than estrogens. The SERMs with raloxifene are new molecules that have estrogen agonist effects on bone and estrogen antagonist or neutral effects on endometrial and breast tissue. The efficacy of raloxifene to inhibit postmenopausal bone loss as well as to reduce the incidence of vertebral fractures has been demonstrated in women at high risk for osteoporosis through a large randomized placebo-controlled trial involving several thousands of postmenopausal women (MORE trial). Furthermore, the extraskeletal effects of raloxifene might represent an advantage for a global management approach of postmenopausal women, although to date, its exclusive indication is namely the prevention of osteoporosis. However, the estrogen antagonist effects of raloxifene on breast tissue as well as its good safety profile with regard to both the endometrium and the risk of heart diseases are likely to make raloxifene of particular interest for women around the age of 60 years old. Adverse events associated with raloxifene only included an increase in the absolute risk of venous thromboembolism in a comparable manner as with estrogen therapy. Also, its lack of efficacy in reducing hot flushes or preventing vaginal dryness may limit its use in young symptomatic postmenopausal women. Also, its lack of reimbursement in women with no prior fragility fracture must be taken into account.

Bone Density Conservation Agents↗

PubMed2004

Phono-articulatory variations of women in reproductive age and postmenopausal.

Human verbal expression requires coordinated interaction among cortical, neuromuscular, and peripheral events. It is affected by hormonal factors and shows different characteristics in reproductive age and postmenopausal women. The present study compared phono-articulatory characteristics between women in reproductive age postmenopausal. Acoustic variations in fundamental frequency, voice sustenance, formants, vocal intensity, and verbal diadochokinesis were measured. Forty-five women in reproductive age with regular menstrual cycles and taking no hormonal contraceptives and 45 postmenopausal women receiving no hormonal replacement therapy for at least 3 years were interviewed, and their verbal productions were tape-recorded. Acoustic analyses were performed using the Kay Elemetrics Motor Speech Profile (Lincoln Park, NJ). Student t test was employed to compare data between the two groups when they presented normal distribution and Mann-Whitney test when they were asymmetrical. Results showed a greater variability in vocal sustenance, less variation in formants, and verbal diadochokinesis in postmenopausal women. There were no significant variations in fundamental frequency and vocal intensity. These results emphasize the need of a multidisciplinary integrated research, when assessing phono-articulatory processes after the menopause. A better understanding in this field will make it possible to elaborate strategies to offer a better life quality for postmenopausal women.

Adult↗

PubMed2005

Cardiovascular, anthropometric and neurocognitive features of healthy postmenopausal women: effects of hormone replacement therapy.

UNLABELLED: Randomized clinical trials have not shown long-term benefit of postmenopausal hormone replacement therapy (PHT) nor have they shown conclusively that the harmful consequences outweighs the benefits of the treatment. Rather, it is possible that an individualized hormone replacement therapy in questionably clinically healthy postmenopausal women may lead to different results than randomized trials. DESIGN: In this cross-sectional study we evaluated anthropometric parameters, body composition, serum lipids, blood pressure, heart rate variability (HRV) and neurocognitive functions in 39 healthy postmenopausal women PHT users or not users (n=13, age 53.0+/-3.3 and n=26, age=53.3+/-5.0 SD, respectively) as well as in 27 younger controls (ages=33.3+/-7.1). RESULTS: Demographic parameters were similar in women PHT users and not users. Postmenopausal women showed a significantly increase of body mass index (BMI) as well as of waist circumference, compared to younger controls, but in PHT users the values of fat free mass were intermediate between the ones of not treated and younger women. The study of HRV showed a reduction in low frequency (LF) component (sympathetic modulation) during the day, and a reduction in high frequency (HF) component (parasympathetic modulation), particularly in postmenopausal women without PHT. PHT users were characterized by autonomic parameters intermediate between younger controls and age-matched women without PHT. CONCLUSIONS: The impact of PHT on the age-dependent changes of anthropometric features and body composition seems to be modest but positive. Furthermore, PHT seems to play a positive role on the autonomic modulation of cardiac function, through a shift of LF/HF ratio values towards those of young controls.

