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PubMed2005

[The value of ultrasonography in diagnosis of atypical endometrial hyperplasia in postmenopausal women].

UNLABELLED: There is no agreement if an incorrect endometrial ultrasound image without clinical symptoms or postmenopausal bleeding despite normal ultrasound results are the indications for histopathological diagnosis of endometrium to exclude its pathological hyperplasia. OBJECTIVES: The aim of the study was a comparison the compatibility of ultrasound results with histopathological examination of uterine scrapings in postmenopausal women. MATERIAL AND METHODS: The study included 659 postmenopausal women aged 41-85 (mean 61.5). They were divided into three groups. The first one counted 186 women (28.22%) with metrorrhagia and normal endometrial ultrasound image. The second one counted 293 women (44.46%) with only changes in ultrasound examination and the third one counted 180 women (27.31%) with metrorrhagia and incorrect ultrasound image of endometrium. As an incorrect ultrasound images the endometrial thickness above 5 mm, especially with non-homogenous structure, polyps and fluid in uterine cavity, were assumed. Each examined women had a D&C with consecutive histopathological evaluation of the tissue material. RESULTS: The endometrial cancer was the most frequent in the third group--in 29 examined women (16.11%) and was significantly rare in the first and second groups: 9 women (4.84%) and 2 women (0.68%), respectively. The most frequent (in 19 from 107 women--17.75%) the cancer was recognized in cases of endometrial hyperplasia, especially when ultrasound image of endometrium was non-homogenous and irregular, and the rarest was in the cases of affirmed fluid in uterine cavity (1 from 22 examined women--4.5%). CONCLUSIONS: The endometrial cancer is the frequent in women with postmenopausal bleeding and endometrial hypertrophy in ultrasound examination, especially when endometrial image is non-homogenous and irregular. However, the rarest endometrial cancers were affirmed in postmenopausal women with ultrasound image of fluid in uterine cavity with thin endometrium.

Adult↗

PubMed2005

[Postmenopausal uterine bleeding. Analytic study about 65 cases].

UNLABELLED: Postmenopausal uterine bleeding is frequent in gynecology. This symptom can reveal benign causes as well as cancers. So it's essential to rule out organic pathology. MATERIALS AND METHODS: We propose a retrospective study of 65 postmenopausal women who had uterine bleeding for two years. OBJECTIVES: - To study the relative frequency of different causes of postmenopausal uterine bleeding. - To evaluate the different investigation procedures. RESULTS: In 65 cases of postmenopausal bleeding, we found: - 6 cases of cancer (9.2 %): 4 cases of cancer of uterine corpus and 2 cases of cancer of uterine cervix. - Benign pathology was more frequent (59 cases : 90.8%), essentially represented by endometrial atrophy (37 cases) and hyperplasia (11 cases). - Hysteroscopic aspect in the 4 cases of endometrial cancer: - Polypoid hypertrophy: 2 cases. - Simple hyperplasia: 2 cases. CONCLUSION: Despite the fact that benign pathology is more frequent than malignancy as a cause postmenopausal uterine bleeding, we must always rule out a cancer by oriented biopsy.

Aged↗

PubMed2005

[Effects of raloxifene on bone biomarkers in postmenopausal women on maintenance haemodialysis].

Postmenopausal women on maintenance haemodialysis (MHD) has considerably higher risk of bone fracture than general population with combination of postmenopausal osteoporosis and renal osteodystrophy. However, the treatment of osteoporosis on MHD has not been established. Evidence indicates raloxifene (RLX), a selective estrogen receptor modulator, is effective for a protection of bone fracture without increasing of breast cancer and endometrial cancer. We hereby report short-term use experience of RLX for the postmenopausal MHD patients. Fifteen postmenopausal MHD patients with less than 80% of YAM bone density in DEXA administrated 60 mg RLX on every HD days (3 days/week). Serum NTX level significantly decreased after 6 months (180 +/- 18 vs. 95 +/- 12 nmol/BCE/L, p< 0.05), however, i-PTH did not have the significant difference. (115 +/- 23 vs. 157 +/- 29 pg/mL). RLX is effective for bone biomarker improvement in postmenopausal MHD patients. Further evaluation for the effectiveness and safety of RLX is necessary in the long term.

Aged↗

PubMedDate not supplied

Effects of hormone replacement therapy on the main fatty acids of serum and phospholipids of postmenopausal women.

