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[Configuration frequency analyses of psychiatric symptoms in climacteric females].

Configurational frequency analysis according to Krauth and Lienert is a multivariant no-parametric statistical test method to identify types and syndromes. It was used in an attempt to disclose combinations of symptoms by which the various forms of climax of women could be typed. The point is made that outcome of this study should be evaluated in terms of heuristics, with further studies being necessary.

Adaptation, Psychological↗

Treatment with oral estrone sulphate in the female climacteric. I. Influence on lipids.

Twenty women in the perimenopause were studied for 12 months during which sodium-piperazine-estrone-sulphate 2.5 mg/day was given for 3 weeks out of 4 as a hormone replacement therapy. Blood samples were drawn at the start of therapy, then after 3, 6 and 12 months and analyzed for serum triglyceride, total cholesterol, cholesterol content of high density lipoprotein (HDL) fraction and the relative fatty acid composition of serum lecithin. Triglyceride levels were increased after 3 months (p less than 0.01). After that there was a gradual decline to almost pretreatment levels. Total cholesterol decreased during the latter period of treatment and became virtually normal; significantly lower levels (p less than 0.01) were found at 12 months. The HDL-cholesterol, which constitutes most of the high density lipoprotein fraction, showed a continuous increase and reached statistical significance at 12 months (p less than 0.01). This type of lipoprotein pattern is associated with a reduced risk of ischemic cardiovascular disease. After 3 and 6 months of treatment an increase in the relative content of palmitic acid in serum lecithin was seen, an increase that might indicate an altered liver lecithin synthesis, usually seen in cholestasis. However, after 12 months the palmitic acid level declined and was not significantly altered from the pretreatment value, indicating that the change was transitory.

Adult↗

Treatment with oral estrone sulphate in the female climacteric. II. Hormonal aspects.

Of forty-three perimenopausal women aged 40.1-56.5 years with climacteric complaints 25 were treated with sodium piperazine estrone sulphate 2.5 mg daily and 18 were given methyl scopolamine. All subject had initial serum FSH levels in the postmenopausal range (20 U/l). The serum levels of FSH, LH, unconjugated immunoreactive estrogens, total estrone, total dehydroepiandrosterone (DHAS), and the urinary low polar estrogens were followed during 18 months of treatment. In the estrogen treated group serum unconjugated immunoreactive estrogens and total estrone as well as urinary low polar estrogens increased significantly during treatment. The serum levels of FSH decreased significantly during the whole test period; LH only at three months. No effects could be seen on serum DHAS. In the group given methyl scopolamine the only changes found were a decrease in FSH at three months and a positive trend for LH (during the whole treatment period). In the total material, positive correlations were found between pretreatment values of unconjugated immunoreactive estrogens and total estrone and between total estrone and DHAS. A negative correlation was found between unconjugated immunoreactive estrogens and FSH. It is concluded that the effects of estrogens on the endocrine system in peri- and postmenopausal women are influenced by chemical structure, dosage and mode of administration of the estrogen as well as by the endogenous hormone profile.

Adult↗

Natural oestrogen in the female climacteric--influence on blood coagulation and fibrinolysis.

The aim of the present study was to investigate the effect on blood coagulation and fibrinolysis of a natural oestrogen preparation, piperazine oestrone sulphate, prospectively in menopausal women. Scopolamine was given to the control group. The women were investigated before and during treatment with regard to factors VIII, VII, X, V, fibrinopeptide A, antithrombin III, plasminogen, rapid antiplasmin and alpha 1-antitrypsin. There was no significant change towards hypercoagulability or decreased fibrinolysis in any group. In the oestrogen group, however, a tendency towards an increased level of plasminogen and a decreased level of antiplasmin was demonstrated. In the scopolamine group there was an unexpected fall in factors X and V and also in plasminogen and alpha 1-antitrypsin. A low level of some blood coagulation factors in some of the women before treatment is somewhat astonishing; none of them had any history of excessive bleeding.

