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PubMed2000

Effect of a fish-oil concentrate on serum lipids in postmenopausal women receiving and not receiving hormone replacement therapy in a placebo-controlled, double-blind trial.

BACKGROUND: n-3 Fatty acid supplementation lowered serum triacylglycerol concentrations in studies in which most of the subjects were male. The effects of n-3 fatty acid supplementation in postmenopausal women receiving and not receiving hormone replacement therapy (HRT) have received little attention. OBJECTIVE: We sought to determine the effects of a fish-oil-derived n-3 fatty acid concentrate on serum lipid and lipoprotein risk factors for cardiovascular disease in postmenopausal women receiving and not receiving HRT, with an emphasis on serum triacylglycerol concentrations and the ratio of triacylglycerol to HDL cholesterol. DESIGN: Postmenopausal women (n = 36) were grouped according to exogenous hormone use and were randomly allocated to receive 8 capsules/d of either placebo oil (control) or n-3 fatty acid-enriched oil (supplement). The supplement provided 2.4 g eicosapentaenoic acid (EPA) plus 1.6 g docosahexaenoic acid (DHA) daily. Serum lipids and the fatty acid composition of serum phospholipids were determined on days 0 and 28. RESULTS: Supplementation with n-3 fatty acids was associated with 26% lower serum triacylglycerol concentrations (P < 0.0001), a 28% lower overall ratio of serum triacylglycerol to HDL cholesterol (P < 0.01), and markedly greater EPA and DHA concentrations in serum phospholipids (P < 0.05). CONCLUSIONS: These results show that supplementation with a fish-oil-derived concentrate can favorably influence selected cardiovascular disease risk factors, particularly by achieving marked reductions in serum triacylglycerol concentrations and triacylglycerol:HDL cholesterol in postmenopausal women receiving and not receiving HRT. This approach could potentially reduce the risk of coronary heart disease by 27% in postmenopausal women.

Adult↗

PubMed1999

Body fat distribution and obesity in pre- and postmenopausal breast cancer.

BACKGROUND: Excessive body weight is known to increase the risk of postmenopausal, but not premenopausal breast cancer. Some studies have suggested that being overweight is protective against premenopausal breast cancer, but the evidence is not compelling. Much less is known about the role of body fat distribution in either pre- or postmenopausal breast cancer. METHODS: Breast cancer risk was examined in relation to body weight, height, Quetelet index (kg/m2), and waist/hip ratio (WHR) in the New York University Women's Health Study, a prospective cohort study. Cases were 109 premenopausal and 150 postmenopausal women diagnosed with breast cancer between 1985 and 1994. Non-cases were 8,157 cohort members free of breast cancer. RESULTS: Among premenopausal women, there was an increasing risk of breast cancer with increasing WHR. The relative risk (RR) of breast cancer increased to 1.72 (95% confidence interval [CI]: 1.0-3.1) in the upper quartile of WHR. The association was limited to subjects who had elevated Quetelet index, but not among those with lower weight. Overall, Quetelet index itself was not related to breast cancer risk in the premenopausal group, but there was a protective association among those ranking below the median WHR. In postmenopausal women, the RR for breast cancer increased to 2.36 (95% CI: 1.4-3.9) in the upper quartile of Quetelet index, but there was no association with WHR. Height was not associated with breast cancer in this study. CONCLUSIONS: The study confirms that excessive body weight increases breast cancer risk in postmenopausal women. On the contrary, in premenopausal women, excessive body weight may be protective among women who have a lower-body type of fat accumulation (low WHR). An upper-body fat accumulation (high WHR) is a predictor of breast cancer risk in premenopausal women, and this effect is especially pronounced among subjects who are overweight.

Adipose Tissue↗

PubMed2004

Hormone replacement therapy and cardiovascular disease: lessons from a monkey model of postmenopausal women.