BACKGROUND: The anti-atherosclerotic effects of hormone replacement therapy (HRT) in postmenopausal women are partly mediated by improvement of the lipid and lipoprotein profiles. The present study aimed to investigate the effects of HRT on the main fatty acids of serum and phospholipids in postmenopausal women. PATIENTS AND METHODS: Serum samples of two groups of postmenopausal women, receiving either single oestrogen or in combination with progestogens, were analysed before and after a 6- month treatment period. RESULTS: Of the main serum fatty acids, there was a significant reduction in palmitic (p < 0.05) and arachidonic acids (p < 0.001), followed by an increase in oleic (p < 0.05) and linoleic acids (p < 0.05) in postmenopausal women receiving HRT compared to single oestrogen. The main fatty acids in phospholipids showed a similar pattern in those women. CONCLUSION: The above results demonstrate the beneficial effects of HRT in reducing the risk of cardiovascular disease through modification of the fatty acid profiles of postmenopausal women.

Estrogen Replacement Therapy↗

PubMed2006

Receptor activator of NF(Kappa)B ligand/osteoprotegerin (RANKL/OPG) system and osteopontin (OPN) serum levels in a population of apulian postmenopausal women.

AIM: Osteoporosis is a bone disease, characterized by a reduction of bone resistance; in postmenopausal period bone metabolism is imbalanced. Several parameters have been proposed as markers of bone metabolism; the attention have been recently placed on the receptor of activator of NF(Kappa)B ligand receptor (RANKL) and osteoprotegerin (OPG), namely RANKL/OPG system. The aim of this paper is to evaluate changes in postmenopausal women in serum concentration of OPG, RANKL, and their ratio (i.e. RANKL/OPG ratio), osteopontin (OPN), bone-type alcaline phosphatase (BAP), serum-N-Telopeptide of type I collagen (serum-NTX); and their correlations with bone mineral density (BMD). METHODS: An Apulian population group of 163 native postmenopausal women were followed at the Osteoporosis Centre of Policlinico of Bari (Southenrn Italy). Patients were classified into 3 separate groups, according to T-score: osteoporotic, osteopenic and control group. Serum concentrations of OPG, RANKL, RANKL/OPG ratio, BAP and NTX have been calculated. RESULTS: No differences were found in OPG and BAP values. Significant correlations were found in the osteopenic group between OPG and RANKL (negative), and between RANKL and OPN or serum-NTX, OPN and serum-NTX or RANKL/OPG ratio, BAP and serum-NTX, serum-NTX and RANKL/OPG ratio (positive). In the other groups a significant correlation was observed between BAP and NTX. CONCLUSIONS: In postmenopausal women, important modifications of bone metabolism markers (i.e. RANKL, OPG and OPN) could be due to serious engagement of bone turnover, especially in the pre-osteoporotic phase. Low bone density in postmenopausal women should be identified as soon as possible, and urgent measures are needed to reverse the process. Parameters namely RANKL e OPG may become an important index for the evaluation of the activity of drugs against osteoporosis, old and new like AMG 162 (anti-RANKL action).

Adult↗

PubMed1991

Decreased serum osteocalcin levels in patients with postmenopausal osteoporosis.

Osteocalcin is a 49 amino acid non collagenous bone matrix protein which is synthesized by the osteoblasts. The serum levels of osteocalcin have been found to be a specific biochemical parameter of bone formation. We determined the serum levels of osteocalcin, parathyroid hormone, calcitonin and alkaline phosphatase as well as the 2 hour fasting hydroxyproline excretion in 26 patients with postmenopausal osteoporosis and in 24 postmenopausal control subjects. Serum levels of osteocalcin were significantly lower in the patients with postmenopausal osteoporosis than in the control subjects (p less than 0.002). In contrast, serum levels of parathyroid hormone, calcitonin, alkaline phosphatase and the 2 hour hydroxyproline excretion in the patients with postmenopausal osteoporosis and the control subjects were not statistically different. Our data give evidence of a decreased bone formation in patients with postmenopausal osteoporosis.

Aged↗

PubMed1990

A total dietary program emphasizing magnesium instead of calcium. Effect on the mineral density of calcaneous bone in postmenopausal women on hormonal therapy.

