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PubMed2006

Comparison of the effect of alendronate on lumbar bone mineral density and bone turnover in men and postmenopausal women with osteoporosis.

The purpose of the present study was to compare the effect of alendronate treatment on lumbar bone mineral density (BMD) and bone turnover in men and postmenopausal women with osteoporosis. Sixty men with primary or secondary osteoporosis and 318 women with postmenopausal osteoporosis were treated with alendronate. The primary end points were lumbar BMD and urinary cross-linked N-terminal telopeptides of type I collagen (NTX) and serum alkaline phosphatase (ALP) levels. The secondary end point was the incidence of vertebral and nonvertebral fractures. Forty-seven (78.3%) men and 254 (79.9%) women who could complete the 12-month trial were analyzed. The mean ages of men and postmenopausal women were 69.1 and 70.4 years, respectively. Both men and postmenopausal women showed higher levels of urinary NTX as compared with normal range of premenopausal women. Alendronate treatment decreased urinary NTX level by 39.2% in men and 45.4% in postmenopausal women at 3 months and serum ALP level by 17.8 and 21.0%, respectively, at 12 months. Following reduction in bone turnover markers, lumbar BMD increased 5.8 and 7.6% in men and postmenopausal women, respectively, at 12 months. Reduction in urinary NTX level and increase in lumbar BMD were smaller in men than in postmenopausal women. The incidence of vertebral and nonvertebral fractures was 10.6 and 8.5%, respectively, in men and 8.3 and 7.5%, respectively, in postmenopausal women, with no significant difference in these incidences between them. These results suggested that alendronate treatment effectively increased lumbar BMD from baseline in men with primary or secondary osteoporosis following reduction in bone turnover, although its efficacy did not appear to be greater than in postmenopausal women with osteoporosis.

Absorptiometry, Photon↗

PubMed1994

Diclofenac sodium inhibits bone resorption in postmenopausal women.

BACKGROUND: The results of experimental studies with animals indicated that prostaglandins stimulate bone resorption, that skeletal production of prostaglandin E2 is enhanced by ovariectomy and is diminished by 17 beta-estradiol, and that the nonsteroidal anti-inflammatory drug (NSAID) naproxyn prevents bone loss after ovariectomy. Studies were carried out to investigate the effects of the NSAID diclofenac sodium on bone and mineral metabolism in premenopausal women and to compare the effects of diclofenac sodium and conjugated estrogens on bone and mineral metabolism in postmenopausal women. PATIENTS AND METHODS: Ten healthy premenopausal women and 17 healthy postmenopausal women were studied while not being treated and again after 4 weeks of treatment with diclofenac sodium, 150 mg per day in divided doses (both groups), and conjugated estrogens, 0.625 mg per day (postmenopausal women). Cross-linked N-telopeptides of type I collagen were measured in the urine as an index of bone resorption. The postmenopausal women were separated into two groups, responders and nonresponders, based on their response to conjugated estrogens as assessed by linear discriminant analysis for groups. Conjugated estrogens lowered urinary N-telopeptides of type I collagen in responders, but not in nonresponders. RESULTS: Urinary cross-linked N-telopeptides were higher in the eight postmenopausal women responders than in the nine postmenopausal nonresponders or in the premenopausal women, and were not altered by diclofenac sodium in premenopausal women. In the eight postmenopausal women with higher rates of bone resorption, diclofenac sodium and conjugated estrogens significantly lowered both urinary calcium concentration and urinary cross-linked N-telopeptides. The effects of the two drugs were comparable. CONCLUSION: The preliminary results demonstrate that, at the dose used, diclofenac sodium is almost as effective as conjugated estrogens for decreasing bone loss in postmenopausal women. Further studies will be needed to determine whether diclofenac sodium can prevent postmenopausal bone loss.

Adult↗

PubMed1996

Postmenopausal bartholin gland enlargement: a hospital-based cancer risk assessment.