Concerns exist about the cardiovascular effects of hormone replacement therapy (HRT) in postmenopausal women because results from the Women's Health Initiative (WHI) and the Heart and Estrogen/Progestin Replacement Study (HERS) are contradictory. In both of these studies, postmenopausal conjugated equine estrogens + medroxyprogesterone acetate did not reduce risk, and somewhat increased the risk of myocardial infarction in both primary (WHI) and secondary (HERS) prevention. These results appear to contradict numerous observational clinical trials and animal studies, which reported profound beneficial effects of HRT on cardiovascular disease risk. Results of both human and monkey studies indicate that estrogen replacement therapy (ERT)/HRT is effective in inhibiting progression of early stage (fatty streak) atherosclerosis but that ERT/HRT is much less effective in inhibiting progression of more advanced (established plaque) atherosclerosis. Results of these monkey studies are consistent with those of studies in women wherein ERT/HRT was initiated in postmenopausal women with different initial amounts of atherosclerosis. Based on these findings, it is speculated that ERT/HRT may be more cardioprotective in younger postmenopausal women with less coronary artery disease, and less effective in women with established coronary artery disease. Researchers are challenged to define the relative cardiovascular risk/benefit in different populations of postmenopausal women based on differences in age, amounts of pre-existing atherosclerosis, and risk factors.

Age Factors↗

PubMed2004

Polymorphisms associated with circulating sex hormone levels in postmenopausal women.

BACKGROUND: Reports suggest a relationship between circulating sex hormone levels and breast cancer risk, but genetic association studies have been inconclusive. We investigated the association between levels of sex hormones and single nucleotide polymorphisms (SNPs) in genes coding for the enzymes that regulate them. METHODS: We assayed circulating levels of estradiol, testosterone, estrone, androstenedione, 17alpha-hydroxyprogesterone, and sex hormone-binding globulin (SHBG) in 1975 normal postmenopausal women. Fifteen SNPs in the CYP17, CYP19, EDH17B2, SHBG, COMT, and CYP1B1 genes were genotyped in these postmenopausal women and in a breast cancer case-control study. Associations of genotypes with breast cancer risk were evaluated in the case-control study and with hormone levels in the postmenopausal women using multiple linear regression with assay batch, body mass index, parity, peri- or postmenopausal status, and age band as covariates. RESULTS: CYP19 SNPs (rs10046 and [TCT]+/-) were associated with differences in estradiol level (P =.0006 and P =.0003, respectively) and the estradiol : testosterone ratio (P =.000001() and P =.002). SNP rs10046 explained 1.6% of the variance (r2) in the estradiol : testosterone ratio. SHBG SNPs (5' untranslated region [5'UTR] g-a and D356N) were associated with both SHBG levels (P<10(-6) and P =.005) and the estradiol : SHBG ratio (P =().000008() and P =.01). These SNPs explained 2.4% and 0.6% of the variance in SHBG levels, respectively. SNPs in the other genes were not associated with differences in any hormone levels, and none were statistically significantly associated with breast cancer risk. CONCLUSION: Genetic variation in CYP19 and SHBG contributes to variance in circulating hormone levels between postmenopausal women, but low r2 values may explain why these genes have given inconclusive results in breast cancer case-control studies.

17-alpha-Hydroxyprogesterone↗

PubMed1999

Lactation in relation to postmenopausal breast cancer.

A modest inverse association between lactation and breast cancer risk has most consistently been observed in premenopausal women, and certain breastfeeding patterns, such as prolonged duration and early age at first lactation, may be important determinants of risk. However, these associations have not generally been observed in relation to postmenopausal breast cancer. As part of a multicenter population-based case-control study, the authors examined postmenopausal breast cancer risk according to breastfeeding characteristics. Breast cancer patients aged 50-79 years were identified from statewide tumor registries in Massachusetts, New Hampshire, and Wisconsin from July 1992 through July 1995. Similarly aged control women were randomly selected from population lists. Information regarding lactation history and breast cancer risk factors was obtained through telephone interviews. This analysis included only data on parous postmenopausal women (3,633 cases and 3,790 controls). After adjustment for age, parity, age at first birth, and other breast cancer risk factors, breastfeeding for at least 2 weeks was associated with a slightly reduced risk of breast cancer in comparison with women who had never lactated (relative risk = 0.87, 95% confidence interval 0.78-0.96). There was only a modest suggestion that increasing cumulative duration of lactation was inversely associated with breast cancer risk; the relative risk for women who had breastfed for > or =24 months was 0.73 (95% confidence interval 0.56-0.94) (p-trend for duration = 0.10). Age at first lactation was not consistently associated with risk. Modest inverse associations appeared to persist even up to 50 years since first lactation. Use of hormones to suppress lactation was not associated with postmenopausal breast cancer, nor was inability to breastfeed related to risk. These results suggest that lactation may have a slight and perhaps long-lasting protective effect on postmenopausal breast cancer risk.