Blood Pressure↗

PubMed2004

Effect of hormone replacement therapy and tibolone on serum leptin levels in postmenopausal women.

OBJECTIVE: To evaluate the effect of estrogen replacement therapy (ERT), continuous combined hormone replacement therapy (HRT) and tibolone on serum leptin levels in healthy postmenopausal women. METHODS: Eighty-four healthy postmenopausal women aged 43-63 years were studied prospectively. Hysterectomized women (n = 16) received conjugated equine estrogens (CEE) 0.625 mg. Women with an intact uterus were randomly allocated either to CEE+medroxyprogesterone acetate (CEE/MPA) 5 mg or tibolone 2.5 mg. Serum leptin levels were assessed at baseline and after 6 months of treatment. RESULTS: The three groups did not differ with respect to age, body mass index (BMI) or baseline serum leptin levels. Overweight women (BMI > 25 kg/m2) had higher baseline leptin levels (27.0 +/- 11.4 ng/ml) compared to their lean counterparts (BMI < or = 25 kg/m2; leptin: 16.5 +/- 8.1 ng/ml, P = 0.0001). Neither CEE nor CEE/MPA had any effect on serum leptin levels at the end of 6 months either in overweight or in lean women (overweight: CEE baseline 34.4 +/- 13.3 ng/ml, 6 months 36.9 +/- 15.8, P = 0.89, CEE/MPA baseline 22.4 +/- 9.8 ng/ml, 6 months 26.8 +/- 8.7 ng/ml, P = 0.1; lean: CEE baseline 12.6 +/- 4.4 ng/ml, 6 months 13.2 +/- 5.8 ng/ml, P = 0.36, CEE/MPA baseline 17.2 +/- 10.6 ng/ml, 6 months 18.8 +/- 8.8 ng/ml, P = 0.31). Similarly serum leptin remained unchanged at the end of the study in both lean and overweight women on tibolone (overweight: baseline 22.9 +/- 8.1 ng/ml, 6 months 18.5 +/- 12 ng/ml, P = 0.37; lean: baseline 13.2 +/- 5.6 ng/ml, 6 months 17.3 +/- 8.4 ng/ml). CONCLUSION: BMI is a strong determinant of serum leptin levels in healthy postmenopausal women. Neither ERT/HRT nor tibolone exert any effect on serum leptin after 6 months in lean or overweight postmenopausal women. Further studies are required to verify the exact role of estrogen and tibolone on leptin production and function in postmenopausal women.

Adult↗

PubMed2004

The effect of circulating androgens on bone mineral density in postmenopausal women.

BACKGROUND: Osteoporosis is a common problem in postmenopausal period. Recent studies have suggested that endogenous and exogenous androgens may influence the bone mineral density in women. There is limited data about the effect of circulating androgens on bone density in postmenopausal women. AIM: The aim of this study was to evaluate the effect of circulating androgens of ovarian and adrenal origin on bone mineral density in postmenopausal women. MATERIALS AND METHODS: This cross-sectional study included 178 postmenopausal women, who had never been treated with hormonal therapy or calciotropic agents. Serum free testosterone, dehydroepiandrosterone sulfate and androstenedione levels and their relationship with bone mass (dual X-ray absorptiometry) were evaluated. RESULTS: Serum free testosterone and DHEAS levels were correlated positively with bone mineral density at lumbar spine and femoral neck (P < 0.001). However, stepwise linear regression analyses revealed a differential effect of androgens on bone density. Serum free testosterone was among the independent predictor of bone density at lumbar spine (trabecular bone), whereas serum DHEAS level was of bone density at femoral neck (cortical bone). CONCLUSION: This study suggests that endogenous androgens are influential on bone density in postmenopausal women. However, regression analyses revealed a differential effect of androgens on different bone types.

Adult↗

PubMed2004

Reduced bone mass detected by bone quantitative ultrasonometry and DEXA in pre- and postmenopausal women with endogenous subclinical hyperthyroidism.