OBJECTIVE: To assess the risk of Bartholin gland carcinoma in postmenopausal women. METHODS: A referral patient population from a tertiary care cancer center and a hospital-based regional tumor registry was used in a case-control and retrospective cohort study. We searched for data on any discharge diagnosis or procedures involving the Bartholin gland, including excision, cystectomy, or marsupialization, and pathology reports confirming cancer diagnoses from a hospital-based regional tumor registry and a tertiary hospital's medical records department and operating room log. RESULTS: A total of 284 patients were identified, 161 patients from the hospital-based tumor registry and 123 from the tertiary hospital data bases. Pathology reports from 104 of the 161 patients with vulvar cancer were available and revealed two primary adenocarcinomas in postmenopausal women, one squamous cell carcinoma of the Bartholin gland in a postmenopausal woman, and two squamous cell carcinomas of the Bartholin gland in premenopausal patients over a 24-year period. Based on local New York State Department of Health census data, the incidence of Bartholin gland carcinoma was 0.023 per 100,000 woman-years in premenopausal women and 0.114 per 100,000 woman-years in postmenopausal women (incidence rate ratio 5.01, 95% confidence interval [CI] 0.67-25.1). The overall incidence rate of squamous cell vulvar carcinoma was 0.42 per 100,000 woman-years in premenopausal and 4.72 per 100,000 woman-years in postmenopausal women (odds ratio [OR] 11.55, 95% CI 7.82-17.14). The ratio of Bartholin gland cancer to other vulvar cancers was two per 37 in premenopausal women versus three per 124 in postmenopausal women (OR 2.3, 95% CI 0.39-17.9). Of thirteen postmenopausal patients (mean age 65.4 years) with Bartholin gland enlargement admitted to the tertiary care center, only four (30.8%) had excisions, whereas the remainder (69.2%) had drainage or marsupialization. None of the patients treated with drainage or marsupialization were listed subsequently in the tumor registry as developing Bartholin gland cancer during a median surveillance of 10.3 years (range 1.7-14.4). CONCLUSION: Bartholin gland cancer is exceedingly rare in all women, including postmenopausal women. We were unable to find evidence that would justify excision as the initial treatment of a Bartholin gland enlargement in postmenopausal women. Drainage and selective biopsy may be sufficient as initial management.

Adult↗

PubMed2005

A selective estrogen receptor modulator, tamoxifen, and membrane fluidity of erythrocytes in normotensive and hypertensive postmenopausal women: an electron paramagnetic resonance investigation.

BACKGROUND: Recent studies have shown that tamoxifen, which belongs to a group called selective estrogen receptor modulators (SERM), may exert protective effects against cardiovascular diseases and stroke in postmenopausal women. On the other hand, abnormalities in physical properties of the cell membranes may underlie the defects that are strongly linked to hypertension, stroke, and other cardiovascular diseases. The present study was performed to investigate the effects of tamoxifen on cell membrane fluidity (a reciprocal value of membrane microviscosity) in normotensive and hypertensive postmenopausal women. METHODS AND RESULTS: We used an electron paramagnetic resonance (EPR) and spin-labeling method. Tamoxifen significantly decreased the order parameter (S) for 5-nitroxide stearate (5-NS) and the peak height ratio (h(o)/h(-1)) for 16-NS obtained from EPR spectra of erythrocyte membranes in normotensive postmenopausal women (mean +/- SEM, order parameter value; control 0.719 +/- 0.002, n = 41; tamoxifen 1 x 10(-7) mol/L 0.704 +/- 0.002, n = 41, P < .0001; tamoxifen 1 x 10(-6) mol/L 0.696 +/- 0.002, n = 41, P < .0001; tamoxifen 1 x 10(-5) mol/L 0.692 +/- 0.002, n = 41, P < .0001). The finding indicated that tamoxifen increased the membrane fluidity and improved the membrane microviscosity of erythrocytes. The membrane action of tamoxifen was antagonized by the estrogen receptor antagonist ICI 182,780. The effect of tamoxifen was significantly potentiated by the nitric oxide (NO) donors, l-arginine and S-nitroso-N-acetylpenicillamine, and a cGMP analog 8-bromo-cGMP. In contrast, the change evoked by tamoxifen was counteracted by the NO synthase inhibitors N(G)-nitro-l-arginine-methyl-ester and asymmetric dimethyl-l-arginine. In hypertensive postmenopausal women, the membrane fluidity of erythrocytes was significantly lower than in normotensive postmenopausal women. The effect of tamoxifen on the membrane fluidity was more pronounced in hypertensive postmenopausal women than in normotensive postmenopausal women. CONCLUSIONS: These results showed that tamoxifen increased the membrane fluidity of erythrocytes and improved the rigidity of cell membranes in postmenopausal women, to some extent, through the NO- and cGMP-dependent mechanisms. Furthermore, the greater effect of tamoxifen in hypertensive postmenopausal women suggests that tamoxifen could have a beneficial effect in regulating the blood rheologic behavior and in the improvement of the microcirculation in hypertension.