The use of calcium supplementation for the management of primary postmenopausal osteoporosis (PPMO) has increased significantly in the past few years. A review of the published data does not support calcium megadosing during postmenopause. Controlled studies showed no significant effect of calcium intake on mineral density of trabecular bone and a slight effect on cortical bone. Since PPMO is predominantly due to demineralization of trabecular bone, there is no justification for calcium megadosing in postmenopausal women. Soft tissue calcification is a serious risk factor during calcium megadosing under certain conditions. A total dietary program emphasizing magnesium instead of calcium for the management of PPMO takes into account the available data on the effects of magnesium, life-style and dietary habits on bone integrity and PPMO. When this dietary program was tested on 19 postmenopausal women on hormonal replacement therapy who were compared to 7 control postmenopausal women, a significant increase in mineral bone density of the calcaneous bone (BMD) was observed within one year. Fifteen of the 19 women had had BMD below the spine fracture threshold before treatment; within one year, only 7 of them still had BMD values below that threshold.

Adult↗

PubMed1995

The myometrium of postmenopausal women produces prolactin in response to human chorionic gonadotropin and alpha-subunit in vitro.

OBJECTIVES: To examine the effect of equimolar concentrations of hCG and dissociated alpha-subunit on PRL production by leiomyoma and myometrial tissue obtained from different hormonal states and to examine changes in PRL messenger RNA levels as PRL protein levels increased. DESIGN: Explant cultures of leiomyomas and myometrium were established and cultured for 96 hours. Tissue was studied from normal cycling women, postmenopausal women, pregnant women, and women undergoing GnRH agonist (GnRH-a) therapy. Cultured medium was collected at 24, 48, and 96 hours and assayed for PRL. In selected experiments, tissue was processed at 0 and 96 hours to analyze messenger RNA (mRNA) levels. RESULTS: Human chorionic gonadotropin and alpha-subunit stimulated PRL secretion in [1] explant cultures of leiomyoma and myometrium from premenopausal women, [2] cultures of tissue treated in vivo with leuprolide acetate for both leiomyoma and myometrium, and [3] myometrium obtained from postmenopausal women. Postmenopausal myometrium was significantly more responsive to stimulation. Prolactin mRNA levels were documented to increase after hormone treatment in postmenopausal myometrium. CONCLUSION: Myometrium from postmenopausal women is very responsive to hCG and alpha-subunit. There is a difference in response between tissue obtained from menopausal women and that from women undergoing GnRH-a therapy to achieve a "medical menopause" and reproductive age women. The level of endogenous gonadotropins as well as the steroid milieu may modulate myometrial PRL secretion.

Antineoplastic Agents, Hormonal↗

PubMed1994

Postmenopausal frontal fibrosing alopecia. Scarring alopecia in a pattern distribution.

BACKGROUND: Recession of the frontal hairline is a common event in postmenopausal women. This has been shown not to be a marker of gross androgenization, and is usually a progressive nonscarring alopecia. Six postmenopausal women, who developed a progressive frontal scarring alopecia, were studied and their clinical and laboratory data, as well as the results of scalp biopsy specimens in all six patients, were analyzed and compared with recognized forms of scarring alopecia and recently described findings in androgenetic alopecia. OBSERVATIONS: The six postmenopausal women developed a progressive frontal hairline recession that was associated with perifollicular erythema within the marginal hairline, producing a frontal fibrosing alopecia extending to the temporal and parietal hair margins. Scalp biopsy specimens from the frontal hair margin showed perifollicular fibrosis and lymphocytic inflammation concentrated around the isthmus and infundibular areas of the follicles. Immunophenotyping of the lymphocytes showed a dominance of activated T-helper cells. Clinical review of all six cases showed a progressive marginal alopecia without the typical multifocal areas of involvement seen in lichen planopilaris or pseudopelade. None of the patients had mucous membrane or skin lesions typical of lichen planus. Hormonal studies, in five patients, showed no elevated androgen abnormalities. CONCLUSIONS: Progressive frontal recession in postmenopausal women may show clinical features of a fibrosing alopecia. The histologic findings are indistinguishable from those seen in lichen planopilaris. However, the absence of associated lesions of lichen planus in all six women raises the possibility that this mode of follicular destruction represents a reaction pattern triggered by the events underlying postmenopausal frontal hairline recession.

Aged↗

PubMed1993

[Bone metabolism in postmenopausal women and after estrogen treatment].