Adult↗

Treatment with oral estrone sulphate in the female climacteric. III. Effects on bone density and on certain biochemical parameters.

Thirty-eight women were treated with estrone sulphate over a period of 30 months for climacteric problems. A random control group of 29 women were given methyl scopolamine. Bone mineral assays were performed by means of dual photon absorptiometry before the start of treatment and after 6, 12, 18, and 30 months. There was a difference in the mineral loss of trabecular bone between the two groups after 30 months of treatment, that the control group being significantly higher (p less than 0.001). In the estrogen-treated group there was a decrease in serum phosphorus (p less than 0.01), alkaline phosphatase activity (p less than 0.001), and albumin (p less than 0.001). In the control group, serum albumin showed the same decrease, while the other factors either showed no differences or even increased. The urinary excretion of calcium was not significantly reduced in the estrogen group, whereas there was an increase in the control group (p less than 0.01). There was an increase in hematocrit in both groups. Positive correlation was found between parity and loss of trabecular bone mineral (p less than 0.01).U

Adult↗

[Psychosomatic dysfunctions in the female climacteric. Clinical effectiveness and tolerance of Kava Extract WS 1490].

Within the framework of a randomized, placebo-controlled double-blind study, two groups each containing 20 patients with climacteric-related symptomatology were treated for a period of 8 weeks with kava WS 1490 extract 3 X 100 mg/day or a placebo preparation. The target variable - the HAMA overall score of anxiety symptomatology - revealed a significant difference in the drug-receiving group vis-à-vis the placebo group already after only 1 week of treatment. The course of such further parameters as depressive mood (DSI), subjective well-being (patient diary), severity of the disease (CGI), and the climacteric symptomatology (Kuppermann Index and Schneider scale) over the overall period of treatment demonstrate a high level of efficacy of kava extract WS 1490 in neurovegetative and psychosomatic dysfunctions in the climacteric, associated with very good tolerance of the preparation.

Climacteric↗

[Hormone substitution in the female climacteric--goals, means, effects].

Traditional beliefs about climacteric symptoms and widespread imaginations about unwanted effects of estrogens in the pill have long been interfering with the recommendation of an early onset of effective replacement therapy. The somatic symptoms of rush or genital atrophia have later on been classified as hard evidence to justify a therapy, much more than the predominant psychic signs occurring in the postmenopausal years as mental depressions, decrease or lacking of libido, nervousness, insomnia. Those signs were neglected as weaker indications responding even to a placebo treatment. The present knowledge understands somatic and psychosomatic signs as an entiety, both being accessible to hormonal replacement therapy. 85% of the postmenopausal signs can effectively be treated with hormones. What is now known about atherosclerosis, lipid metabolism and osteoporosis in ageing woman adds further justification to even the prophylactic use of estrogens. Natural estrogens administered orally, transdermally or parenterally are the means of choice. The dosage might be tailored on the relief of symptoms (and afterwards reduced to a mere maintaining dosage), or given in a fixed cyclic regimen. The treatment cycle will be three or four weeks, a progestogen should be added for the last 12-14 days. Only one estrogen-androgen combination has survived (Gynodian). The transdermal application (in three different concentrations) with administration twice a week is in progress. Indications and contraindications for transdermal estrogens are similar to estrogens administered orally.

Aged↗

[The effect of oral contraceptives on bone density in climacteric females].

The aim of the study was to investigate the influence of long-term administration of oral contraceptives on bone density in climacteric women. Two hundred (n = 200) climacteric women were allocated to three study groups (I, II, III). The first (n = 30) one had been using oral contraceptives for more than 10 years, the second (n = 50) one for between 2 and 9 years, while the third (n = 120) one had never used oral contraceptives. Bone mineral content (BMC) of the left forearm was measured by single photon absorptiometry. The results demonstrate that osteoporosis occurs later and is less frequent during the peri-menopause (p less than 0.05) in women who have used oral contraceptives on a long-term basis (greater than 10 yr). Our findings confirm that there is an important correlation between longterm use of oral contraceptives and bone density.

Adult↗