Aged↗

PubMed2003

Predicting bone mineral density of postmenopausal healthy and cirrhotic Italian women using anthropometric variables.

BACKGROUND: Chronic liver diseases, including cirrhosis of the liver, have been shown to cause bone osteometabolic disease giving rise to osteoporosis and osteomalacia. AIMS: To develop mathematical prediction equations for the lumbar-spine, pelvis and total bone mineral density based on the osteoporosis risk factors age and body mass index in cirrhotic and healthy postmenopausal women. PATIENTS: Twenty-seven postmenopausal women with liver cirrhosis (Child-Pugh class A) and well-preserved liver function (Late postmenopausal cirrhotic), 27 women matched for age and body mass index (Late postmenopausal healthy) and 27 younger women matched only for body mass index (Early postmenopausal healthy). METHODS: Segmental and total fat mass, lean body mass and bone mineral density were measured for all participant women using dual X-ray absorptiometry. RESULTS: Segmental and total fat mass and bone mineral density were significantly lower for Late postmenopausal cirrhotic women as compared with Late and Early postmenopausal healthy women. Segmental and total lean body mass were comparable among the three study groups. CONCLUSIONS: The mathematical equations based on the variables age and body mass index were capable of predicting lumbar-spine bone mineral density, pelvis bone mineral density and total bone mineral density for the three groups of postmenopausal women with the lowest standard error of estimation and root mean square residuals of predictions for equations describing the Late postmenopausal healthy group.

Adipose Tissue↗

PubMed1999

The impact of race and fractures on mortality in a postmenopausal Medicaid population.

The purpose of this study was to model fractures and survival by age and race in a large postmenopausal Medicaid population. All Georgia Medicaid claims were abstracted for the years 1992, 1993, and 1994. Claims for postmenopausal women (> or =50 years of age) were retained, and patients with fractures were identified by International Classification of Diseases, Ninth Revision codes for fracture. A survival analysis was conducted using Kaplan-Meier estimators to evaluate the effect of fracture, age, and race on 3-year survival. A total of 159,400 white and black postmenopausal women were identified. The cohort with fracture totaled 5933 patients, with femoral fractures constituting 46% of all fractures. Discounting those with fracture before the study, the fracture incidence was approximately 1.2% in this postmenopausal female cohort. The survival analysis suggested that after age was accounted for, black postmenopausal women had a 42% increased risk of death within 3 years of fracture, compared with 13% for white women. However, postmenopausal black women were approximately 50% less likely to experience a fracture, and postmenopausal black women without fracture had better survival rates than comparable white women. Mortality crossover and the diminished likelihood of fracture mask the true nature of fracture survival in postmenopausal black women. Postmenopausal black women with fracture are at greater risk of dying than their white counterparts.

Aged↗

PubMedDate not supplied

Postmenopausal changes in production of type 1 and type 2 cytokines and the effects of hormone replacement therapy.