BACKGROUND: Although overt hyperthyroidism is a well known cause of bone loss, systemic effects of subclinical hyperthyroidism (SH) are still a matter of debate. OBJECTIVE: The aim of this cross-sectional study was to evaluate the effect of endogenous SH on bone in relation to the menopausal status. METHODS: Bone mass and turnover were assessed in a group of 60 patients with endogenous SH due to multinodular goitre; 30 of them were premenopausal and 30 early postmenopausal (mean age, 40.9 +/- 7.3 and 57.7 +/- 6.75, respectively). Sixty healthy women matched for age-, BMI- and menopausal status served as controls. Three different skeletal sites were evaluated using two different techniques: lumbar spine and femoral neck were assessed by DEXA whereas the proximal phalanges were evaluated by quantitative ultrasonometry (QUS), measuring the amplitude-dependent speed of sound (Ad-SoS). Serum osteocalcin and urinary deoxypyridinoline (DPD) were also determined as markers of bone turnover. RESULTS: A significant decrease was found in femoral BMD (P < 0.05) and phalangeal Ad-SoS (P < 0.001) in pre- and postmenopausal patients compared to controls, being greater in those postmenopausal. Lumbar BMD was decreased only in postmenopausal patients (P < 0.05). Bone turnover markers were higher in patients than in controls and in post- than in the premenopausal ones. A significant negative correlation was found between femoral BMD, Ad-SoS and serum free T3 levels, the latter considered a marker of disease activity. CONCLUSIONS: A significant increase in bone turnover markers and a decrease in bone mass was found in women affected by endogenous SH, being greater in early postmenopausal patients. Cortical rich bone was mainly affected. Both QUS and the conventional DEXA technique were equally able to determine bone density decrease related to mild thyroid hormone excess and sexual hormone decrease.

Absorptiometry, Photon↗

PubMed2004

Inter-arm asymmetry in bone mineral content and bone area in postmenopausal recreational tennis players.

OBJECTIVE: To determine whether long-term recreational tennis participation is associated with increased bone and muscle mass in the dominant compared to the non-dominant arm, in postmenopausal tennis players. METHODS: Dual-energy X-ray whole body scans were performed in 10 postmenopausal tennis players (mean +/- S.D.; 59.7 +/- 4.8 years) and 12 postmenopausal non-active women (62.8 +/- 7.2 years) matched for age and height. Tennis players started in this sport at 31.4 +/- 8.8 years, and had been playing for 26.8 +/- 6.8 years, at least 3 h per week. In addition, shoulder isokinetic muscular strength was also evaluated. RESULTS: Tennis participation resulted in a lower whole mass and fat mass in both arms (P < 0.05). Dominant arm muscle mass and shoulder joint isokinetic strength were essentially similar in both groups, however, the tennis players showed 8% greater bone mineral content and 7% greater osseous area in the dominant than in the non-dominant arm (P < 0.05). No inter-arm differences were found in bone mineral density. A relationship was observed between the length of tennis participation and the degree of inter-arm asymmetry in bone mineral content (r = 0.81, P < 0.01) and bone area (r = 0.78, P < 0.01). However, the BMD of the arms was essentially similar in both groups. No differences were observed in femoral and lumbar bone mass and density between groups. CONCLUSIONS: Long-term tennis participation is associated with increased bone mass, but not BMD, in the dominant arm of postmenopausal tennis players. The magnitude of the inter-arm asymmetry of postmenopausal tennis players is proportional to the length of tennis participation.

Absorptiometry, Photon↗

PubMed2006

MR imaging evaluation of postmenopausal adnexal masses: correlation with final pathologic diagnosis.