Changes of bone metabolism in 11 premenopausal women and 109 postmenopausal women were studied. 50 postmenopausal women were randomly divided into 4 groups: 20, 10 and 6 cases were given nylestriol, diethyl stilbestrol and chlorotrianisen respectively, and 14 cases served as control. It was shown that bone mineral content (BMC), and, blood estrogen level in postmenopausal women were significantly lower than those of premenopausal women. Close correlation existed between E1, E2, and BMC. Serum alkaline phosphatase (ALP), bone GLA protein (BGP), urine Ca/Cr and Hpr/Cr were markedly increased in postmenopausal women and declined after 3 months of treatment with nylestriol, diethylstilbestrol or chlorotrianisen. The radial BMC increased by 0.8% with (P > 0.05) nylestriol treatment for one year and decreased by 1.1% (P < 0.05) in the control cases. The present study indicated that postmenopausal estrogen deficiency accelerated bone loss, which was prevented by small substitution doses of estrogen such as nylestriol.

Bone Density↗

PubMed1993

Structural changes of iliac cancellous bone in postmenopausal women: a scanning electron microscopic study.

The functional state of iliac cancellous bones in healthy postmenopausal women was investigated by scanning electron microscopy (SEM) using a modified organic preparation method. SEM analysis of the location, number, size and phase of the remodeling sites showed that normal iliac cancellous bone of postmenopausal women has high resorbing activity in the early stage of postmenopause in both the region near the cortico-endosteum and the midway region, while in the late stage of postmenopause there is a great difference in resorbing activity between the two regions; namely, the resorbing activity progressively decreases with age, but high resorbing activity is continuously present in the region near the cortico-endosteum. Our results suggest the possibility that at the region near the cortico-endosteum the bone volume loss occurs continuously throughout all the stages of post-menopause, while at the midway region it occurs only in the early stage and not in the late stage of postmenopause.

Aged↗

PubMed1995

[Effects of estrogen therapy on bone mass in postmenopausal women with osteopenia].

Estrogen treatment prevents early postmenopausal bone loss. The aim of this study was to evaluate the effects of estrogen-progestogen therapy on bone mass in elderly osteopenic postmenopausal women. Fifteen women with a mean age of 58 +/- 6 (mean +/- SD) years and 12 +/- 7 (5-31) years from menopause were evaluated. Bone mineral density (BMD) was assessed by dual X-ray absoptiometry (DXA) with 1.7% variation coefficient at lumbar spine (L2-4) and 1.9% at femur neck. Measurements were done at both sites before and after a 12 month treatment. At the beginning of the study lumbar spine BMD (LS BMD) was low: < 0.9 grs/cm2; z-score: -1.4 +/- 0.17 (mean +/- SEM). Treatment consisted in transdermal 17 beta estradiol (50 micrograms/day) (n = 10) or an equivalent natural estrogen oral dose (n = 5). Variable doses of medroxiprogesterone acetate were added on an individualized basis to women with an intact uterus (n = 12). Calcium intake was increased up to a median of 1200 mg/day (800-1600). After a one year treatment LS BMD was increased by 8.4 +/- 1.1% (mean +/- SEM) (95% CI: 6-10.8), from 0.748 +/- 0.02 to 0.810 +/- 0.02 gr/cm2 (p < 0.0001). A less marked gain in femur neck bone mineral density (FN BMD) was also noticed: 3.9 +/- 1.5% (95% CI: 0.6-7.2); 0.671 +/- 0.02 vs 0.697 +/- 0.02 gr/cm2 (p < 0.05). Patients treated with transdermal and oral routes showed similar results. Percentage variations in LS BMD and FN BMD were positively correlated (r: 0.53; p < 0.05). Six patients were treated for 2 years; LS BMD continued to rise, the additional gain being 5.1 +/- 2.2% (p < 0.05), while a non significant increase in FN BMD was observed (7.5 +/- 3.5%; p = 0.06). In the early postmenopausal period, hormonal replacement therapy (HRT) produces either a stabilization or a slight increase (2-4%) in BMD. In contrast, a significant augmentation of bone mass (especially at the spine) seems to occur in osteopenic women when THR is administered in the late postmenopausal period. This suggests that HRT could be used for the prevention as well as for the treatment of postmenopausal osteoporosis. Further studies should be done to evaluate whether HRT reduces the incidence of osteoporotic fractures in elderly osteopenic women.

Absorptiometry, Photon↗

PubMed1997

Does persistent postmenopausal bleeding justify hysterectomy?