OBJECTIVE: An appropriate defense against infective agents or malignant cells is attributed to the exquisitely balanced T helper 1 type (cellular) and T helper 2 type (humoral) immune reactions. We investigated the effect of hormone replacement therapy (HRT) on postmenopausal changes in the production of interferon (IFN)-gamma and interleukin (IL)-10, a type 1 and a type 2 cytokine, respectively. DESIGN: Both cytokines were measured by ELISA in the supernatant of lipopolysaccharide-stimulated whole blood cells from 72 untreated and 44 HRT-treated women. Thirteen women were examined before and during HRT. RESULTS: The production of IFN-gamma in women in their 40s and in postmenopausal women was significantly higher compared with that of younger women. However, IFN-gamma fell to the lowest level in the late postmenopausal stage, whereas the production of IL-10 increased gradually with age and in parallel with the postmenopausal period. Thus, in women in the mid-and late postmenopausal period, excessive production of type 2 cytokine (IL-10) compared with type 1 cytokine (IFN-gamma) occurred. The IFN-gamma levels of women on HRT were significantly lower than those of untreated women in the early and mid-postmenopausal stages, and IL-10 levels of women on HRT were significantly lower than those of untreated women in the mid-and late postmenopausal stages. HRT induced a significant decrease in the production of IL-10 and tended to lower the level of IFN-gamma. CONCLUSIONS: Production of IL-10 is augmented in postmenopausal women. HRT probably prevents postmenopausal women from an aberration of the immune system by improving the balance of type 1 and type 2 immune reactions.

Adult↗

PubMed2005

Comparison of HER-2/neu, ER and PCNA expression in premenopausal and postmenopausal patients with breast carcinoma.

We attempted to compare the pattern of HER-2/neu, ER and PCNA in premenopausal and postmenopausal patients with breast carcinoma to identify potential biological differences. Five hundred and forty-eight samples from 318 premenopausal and 230 postmenopausal women with invasive ductal carcinoma of the breast were evaluated for HER-2/neu, ER and PCNA expression by immunohistochemistry. HER-2/neu expression showed 27.4% positivity in premenopausal and 24.8% in postmenopausal women; there was no significant difference between the two groups (p>0.05). In contrast, HER-2/neu expression was found to be significantly associated with ER negativity in the two groups (p<0.05 in premenopausal, p<0.001 in postmenopausal patients). However, it was significantly associated with PCNA expression only in the postmenopausal group (p<0.001). 54.4% showed premenopausal tumor cell ER positivity, whereas 64.3% of the postmenopausal group showed positivity. ER expression showed a significant correlation with patient menopausal status (p<0.05). The prevalence of PCNA positivity in the tumor cell components is slightly higher in postmenopausal compared to premenopausal women (p>0.20). The current study is consistent with reports from other groups regarding the correlation of HER-2/neu with adverse pathologic features and with expression of other markers in carcinoma. We also observed there was no trend toward increased HER-2/neu expression in either premenopausal or postmenopausal patients, i.e. there was similar HER-2/neu expression in the two groups. This suggests that HER-2/neu status could be used to determine assignment to specific intensive adjuvant therapy and evaluation of biological behavior in both pre- and postmenopausal patients with breast carcinoma.

Biomarkers, Tumor↗

PubMed2002

Prevalence of bacterial vaginosis and vaginal flora changes in peri- and postmenopausal women.