OBJECTIVE: Adoption of transvaginal ultrasound in usual clinical settings allowed us to find asymptomatic adnexal masses more frequently in postmenopausal women. These masses were traditionally considered as the indication of surgical excision to determine histological diagnosis. Recently, if the appearance of that is simple cyst, conservative management may be acceptable because ultrasound benign diagnosis is proved to be reasonably reliable. We investigate here the reliability of benign diagnosis by MR imaging with gadolinium enhancement for both of simple and complex postmenopausal adnexal cystic masses. METHOD: We retrospectively examined the data of 121 postmenopausal patients who underwent surgery during a 3-years-period (from January, 2000 to December 2002) for adnexal mass under diagnosis of benign adnexal cysts based on MR imaging. RESULTS: Pathological examination identified two cases of malignancy among 121 cases diagnosed as benign by MR imaging. Among the cysts that revealed a simple pattern by MR imaging, 64/66 cases (97.0%) were benign histology and among the cysts that showed a complex pattern by MR imaging, 55/55 cases (100%) were benign histology. Among the cysts with diameter less than or equal to 10cm, 48/49 simple cysts and 32/32 complex cysts were benign histology. CONCLUSIONS: The diagnosis of benign adnexal mass in postmenopausal women by MR imaging was reliable. Conservative observation for postmenopausal patients of asymptomatic and small cysts under benign diagnosis based on MR imaging with gadolinium enhancement will be feasible even if the cysts appearances are complex, with careful follow-up program.

Adnexal Diseases↗

PubMed2006

Raloxifene therapy interacts with serum osteoprotegerin in postmenopausal women.

OBJECTIVES: Osteoprotegerin (OPG) is a protein expressed by osteoblasts that, linking the receptor activator of nuclear factor kappaB (RANK) ligand (RANKL), produced by osteoblasts, blocks the process of osteoclastic differentiation and modulates osteoclastic apoptosis. Raloxifene (RAL) stimulates the production of OPG from osteoblasts, as demonstrated in vitro, carring out their antiresorption activity, at least in part, as means of the OPG/RANK/RANKL system. The aim of this study was to evaluate in vivo if the RAL treatment of postmenopausal women was associated to changes in serum OPG; moreover, to evaluate the serum changes of bone turnover modulators interleukin-6 (IL-6) and C-telopeptides of type-1 collagen (CrossLaps). METHODS: A prospective, randomized, placebo-controlled study was designed. A group of consecutive healthy postmenopausal women (n=40) referred to II Menopause Centre of the Department of Gynaecology of Second University of Naples for climacteric syndrome was enrolled and divided in two groups: (n=20) postmenopausal women received for 6 months oral raloxifene (60 mg/day) versus (n=20) postmenopausal women received placebo tablets. RESULTS: Serum OPG levels in postmenopausal women after RAL treatment are statistically significant increased (P<0.001) versus baseline (P=0.007) versus placebo. CONCLUSIONS: These in vivo data demonstrate that RAL could improve osteoporosis, also through an increase of OPG production by osteoblasts.

Bone Density↗

PubMed2006

Effects of menopause and postmenopausal tibolone treatment on plasma TNFalpha, IL-4, IL-10, IL-12 cytokine pattern and some bone turnover markers.

OBJECTIVE: To asses plasma TNFalpha, IL-4, IL-10, IL-12; urinary hydroxyproline (Hyp) and calcium as bone resorption markers in healthy postmenopausal women compared with premenopausal ones, and to observe the effect of tibolone (2.5mg/day for 6 months) upon above mentioned parameters. PATIENTS AND METHODS: The study involved 24 healthy postmenopausal women (study group) and 25 premenopausal women (control group). Plasma TNFalpha, IL-4, IL-10 and IL-12 concentrations were measured using ELISA kits. Fasting urinary Hyp was measured by Ehrlich's spectrophotometric reaction. Calcium was determined by oxalate precipitation and the redox titration procedure. Statistical significance was analysed by the Mann-Whitney U-test for unpaired data, Wilcoxon Signed Rank test for paired data, and Pearson correlation test. RESULTS: Postmenopausal women (both before and after tibolone treatment) have increased (p<0.001) plasma TNFalpha, IL-4, IL-10, IL-12; and increased urinary Hyp (p<0.05) and calcium (p<0.001) concentrations in comparison with premenopausal individuals. Tibolone treatment has no effect on reversing the increased postmenopausal plasma TNFalpha, IL-4, IL-10 and IL-12, but decreases urinary Hyp and calcium to premenopausal levels. There is a weak positive correlation (r=0.532; p<0.05) between TNFalpha and IL-4 levels in postmenopausal women. CONCLUSIONS: The results show that plasma TNFalpha, IL-4, IL-10, IL-12, urinary Hyp and calcium increase with menopause. The increase of anti-inflammatory IL-10, IL-12 and especially IL-4 is probably a compensatory mechanism, by which these cytokines counteract to pro-inflammatory TNFalpha, and thus balance its osteoclast activating and oxidative stress inducing effects. Tibolone is successful in decreasing of bone resorption markers (urinary Hyp and calcium), but has no effect on reversing the impact of menopause on plasma TNFalpha, as well as IL-4, IL-10, IL-12. The last effect probably is related with progestogenic and androgenic properties of tibolone. Clearly, further studies are necessary to establish a risk/benefit ratio for tibolone in view of its effects on bone turnover as a new hormone replacement rationale.