Postmenopausal vaginal bleeding is an early sign of endometrial cancer. persistent postmenopausal bleeding refers to uterine bleeding for which no malignant cause can be demonstrated by endometrial sampling. Hysterectomy has routinely been performed in this group of patients because of a perceived risk of endometrial cancer. The objective of this study was to quantify the risk of endometrial cancer in patients undergoing hysterectomy for postmenopausal bleeding after benign histology on endometrial sampling. One thousand four hundred and sixty-three patients underwent a hysterectomy during the study period. Forty hysterectomies (2.7%) were performed for persistent postmenopausal bleeding. The final pathology of the 40 hysterectomy specimens demonstrated hyperplasia with atypia in four patients (10%), hyperplasia without atypia in 14 (35%), and other non malignant pathology in 22 (55%). There were no cases of carcinoma of the endometrium. We conclude that persistent postmenopausal bleeding with non malignant pathology on endometrial sampling is not an indication for hysterectomy.

Aged↗

PubMed1998

[Relation between common allelic variation in a cross-sectional longitudinal population study. Vitamin D receptor locus, bone mineral density and postmenopausal bone loss].

The aim of this study was to determine whether common allelic variation at the vitamin D receptor locus is related to bone mineral density and postmenopausal bone loss. Five hundred and ninety-nine healthy women aged 27 to 72 and 125 women with low bone mass aged 55-77 were measured once in a cross-sectional design. Furthermore, 136 women aged 45-54 were followed longitudinally for 18 years. The vitamin D receptor genotypes were determined using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism analysis for three different polymorphic restriction sites (BsmI, ApaI and TaqI). Bone mineral density was measured by photon and X-ray absorptiometry. The cross-sectional study showed no significant relationship between vitamin D receptor genotype and bone mineral density. The maximum difference between homozygotes was 1.3%, P = 0.33, N = 723. The low bone mineral density group had virtually the same genotype frequencies as the normal bone mineral density group. The results of the longitudinal study showed that vitamin D receptor genotype was neither related to early postmenopausal bone loss: age 51-53 (total bone loss at the lower forearm: -3.6% [3.6%], mean [standard deviation]), late postmenopausal bone loss: age 63-69 (total bone loss at the hip: -6.2% [8.7%]) nor to long term postmenopausal bone loss: age 51-69 (total bone loss at the lower forearm: -24.5% [11.4%]). Using analysis of variance to test for differences in the rates of bone loss between the vitamin D receptor genotypes, P values ranged from 0.07 to 0.79. We conclude that common allelic variation at the vitamin D receptor locus as defined by the endonucleases ApaI, BsmI and TaqI is neither related to bone mineral density nor to the rate of bone loss in healthy postmenopausal Danish women.

Adult↗

PubMedDate not supplied

Exercise and regional bone mineral density in postmenopausal women: a meta-analytic review of randomized trials.

By using the meta-analytic approach, the purpose of this study was to examine the effects of exercise on regional bone mineral density in postmenopausal women. A total of 11 randomized trials yielding 40 outcome measures and a total of 719 subjects (370 exercise, 349 nonexercise) met the criteria for inclusion: (1) randomized trials; (2) exercise as a primary intervention in postmenopausal women; (3) changes in regional bone mineral density reported; (4) comparative nonexercise group included; (5) studies published in English-language journals between January 1975 and December 1995. Across all designs and categories, treatment effect changes in bone density, weighted by sample size, ranged from -17.10 to 17.30% (mean, 0.27%; 95% confidence interval, 0.16-0.37%). When analyzed separately, sample weighted decreases of approximately -0.51 and -0.86% were found for exercise and nonexercise groups, respectively. Larger effects were observed when groups that did not measure bone density specific to the site loaded and groups that received some type of supplementation (calcium or hormone replacement therapy) were deleted from the model (mean change, 0.76%; 95% confidence interval, 0.6-0.93). Both aerobic and strength training enhanced regional bone mineral density (mean change: aerobic, 1.62% and 95% confidence interval, 1.12-2.12; strength, 0.65% and 95% confidence interval, 0.48-0.83). In conclusion, meta-analytic review of included studies suggests that exercise may slow the rate of bone loss in postmenopausal women. However, it is premature to form strong conclusions regarding the effects of exercise on regional bone mineral density in postmenopausal women. A need exists for additional, well designed studies on this topic before a recommendation can be made regarding the efficacy of exercise as a nonpharmacologic therapy for maintaining and/or increasing regional bone mineral density in postmenopausal women.