Our aim was to evaluate the prevalence of bacterial vaginosis and decrease in lactobacillus colonization in women 40 years old or older in relation to menopausal status by evaluation of Gram-stained smears. A total of 1,486 smears from Italian Caucasian women aged 40 to 79 years were examined. Women were classified as follows: fertile (regular cycles) (n = 328), perimenopausal (irregular cycles) (n = 237), and postmenopausal (n = 921), including 331 women on estroprogestinic hormone replacement therapy (HRT). The prevalences of bacterial vaginosis (assessed as a Nugent score of >or=7) in fertile (9.8%) and perimenopausal (11.0%) women were not statistically different, whereas the prevalence was significantly lower overall in postmenopausal women (6.0%) (P = 0.02). Specifically, 6.3% of postmenopausal women without HRT and 5.4% of postmenopausal women with HRT were positive for bacterial vaginosis. The Nugent score system was not adequate for evaluating the normal and intermediate vaginal flora in women over the age of 40 years. High numbers of peri- and postmenopausal women had no lactobacilli and no bacterial-vaginosis-associated microorganisms. This nonpathological absence of lactobacilli in women with a Nugent score of 4 was scored as 4*, and this group was considered separately from the intermediate flora group. A score of 4* was obtained for 2.1% of fertile women, 11.4% of perimenopausal women, 44.1% of postmenopausal women without HRT, and 6.9% of postmenopausal women with HRT. The physiological reduction in lactobacillus colonization of the vagina in postmenopausal women does not cause an increase in bacterial-vaginosis prevalence. Reversion of lactobacillus flora to premenopausal levels due to HRT does not increase the prevalence of bacterial vaginosis in postmenopausal women.

Adult↗

PubMed2003

Lifetime physical activity and breast cancer risk in pre- and postmenopausal women.

PURPOSE: This research examined associations between leisure time and occupational physical activity (PA) across the lifespan and pre- and postmenopausal breast cancer. METHODS: In a population-based case-control study, 301 premenopausal cases, 316 premenopausal controls, 439 postmenopausal cases, and 494 postmenopausal controls, 40- to 85-yr-old reported time spent in exercise or sports strenuous enough to sweat and miles walked per week for time periods 2, 10, and 20 yr before the interview and at age 16. Lifetime occupational history was obtained. Jobs were coded according to the National Cancer Institute's PA job matrix. RESULTS: Strenuous PA was generally associated with a reduced breast cancer risk. Among women categorized as active at all four periods [at least 91+ h.yr(-1) (1.75+ h.wk(-1) avg)], a strong, significant protective effect was observed in postmenopausal [odds ratio (OR) 0.50 (0.28-0.90)] but not in premenopausal women [OR 1.06 (0.54-2.08)]. A strong protective effect was observed for activity performed 20 yr prior, in both pre- and postmenopausal women, although CIs overlapped for different time periods. Using women who reported no strenuous activity as the referent, OR (95% CIs) for the highest PA category [182+ h.yr(-1) (3.5 h.wk(-1) avg)] 20 yr ago were 0.57(0.31-1.05) and 0.51(0.31-0.83) for pre- and postmenopausal women, respectively. Walking was generally unrelated to risk. There was some indication of increased risk for the upper category of occupational PA for postmenopausal women, perhaps related to other industrial occupational exposures. CONCLUSION: Our results suggest a modest protective effect of strenuous leisure time PA on breast cancer risk in both pre- and postmenopausal women. The effects appear strongest for those active at least 20 yr prior and among postmenopausal women who were consistently active throughout their lifetime.

Adult↗

PubMed1999

Diagnostic value of biochemical markers of bone turnover and postmenopausal osteoporosis.

We studied 77 women divided into postmenopausal osteoporotic and premenopausal and postmenopausal non-osteoporotic groups in order to evaluate bone metabolism and diagnostic value of biochemical markers of bone turnover in postmenopausal osteoporosis. Postmenopausal osteoporotic (n: 40), postmenopausal non-osteoporotic (n: 24) and premenopausal non-osteoporotic (n: 13) groups were defined according to bone mineral density (BMD) scores obtained with dual energy X-ray absorptiometry (DEXA). Urinary deoxy-pyridinoline (Dpd), pyridinoline (Pyd), serum total alkaline phosphatase (ALP), bone specific alkaline phosphatase (BALP), osteocalcin (BGP), total calcium, phosphorus, and creatinine levels were determined. Urinary Dpd and Pyd levels of postmenopausal osteoporotic group (8.7 and 18.7 mumol/mg creatinine) were significantly higher than postmenopausal control (5.1 and 11.7 mumol/mg creatinine, p < 0.0001) and premenopausal control (6.0 and 13.0 mumol/mg creatinine, p < 0.0005 and p < 0.001) groups. Bone formation markers were not significantly different between groups, although BGP correlated with Dpd and Pyd (r: 0.26 and r: 0.31, p < 0.05) in osteoporotic subjects. From receiver operating curve (ROC) analysis Dpd had the best diagnostic value (0.846), followed by Pyd (0.802) in evaluation of osteoporosis, whereas BALP (0.570) and BGP (0.528) were relatively inefficient in the discrimination of postmenopausal osteoporosis. This study suggests that bone resorption markers are more efficient than bone formation markers in the diagnosis of postmenopausal osteoporosis. Urinary Dpd/creatinine ratio has the highest diagnostic value.