Adult↗

PubMed2005

Saliva versus serum estradiol: implications for research studies using postmenopausal women.

OBJECTIVE: The authors investigated saliva as a potentially reliable medium for estradiol (E2) measurements in postmenopausal women. The goal of this study was to determine whether or not saliva could be used in studies of postmenopausal women in place of serum samples. Specifically, the authors wondered whether or not saliva and serum E2, obtained simultaneously from samples collected from postmenopausal women, would correlate. DESIGN: Samples of saliva and serum were collected simultaneously from 43 postmenopausal women. 31 were regular users of estrogen therapy (ET), 12 used no ET. Pearson's correlation coefficients were conducted to determine the degree of relationship between saliva and serum samples among ET users and non-users. RESULTS: Among ET users saliva and serum E2 levels were significantly and positively correlated (r = 0.81, p < 0.0001). The two E2 values were not significantly correlated among ET non-users (r = 0.32, p < 0.31). CONCLUSIONS: These data suggest that saliva E2 may be a fairly robust predictor of serum E2, but only among postmenopausal women who use ET.

Aged↗

PubMed2005

Non-invasive respiratory monitoring during wakefulness and sleep in pre- and postmenopausal women.

Menopause and aging cause hormonal changes with respiratory consequences. The aim of the present study was to investigate the physiological changes in respiration during wakefulness and sleep across menopause in non-patient population using non-invasive measurements of blood and tissue gases. The arterial oxyhemoglobin saturation (SaO2), heart rate, end-tidal partial carbon dioxide tension (EtCO2) and transcutaneous partial carbon dioxide tension (TcCO2) were measured during wakefulness and sleep in thirteen pairs of BMI-matched pre- and postmenopausal women. Postmenopausal women had lower SaO2 during sleep than during wakefulness, whereas premenopausal women maintained their wakefulness SaO2 levels also during sleep. EtCO2 levels did not change either between wakefulness and sleep or between premenopausal and postmenopausal groups. TcCO2 levels increased from wakefulness to sleep in both groups and the increase was greater in the postmenopausal group. The impact of sleep on the non-invasive measurements of blood and tissue gases is stronger in postmenopausal women.

Adult↗

PubMed2005

Effects of hormone replacement therapy on blood coagulation and fibrinolysis in hypertensive and normotensive postmenopausal women.

INTRODUCTION: Hypertension and estrogens are both prothrombotic. We investigated the effect of 12-month hormone replacement therapy (HRT) on hemostatic factors in mild to moderate essential hypertensive and normotensive postmenopausal women. MATERIALS AND METHODS: A group of 38 hypertensive and 32 normotensive postmenopausal women received HRT (conjugated equine estrogen 0.625 mg plus medroxyprogesterone acetate 2.5 mg daily) for 12 months, and 19 hypertensive and 15 normotensive postmenopausal women did not. All hypertensive women had been administered antihypetensive drugs before the start of the study. Hemostatic factors, i.e., fibrogen, antithrombin, protein C activity, plasminogen activator inhibitor-1, D-dimer, and plasminogen, were measured in plasma of all women before, and 6 and 12 months after the start of study. RESULT: The antithrombin levels of the hypertensive and normotensive women who received HRT had decreased at 6 (both P<0.001) and 12 months (P<0.001 and P<0.01) and their D-dimer at 12 months (both P<0.05) and plasminogen levels at 6 (both P<0.001) and 12 months (both P<0.001) has increased, but other hemostatic factors were unchanged. There were no changes in hemostatic factors in either control group. CONCLUSION: HRT for 12 months activated blood coagulation and fibrinolysis in both hypertensive and normotensive postmenopausal women. Administration of CEE plus MPA therapy to hypertensive or normotensive postmenopausal women may be related to the thromboembolic events.