Age Factors↗

PubMed1996

Comparison of the clinicopathological characteristics of premenopausal and postmenopausal endometrial carcinomas: analysis of endocrinologically evaluated cases.

A study was performed to clarify the clinicopathological differences between premenopausal endometrial carcinoma, which occurs during the reproductive period, and postmenopausal endometrial carcinoma. We analyzed 76 patients with endometrial carcinoma treated in our department between January 1984 and July 1994. Using classification criteria which included menstrual history and results of endocrinological tests (serum FSH, LH and estradiol), 50 (65.7%) patients were defined as postmenopausal, 16 (21.0%) as premenopausal, and 10 (13.1%) as unclassified. From an epidemiologic viewpoint, the incidence of nulliparity was higher in the premenopausal (37.5%) than in the postmenopausal (10%) patients. However, no significant differences were observed between the two groups with regard to the incidence of obesity, diabetes and hypertension. The results of our clinicopathological study revealed that premenopausal endometrial carcinoma had a significantly higher incidence of well differentiated (63.1%) and relatively less advanced (31.1% of cases at stages III and IV) cancers than postmenopausal carcinoma (38% and 46%, respectively). These features were positively correlated with prognosis, i.e., premenopausal patients in general had a much better prognosis than postmenopausal patients.

Adult↗

PubMed2003

Objective and subjective sleep quality in premenopausal, perimenopausal, and postmenopausal women in the Wisconsin Sleep Cohort Study.

STUDY OBJECTIVE: Assess objectively measured sleep quality in premenopausal, perimenopausal, and postmenopausal women. DESIGN: Observational epidemiology study. SETTING: Community-based. PARTICIPANTS: Probability sample of 589 premenopausal, perimenopausal, and postmenopausal women recruited from state employee records. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Menopausal status was determined by menstrual history, surgical history, and use of hormone replacement therapy. Sleep quality was objectively measured by full in-laboratory polysomnography and by self-reported sleep problems. Linear and logistic regression were used to estimate associations adjusted for potential confounding factors. OBJECTIVE: Sleep quality was not worse in perimenopausal or postmenopausal women, compared with premenopausal women. To the contrary, postmenopausal woman had more deep sleep (16% vs 13% stages 3/4, P < 0.001) and significantly longer total sleep time (388 minutes vs 374 minutes, P = 0.05). Menopausal status was moderately related to self-reported dissatisfaction with sleep but was not consistently associated with symptoms of insomnia or sleepiness. CONCLUSIONS: Menopause is not associated with diminished sleep quality measured by polysomnography. Although perimenopausal and postmenopausal women, relative to premenopausal women, were less satisfied with their sleep, menopause was not a strong predictor of specific sleep-disorder symptoms. Symptoms and signs of sleep abnormalities in midlife women should not be attributed primarily to menopause before ruling out underlying sleep disorders.

Adult↗

PubMed2006

Postprandial lipemia in postmenopausal women with high fasting high-density lipoprotein cholesterol.

BACKGROUND: Several groups of patients at high risk for cardiovascular disease have been found to show an exaggerated postprandial hypertriglyceridemia. Postprandial lipemia (PPL) therefore has been implicated as a potential additional risk factor that has been evading us. The purpose of this study was to test the effect of high fasting high-density lipoprotein cholesterol (HDL-C) levels on PPL in postmenopausal females. METHODS: Oral fat tolerance test, as quantified by the areas under the curve (AUC) of triglyceride (TG) levels, was given to 3 groups: normal postmenopausal females (control), postmenopausal females with exceptionally high HDL-C and a familial history of longevity (longevity syndrome), and postmenopausal females that were heterozygotes of familial hypercholesterolemia (hFH) with exceptionally high HDL-C. RESULTS: The PPL was not different between the control and longevity syndrome groups but was significantly higher in the hFH group; AUC (SD), in mg/dl/h; 749 (195), 882 (278) and 1244 (497) respectively, p=0.002. In linear regression analysis only fasting TG levels were a significant predictor of the AUC (Coefficient B = 11.779, p < 0.001). CONCLUSIONS: In subjects with longevity syndrome the PPL is similar to controls, which means that high fasting HDL-C has not any beneficial influence on PPL. The fasting TG concentration is the main determinant of PPL. Furthermore, postmenopausal females with hFH have higher TG response postprandially, even in the case of high fasting HDL-C. Whether there is a threshold below or above, where HDL-C becomes a significant independent determinant of PPL is a question to be answered by future research.