Absorptiometry, Photon↗

PubMed2000

Five-year follow-up of patients with recurrent postmenopausal bleeding.

BACKGROUND: The most common symptom of endometrial cancer is postmenopausal bleeding. For women who present with postmenopausal bleeding and a benign tissue diagnosis, recurrent bleeding is a worrisome problem. We evaluated such patients to search for a model of good management. METHODS: We studied women aged 50 years or over who presented with postmenopausal bleeding and underwent either dilatation and curettage (D & C) or endometrial biopsy from 1990 to 1991 at Long Island Jewish Medical Center, New Hyde Park, NY, USA. The selected patients were monitored for 5 years, until 1996. For those who had an initial benign tissue diagnosis and presented with recurrent postmenopausal bleeding in the following 5 years, we studied the differences in histologic diagnoses. RESULTS: Seventy-seven patients had an initial benign tissue diagnosis of postmenopausal bleeding followed by recurrent bleeding. After repeat D & C or endometrial biopsy (2-6 times), 16 patients (20.8%) had endometrial cancer or endometrial complex hyperplasia. Of the 12 patients who had two or more benign tissue diagnoses, seven (58.3%) had tumors found in subsequent surgery. The diagnoses included endometrial cancer, ovarian cancer, cervical cancer and benign tumor. Postmenopausal women aged 65 years or over had a much greater chance (13/29, 44.8%) of having endometrial cancer or complex hyperplasia than women aged below 65 years (6/48, 12.5%) who presented with recurrent postmenopausal bleeding and had an initial benign tissue diagnosis (c2 = 7.893, p = 0.0050). CONCLUSIONS: Although the initial tissue diagnosis might be benign, the possibility of endometrial cancer or complex hyperplasia cannot be ruled out for women with recurrent postmenopausal bleeding. Diagnostic D & C or endometrial biopsy combined with other tools (vaginal ultrasound, hysteroscopy, transvaginal sonohysterography) are more reliable for evaluating women with recurrent postmenopausal bleeding than D & C or endometrial biopsy only. If these diagnostic results are negative, a total hysterectomy with bilateral salpingo-oophorectomy should be considered to reduce the risk of endometrial cancer in women who present with recurrent bleeding.

Age Factors↗

PubMed2002

[Changes of plasma serotonin precursor metabolite concentrations in postmenopausal women with hot flushes].