Absorptiometry, Photon↗

PubMed1998

Breastfeeding experience and breast cancer risk among postmenopausal women.

Results of studies of breastfeeding and postmenopausal breast cancer risk have been inconsistent, with many investigators concluding that breastfeeding does not influence risk. We examined whether breastfeeding reduces postmenopausal breast cancer risk as well as the details of this relationship, including possible modification in risk by the age that a woman first breastfed a child and the number of children she breastfed. This population-based case-control study compared 974 women who were residents of Los Angeles County and newly diagnosed with breast cancer to 973 women with no history of breast cancer who were matched to patients by age (within 3 years) and neighborhood of residence. Subjects were parous and postmenopausal. Breast cancer patients were ages 55-64 years at diagnosis. Women who breastfed at least 16 months experienced a reduced odds of breast cancer relative to women who never breastfed (odds ratio, 0.73; 95% confidence interval, 0.52-1.01). Risk decreased as the number of children breastfed increased, but the association was attenuated after accounting for lifetime duration of breastfeeding. Breast cancer risk was 30% lower among women ages 20-24 years at first breastfeeding than women who had never breastfed (odds ratio, 0.69; 95% confidence interval, 0.54-0.88), independent of the effect of age at first birth. This study provides some evidence that the protective effect of breastfeeding persists into the postmenopausal years. The potential for nondifferential error in recall of breastfeeding habits among postmenopausal patients and controls may explain the inconsistent results observed across studies and underscores the need for careful assessment of this relationship.

Adolescent↗

PubMed1998

[Postmenopausal osteoporosis in the Emilia-Romagna region. Extent of the problem].

BACKGROUND: The purposes of this paper are to summarise the epidemiological data concerning the frequency of postmenopausal osteoporosis and its related fractures in Emilia-Romagna, a province of northern Italy, and to determine the future impact of this disease. METHODS: To evaluate how many people suffer from postmenopausal osteoporosis it was decided to calculate the number of hospital admissions due to this disease or to its related fractures in postmenopausal women--included and excluded according to the ICD9-CM codes relative to the hospital discharges--during the years 1994 and 1995. RESULTS: The results show that incidence rates of these hospital admissions increase with age, as well as the number of osteoporotic fractures. Hip fractures, which represent a major problem due to their costs and consequences, are the more frequent osteoporotic fractures which need hospital admission, while it is possible that a large part of other fractures (which do not need hospitalisation or have been treated in private structures) has not been calculated. CONCLUSIONS: When projected to the population of women living in Emilia-Romagna in the future decade, also keeping the age-specific fracture rates constant, these data suggest that the occurrence of postmenopausal osteoporosis and of osteoporotic fractures will increase, with a dramatic escalation of economic and human costs. Finally, direct costs related to postmenopausal osteoporosis have been calculated for the decade 1995-2004.

Aged↗

PubMedDate not supplied

Cytochrome P450 3A4 activity in premenopausal and postmenopausal women, based on 6-beta-hydroxycortisol:cortisol ratios.

STUDY OBJECTIVE: To characterize cytochrome P450 (CYP) 3A4 activity in premenopausal and postmenopausal women by evaluating the urinary 6-beta-hydroxycortisol:cortisol ratio. DESIGN: Prospective study SUBJECTS: Thirteen premenopausal and 13 postmenopausal women who were healthy and not receiving drugs known to affect CYP3A4 activity INTERVENTIONS: Beginning on day 2 of menses, premenopausal women collected first morning urine samples every other day for a complete menstrual cycle. Postmenopausal women collected first morning urine every other day for 28 days. MEASUREMENTS AND MAIN RESULTS: Mean weekly 6-beta-hydroxycortisol:cortisol ratios did not differ during the phase (week) of the menstrual cycle. Daily ratios did not differ in postmenopausal women. No difference between premenopausal and postmenopausal women was found on comparing overall median ratios. CONCLUSION: Cytochrome P450 3A4 activity as measured by 6-beta-hydroxy cortisol:cortisol ratio did not differ by week of menstrual cycle, suggesting no menstrual cycle-related changes. Menopause does not appear to be associated with differences in CYP3A4 activity, compared with premenopause.

Adult↗