Aged↗

PubMed2001

Postmenopausal hormone use, screening, and breast cancer: characterization and control of a bias.

Previous investigators have suggested that screening-related biases may explain associations between postmenopausal hormone use and breast cancer. To investigate these biases, we studied postmenopausal women in the Nurses' Health Study from 1988 to 1994. Hormone use is associated with increased subsequent screening. Among women not screened in the previous 2 years, the probability difference, comparing current hormone users with others, for having mammography in the following 2 years is 19.5%; among women previously screened, the difference is 4.9%. These differences persist after control for other factors. If the increase in screening is causal, screening by mammogram could be intermediate in the causal pathway to breast cancer diagnosis. To deal with this problem, we restrict attention to a subset of the cohort in which the effect of postmenopausal hormone use on screening is small (women previously screened). In this subset, the rate ratio comparing breast cancer rates among current postmenopausal hormone users with others is 1.28. In a sensitivity analysis, the bias could not by itself plausibly account for the associations in our data. Our data provide evidence of an association between postmenopausal hormone use and breast cancer that is not solely the product of a detection bias.

Adult↗

PubMed2000

Clinical pain perception and hormone replacement therapy in postmenopausal women experiencing orofacial pain.

OBJECTIVE: The purpose of this study was to examine the magnitude of the relation between a postmenopausal woman's hormonal replacement status and clinical pain report in a sample of women experiencing orofacial pain. DESIGN: To accomplish this, pain ratings were collected during a routine chronic pain evaluation at an orofacial pain clinic from a sample of 87 postmenopausal women. RESULTS: Results of ANCOVA (controlling for pain duration) demonstrated that postmenopausal women receiving hormone replacement therapy (HRT) reported higher levels of pain than postmenopausal women not taking HRT. Numeric pain rating scales revealed large effect sizes for worst pain report (0.62), moderate differences for average (0.48) and current (0.39) pain levels, and trivial differences for least pain (0.04). Effect sizes for the McGill Pain Questionnaire indicated somewhat smaller differences (0.35-0.24) between the two groups. CONCLUSIONS: This study is among the first to examine the relation between a woman's hormonal status and clinical pain perception and is the first to investigate the role of HRT in a postmenopausal woman's orofacial pain report in a clinical treatment setting. This area of inquiry is particularly salient given the high percentage of women who choose to initiate HRT either after hysterectomy or with the onset of menopause.

Adult↗

PubMed1997

Ultrasound bone velocity on proximal phalanges in premenopausal, perimenopausal, and postmenopausal healthy women.

RATIONALE AND OBJECTIVES: The authors studied premenopausal, perimenopausal, and postmenopausal women to determine if ultrasound bone velocity (UBV) on proximal phalanges of women reflect bone changes related to gonadal status and age. METHODS: A total of 166 healthy women-64 postmenopausal women (mean age 58.7 +/- 9.4 years), 41 perimenopausal women (mean age 49.5 +/- 2.9 years), and 61 premenopausal women (mean age 36.8 +/- 7.1 years)-were studied. All the women underwent UBV study of the 2nd to 5th proximal phalanges on the nondominant hand and the mean value of all ultrasound measurements was calculated. RESULTS: The postmenopausal women had a UBV that differed significantly, one-way analysis of variance, from that of the perimenopausal women and premenopausal women (both P < 0.001). The UBV measurements of the perimenopausal women differed significantly from those of the premenopausal women (P < 0.01). Simple linear regression analysis of the relation between UBV and age showed that this was significant and negative in the overall group of women (r = -0.69; P < 0.0001), significant in the perimenopausal (r = -0.66; P < 0.001) and postmenopausal women (r = -0.69; P < 0.001) and nonsignificant in the premenopausal women (r = 0.08; P not significant). In the postmenopausal women, the correlation between UBV and years since menopause was larger (r = -0.71; P < 0.0001) than the correlation between UBV and chronological age. CONCLUSIONS: Ultrasound bone velocity of the phalanx, as a method for measuring changes in bone with age, has a precision that makes it possible to detect changes in bone mass in perimenopausal women and may perform similarly to other bone mass measurements.