OBJECTIVE: To investigate the relationship between changes of serotonin metabolism and hot flushes in climacteric women. METHODS: Ninety seven climacteric women, aged 40 - 60 were enrolled and divided into 4 groups, group A: early menopausal transition 20 cases, group B: late menopausal transition, 26 cases with skip of periods 3 - 12 months, group C: early postmenopause (1 - 3 years) 28 cases, group D: late postmenopause (> 3 - 6 years) 24 cases. Twelve normal women of reproductive age were served as young controls. Fifty two postmenopausal women were subdivided into 3 groups according to presence or absence of hot flushes. (1) postmenopausal controls without hot flush, 17 cases, (2) mild hot flushes group fewer < or = 5 times/day. (3) severe hot flushes group more than 5 times/day. Plasma concentrations of tryptophan (TP), 5-hydroxytryptophane (5-HTP), 5-hydroxytryptamine (5-HT or serotonin) and 5-hydroxyindoleacetic acid (5-HIAA) were measured in all participants by high pressure liquid chromatography-fluorescence spectrophotometer. Plasma level luteinizing hormone (LH) was measured in postmenopausal women by radioimmuno assay. The relationship between serotonin metabolic parameters and menopause, hot flushes and LH level were analysed. RESULTS: (1) Mean 5-HT and 5-HIAA concentrations in plasma were significantly higher in climacteric women than those in young controls, especially in the group B. Mean 5-HTP and 5-HT levels were higher and 5-HIAA lower in group D as compared with those of young controls. (2) Plasma 5-HT levels was positively correlated to luteinizing hormone concentration in postmenopausal women (P < 0.001). (3) In the mild hot flushes group, only plasma 5-HTP levels was significantly higher than that in the postmenopausal control group. In severe hot flushes group, plasma 5-HT and 5-HTP contents were significantly higher and 5-HIAA/5-HT ratio lower than those in the postmenopausal control groups. CONCLUSION: Our results suggest that the catabolic disorder of serotonin may involve in the underlying mechanism of hot flushes in postmenopausal women.

Adult↗

PubMed2003

[Influence of estrogen replacement therapy on atherogenic profile in postmenopausal women].

OBJECTIVE: Postmenopausal women have higher risk of cardiovascular events compared with premenopausal. The aim of this clinical study was to evaluate the effect of hormone replacement therapy (HRT) on the atherogenic profile in apparently healthy postmenopausal women. METHOD: The subjects were 76 healthy postmenopausal women, aged 45 to 59 years, and 15 premenopausal women with regular cycles, aged 40 to 45 years. 63 postmenopausal women completed the study. None of the participating women had a history of hypertension, diabetes mellitus or medications known to affect the cardiovascular system. Twenty seven postmenopausal women received daily 50 micrograms of transdermal estradiol and 100 milligrams of oral progesterone. Thirty six dit not receive HRT. Checkups were preformed at baseline and after six months of treatment, except the group of premenopausal women (only at baseline). Examinations consisted in measurement of body weight, length, waist/hip ratio and plasma levels of biochemical parameters. RESULTS: Estradiol levels were higher among premenopausal women than among treated and non-treated postmenopausal women (83 +/- 78.47 versus 10 +/- 3.99; 12 +/- 4.56 mg/l, p < 0.0001). Levels of serum cholesterol (198 +/- 30.2 versus 236 +/- 33.7; 228 +/- 32.8 mg/dl; p < 0.002), LDL-cholesterol (120 +/- 25 versus 151 +/- 34.2; 144 +/- 31.5 mg/dl, p < 0.02), uric acid (3.98 +/- 0.5 versus 4.6 +/- 1; 4.8 +/- 1 mg/dl, p < 0.004) and homocysteine (9.8 +/- 3.3 versus 13 +/- 3.1; 11 +/- 1.7 mmol/l, p < 0.02) were higher among postmenopausal women than among premenopausal women. The treated women showed higher levels of serum estradiol (49 +/- 34.43 versus 10 +/- 3.99, p < 0.0001) and CRP (0.11 +/- 0.06 vs. 0.24 +/- 0.12 mg/l, p < 0.05), lower waist/hip ratio (0.82 +/- 0.06 versus 0.83 +/- 0.05, p < 0.03), glucose (78 +/- 15.4 versus 85 +/- 14.3 mg/dl, p < 0.03), cholesterol (215 +/- 33.2 versus 236 +/- 33.7 mg/dl, p < 0.03), triglycerides (90 +/- 30.1 versus 106 +/- 47 mg/dl, p < 0.003) and calcium (9.4 +/- 0.4 versus 9.5 +/- 0.4 mg/dl, p < 0.0005) than postmenopausal women without hormone replacement. CONCLUSION: That HRT may have a favourable effect on atherogenic profile in apparently healthy postmenopausal women.