Administration, Oral↗

PubMed1997

Cardiac autonomic function and sensitivity to pain in postmenopausal women with angina and normal coronary arteries.

An increased sensitivity to painful stimuli and an abnormal cardiac autonomic function have previously been reported in patients with angina and angiographically normal coronary arteries, a syndrome that mainly affects postmenopausal women. In this study we compared both general sensitivity to pain, by evaluating time to forearm ischemic pain (FIP) provoked by sphygmomanometer cuff inflation, and cardiac autonomic function, by measuring heart rate variability (HRV), and QT and QT(c) intervals on 24-hour Holter recordings, in 25 postmenopausal women with angina and normal coronary arteries and in 22 healthy postmenopausal women. Compared with controls, patients had a reproducible strikingly lower time to FIP (149 +/- 121 vs 295 +/- 158 seconds, p <0.001), whereas there were no differences between the 2 groups in HRV variables and mean 24-hour QT and QT(c) intervals. HRV indexes, and QT and QT(c) intervals also showed similar circadian patterns. Thus, our data show that postmenopausal women with angina and normal coronary arteries have an enhanced sensitivity to systemic painful stimuli, but no detectable impairment in cardiac autonomic function compared with a well-matched control group of postmenopausal healthy women.

Angina Pectoris↗

PubMed2000

Hydrochlorothiazide reduces loss of cortical bone in normal postmenopausal women: a randomized controlled trial.

PURPOSE: Thiazide diuretics reduce urine calcium excretion and might therefore reduce postmenopausal bone loss. In some, but not all, case-control studies, their use has been associated with a reduced incidence of hip fractures. We studied the effects of hydrochlorothiazide on bone loss in normal postmenopausal women. SUBJECTS AND METHODS: We performed a randomized, double-blind, 2-year trial of the effects of hydrochlorothiazide (50 mg per day) and placebo on bone mineral density in normal postmenopausal women. Participants were not required to have either low bone mineral density or hypertension. Bone mineral density was measured using dual-energy x-ray absorptiometry. RESULTS: One hundred eighty-five women entered the study, of whom 138 completed 2 years of follow-up. In an intention-to-treat analysis, hydrochlorothiazide produced significant benefits on bone mineral density of the total body (between-group difference at 2 years of 0.8%, 95% confidence interval [CI]: 0.3% to 1.3%, P <0.0001), legs (0.9%, 95% CI: 0.2% to 1.7%, P <0.0001), mid-forearm (1.2%, 95% CI: 0.2% to 2.2%, P = 0.02), and ultradistal forearm (1.7%, 95% CI: 0.1% to 3.2%, P = 0.04). There was no effect in the lumbar spine (0.5%, 95% CI: -0.5% to 1.6%) or femoral neck (0.2%, 95% CI: 1.3% to 1.7%). The between-group changes tended to be greatest during the first 6 months, except in the mid-forearm where there appeared to be a progressive divergence. An as-treated analysis produced similar results. Urine calcium excretion and indices of bone turnover decreased in the thiazide group, but parathyroid hormone concentrations did not differ between the groups. Treatment was tolerated well. CONCLUSIONS: Hydrochlorothiazide (50 mg per day) slows cortical bone loss in normal postmenopausal women. It may act directly on bone as well as on the renal tubule. The small size of the effect suggests that thiazides may have a role in the prevention of postmenopausal bone loss, but that they are not an appropriate monotherapy for treating osteoporosis.

Absorptiometry, Photon↗