Adult↗

PubMed2000

Enhanced cardiovascular hemodynamics in endurance-trained postmenopausal women athletes.

PURPOSE: We sought to determine whether older women athletes who had habitually performed vigorous endurance exercise training had higher stroke volumes and cardiac outputs than sedentary postmenopausal women during maximal exercise. METHODS: Seventeen endurance-trained, postmenopausal women athletes (age 65 +/- 4 yr; VO2max 2.11 +/- 0.31 L x min(-1), 38.3 mL x kg(-1) x min(-1)) and 14 sedentary, postmenopausal women (age 63 +/- 5 yr; VO2max 1.41 +/- 0.22 L x min(-1), 23.7 +/- 3.5 mL x kg(-1) x min(-1)) performed maximal treadmill exercise while cardiac output (via acetylene rebreathing) and other cardiovascular hemodynamics were measured. Approximately half of the subjects in each group were on hormone replacement therapy (HRT). RESULTS: The greater VO2max of the athletes was the result of a greater cardiac output (12.8 +/- 1.6 vs. 9.3 +/- 1.4 L x min(-1)) resulting from their significantly larger stroke volume (80 +/- 10 vs 57 +/- 10 mL) at maximal exercise. There were no significant differences in maximal cardiac output or maximal stroke volume related to HRT status in the sedentary women or athletes. CONCLUSIONS: These data indicate that endurance-trained, competitive, postmenopausal women have higher stroke volumes and cardiac outputs during maximal exercise, than their sedentary peers. However, these data suggest that HRT may not affect maximal CV function in sedentary or endurance-trained postmenopausal women.

Aged↗

PubMedDate not supplied

Auditory brainstem response in postmenopausal women treated with hormone replacement therapy: a pilot study.

OBJECTIVE: To research the nongenital audiological target for gonadal steroids in postmenopausal women who are treated with hormone replacement therapy. DESIGN: Fifty postmenopausal volunteers were treated with hormone replacement therapy. Women with an intact uterus had sequential weekly transdermal estradiol plus nomegestrole acetate 5 mg orally for 12 days per month or a continuous daily oral dose of conjugated estrogen 0.625 mg and medroxyprogesterone acetate 5 mg tablet. Eighteen surgically postmenopausal women received a weekly transdermal estradiol system. Twenty-five postmenopausal volunteers-5 with a natural menopause and 10 with a surgical menopause-and 20 premenopausal normally cycling women were used as a control group. Each woman performed auditory brainstem response by auditory-evoked potentials for waves I, III, and V and for interpeak I-III, I-V, and III-V intervals. RESULTS: Women who were treated with hormone replacement therapy showed wave latencies and interpeak latencies shorter than those for postmenopausal women in the control group (p < or = 0.05), overlapping those of the premenopausal women (p > 0.05). Women who were treated with estrogen replacement therapy showed shorter time latencies than those treated with combined hormone replacement therapy (p < or = 0.05). CONCLUSIONS: Our data suggest that fluctuating hormone levels cause changes in auditory brain-stem response waves, even if the exact mechanism of activity of the gonadal steroids is not clear. However, we believe that estrogen may influence the neuronal plasticity, the metabolic levels of neurotransmitters, and thus the neuronal conduction time into the audiological system.

Administration, Cutaneous↗

PubMedDate not supplied

Knowledge, attitudes, and behaviors of healthcare providers for botanical and dietary supplement use for postmenopausal health.

OBJECTIVE: To identify the knowledge, attitudes, and behaviors of health care providers (physicians and nurses) regarding the use of botanical dietary supplements (BDS) for peri- and postmenopausal women. DESIGN: Health care providers (physicians and nurse practitioners/nurse midwives) completed a questionnaire to assess knowledge, attitudes, and behaviors regarding botanical dietary supplement use for peri- and postmenopausal women. A total of 62 providers were included in the final analysis. RESULTS: Two thirds of providers reported that they had limited or no knowledge about botanical dietary supplements. By far, the majority of providers had no formal training nor had they studied these supplements on their own. Although knowledge was limited, a majority of providers wanted additional training predominantly because of growing patient awareness and use and were open to using these therapies for their patients either in combination with conventional Western medicine or as the only support for relief of peri- and postmenopausal symptoms. However, only 25% of providers regularly asked their peri- and postmenopausal patients about use of botanical dietary supplements. Providers who had practiced longer (> or =11 y) were more likely to be knowledgeable about dietary supplements and to have studied on their own (P < 0.01), to believe that botanicals are part of evidence-based medicine (P < 0.05), and to have talked to their patients (P < 0.05) about use of these therapies. Increased knowledge also appeared to predict a more positive attitude on the part of providers toward their patients who use BDS (P < 0.001) as well as more proactive behavior related to referring and recommending these therapies as treatment (P < 0.01). CONCLUSIONS: Our findings suggest that knowledge about botanical therapies among health care providers caring for peri- and postmenopausal women is quite low, but they are open to learning more about these modalities and using them for treatment, if appropriate. Our results suggest that increased years in practice is related to increased knowledge, more positive attitudes, and more proactive behaviors related to botanical dietary supplements.

Adult↗

PubMed2004

Adjuvant cytotoxic and endocrine therapy in pre- and postmenopausal patients with breast cancer and one to nine infiltrated nodes: five-year results of the Hellenic Cooperative Oncology Group randomized HE 10/92 study.

SUMMARY: The present randomized phase III trial was designed to detect a 15% benefit in relapse-free survival (RFS) or overall survival (OS) from the incorporation of adjuvant tamoxifen to the combination of CNF [cyclophosphamide, 500 mg/m2; mitoxantrone (Novantrone), 10 mg/m2; fluorouracil, 500 mg/m2 chemotherapy and ovarian ablation in premenopausal patients with node-positive breast cancer and conversely from the incorporation of CNF chemotherapy to adjuvant tamoxifen in node-positive postmenopausal patients. From April 1992 until March 1998, 456 patients with operable breast cancer and one to nine infiltrated axillary nodes entered the study. Premenopausal patients were treated with six cycles of CNF chemotherapy followed by ovarian ablation with monthly injections of triptoreline 3.75 mg for 1 year (Group A, 84 patients) or the same treatment followed by 5 years of tamoxifen (Group B, 92 patients). Postmenopausal patients received 5 years of tamoxifen (Group C, 145 patients) or 6 cycles of CNF followed by 5 years of tamoxifen (Group D, 135 patients). Adjuvant radiation was administered to all patients with partial mastectomy. After a median follow-up period of 5 years, 125 patients (27%) relapsed and 79 (17%) died. The 5-year actuarial RFS for premenopausal patients was 65% in Group A and 68% in Group B (p = 0.86) and for postmenopausal patients 70% in Group C and 67% in Group D (p = 0.36). Also, the respective OS rates were 77% and 80% (p = 0.68) for premenopausal and 84% and 78% (p = 0.10) for postmenopausal patients. Severe toxicities were infrequently seen, with the exception of leukopenia (18%), among the 311 patients treated with CNF. In conclusion, the present study failed to demonstrate a 15% difference in RFS in favor of node-positive premenopausal patients treated with an additional 5 years of tamoxifen after CNF adjuvant chemotherapy and ovarian ablation. Similarly, six cycles of CNF preceding 5 years of tamoxifen did not translate to a 15% RFS benefit in node-positive postmenopausal patients.

Adult↗

PubMedDate not supplied

Postmenopausal hormone therapy: new questions and the case for new clinical trials.

Observational studies suggest that postmenopausal hormone therapy (HT) prevents coronary heart disease, whereas randomized clinical trials have not confirmed a cardioprotective effect. Although observational studies may have overestimated the coronary benefit conferred by postmenopausal hormone use, there are other plausible explanations for the apparent discrepancy between previous results and the less favorable findings from clinical trials such as the large Women's Health Initiative. There is now a critical mass of data to support the hypothesis that age or time since menopause may importantly influence the benefit-risk ratio associated with HT, especially with respect to cardiovascular outcomes, and that the method of administration, dose, and formulation of exogenous hormones may also be relevant. Although the weight of the evidence indicates that older women and those with subclinical or overt coronary heart disease should not take HT, estrogen remains the most effective treatment currently available for vasomotor symptoms, and its effects on the development of coronary disease in newly postmenopausal women remain unclear. Moreover, effects of HT on quality of life and cognitive function in recently postmenopausal women merit further study. These unresolved clinical issues provide the rationale for the design of the Kronos Early Estrogen Prevention Study, a 5-year randomized trial that will evaluate the effectiveness of low-dose oral estrogen and transdermal estradiol in preventing progression of atherosclerosis in recently postmenopausal women.

Administration, Cutaneous↗

PubMedDate not supplied

Osteoporosis and bone metabolism in postmenopausal women with osteoarthritis of the hand.

OBJECTIVE: Osteoarthritis and osteoporosis are two major health problems affecting postmenopausal women. Epidemiological observations seem to demonstrate a possible inverse relationship between osteoarthritis and osteoporosis. Erosive osteoarthritis (EOA) of the hand is a destructive form of primary osteoarthritis. This study evaluated bone mineral density and bone metabolism changes in erosive and nonerosive hand osteoarthritis women. DESIGN: Fifty-five women (mean age, 59 years; body mass index, 23 +/- 1.4 kg/m) who had been postmenopausal for an average of 9 years and who presented with hand osteoarthritis according to American College of Rheumatology criteria were enrolled in the study; 15 women showed clinical and radiological evidence of hand EOA. Twenty women matched for age, age at menopause, and body mass index formed the control group. Bone mineral density (g/cm) was measured at the hip and lumbar spine using dual-energy x-ray absorptiometry. Serum and urinary calcium and phosphate, serum 25-hydroxyvitamin D, parathyroid hormone, osteocalcin, and urinary breakdown products of bone matrix (CrossLaps) were analyzed. RESULTS: Women with hand EOA had a statistically significant lower T- and Z-score L2-L4 value than non-hand EOA women and controls (P < 0.01). Moreover, postmenopausal women with hand EOA had higher significant percentage of osteoporosis at lumbar spine when compared with non-hand EOA postmenopausal women and controls. Any statistically significant difference in osteocalcin and CrossLaps serum levels was noted among women with hand EOA, hand osteoarthritis, and controls. CONCLUSIONS: Our data suggest that postmenopausal women with clinical and radiological EOA are at risk for development of osteoporosis.

Bone Density↗

PubMed2005

Effects of estrogen on proton secretion via the apical membrane in vaginal-ectocervical epithelial cells of postmenopausal women.

OBJECTIVE: To understand estrogen regulation of proton (H(+)) secretion by human vaginal-ectocervical epithelial cells and the mechanisms involved. DESIGN: Primary-tertiary cultures of human normal vaginal-ectocervical epithelial cells were generated from surgical specimens of premenopausal women (aged 37-46 years) and of postmenopausal women (aged 53-65 years). Cells were grown on filters, and measurements were made of changes in extracellular pH (pHo) in the contraluminal (CL) and luminal (L) solutions 30 minutes after shifting cells to basic salt solution. RESULTS: Upon shifting cells to basic salt solution, CL-pHo decreased from 7.4 to 7.25, and was not affected by removal of intracellular estrogens or treatment with estradiol. L-pHo decreased from 7.4 to 7.05 in cells of premenopausal women, and from 7.4 to 7.20 in cells of postmenopausal women. Removal of intracellular estrogens attenuated the decrease in L-pHo in cells of premenopausal women (only to 7.20). In cells of premenopausal women stripped of estrogens, treatment with 10 nM 17beta-estradiol restored the decrease in L-pHo. In estrogen-stripped cells of postmenopausal women, treatment with estradiol augmented luminal acidification but to a lesser degree than in cells of premenopausal women (L-pHo of 7.15 vs 7.05). In cells of pre- and postmenopausal women, the addition in the L solution of bafilomycin-A(1), a specific inhibitor of the vacuolar-H(+)-ATPase (V-H(+)-ATPase), blocked the decrease in L-pHo. CONCLUSIONS: Human vaginal-ectocervical epithelial cells acidify constitutively their luminal solution, and the effect is mediated by active H(+) secretion by V-H(+)-ATPase expressed predominantly in the apical cell membrane. Estrogen deprivation attenuates, and treatment with 17beta-estradiol augments, active H(+) secretion. Finally, cells of postmenopausal women actively secrete H(+) via apically located V-H(+)-ATPase, but the effect is lesser, and estrogen failed to augment active H(+) secretion, as in cells of premenopausal women. These data suggest that in addition to hypoestrogenism, other factors of the aging process affect the capacity of vaginal-ectocervical cells to secrete acid.

Acids↗