Adult↗

PubMed1990

[Relation of serum growth hormone and estradiol levels and osteoporosis in postmenopausal women].

Serum GH, E2, FSH, LH levels, bone mass, serum alkaline phosphatase (AKP), calcium levels and urinary calcium/creatine ratio in 42 postmenopausal women were compared with those in 30 women of fertile age. In thirteen out of the postmenopausal women we also observed these parameters before and after treatment with diethylstilbestrol (DES). The postmenopausal women had significantly reduced serum GH (P less than 0.01) and E2 levels (P less than 0.001) and increased serum FSH(P less than 0.001), LH levels (P less than 0.001), and had lower bone mass (P less than 0.01). They also had increased serum AKP levels (P less than 0.05) and urinary calcium/creatine ratio(P less than 0.01). There were positive correlations between serum E2 and GH levels, between postmenopausal bone loss and serum E2, GH decline. The postmenopausal bone loss began early as menopause commenced. After treatment with DES in 13 postmenopausal women, we observed that GH significantly increased (P less than 0.01) and FSH, LH decreased (P less than 0.001), AKP decreased by 27.58% and urinary calcium/creatine ratio decreased by 43.94% (compared with that before treatment). Our results indicate that bone turnover increased after menopause and resorption exceeded formation. There is bone loss in early postmenopause. The postmenopausal bone loss is related to serum GH, E2 levels. Estrogen replacement therapy is necessary in postmenopausal women and it should be given as early as possible. After treatment with DES, increased serum GH levels, decreased AKP values (27.58%) and urinary calcium/creatine ratio (43.94%) suggest that estrogen may play a definite role in bone metabolism through increased GH.

Aged↗

PubMed1988

Postmenopausal estrogen use and mortality. Results from a prospective study in a defined, homogeneous community.

The authors studied the association between postmenopausal estrogen use and mortality from cardiovascular disease, coronary heart disease, cancer, and all causes in a cohort of 1,868 women aged 50-79 years residing in a planned community. After 12 years, the age-adjusted all-cause mortality rate was lower in the 734 postmenopausal estrogen users (14.9/100 women) compared with the 1,134 nonusers (21.5/100 women) (relative risk (RR) = 0.69, 95% confidence interval (Cl) 0.55-0.87). After adjustment for age, systolic blood pressure, social class, fasting plasma cholesterol, fasting plasma glucose, Quetelet index (weight (lbs)/height (in)2 x 100), and cigarette smoking by the Cox model, the relative risk increased to 0.79 (95% Cl 0.62-1.01). Because a postmenopausal estrogen-smoking interaction term was significant (p = 0.025), separate Cox models were run for never, past, and current smokers. In never and current smokers, estrogen was protective for all-cause mortality, with relative risks of 0.67 (95% Cl 0.45-0.99) and 0.62 (95% Cl 0.39-0.98), respectively. However, past smokers were not protected by postmenopausal estrogen use (RR = 1.32, 95% Cl 0.84-2.08). Cause-specific models revealed differences in the association of postmenopausal estrogen use with cardiovascular disease mortality and coronary heart disease mortality that were dependent on smoking status. Postmenopausal estrogen use was strongly protective in current smokers but was associated with increased risk in past smokers. As expected, cancer mortality was increased in smokers. The confidence intervals for the relative risk estimate of postmenopausal estrogen use for cancer mortality in each smoking category included one. Finally, a separate analysis of subsequent three-year mortality in women surviving the first nine years of follow-up revealed reduced death rates only for women using estrogen at both baseline and nine years of follow-up, suggesting both a conservative bias in our data introduced by the large reduction in postmenopausal estrogen use during the study period and the possibility of a stronger protective effect for recent postmenopausal estrogen use.

Aged↗

PubMed1992

Sexual assault in postmenopausal women.

OBJECTIVE: To examine patient characteristics, patterns of injury, forensic evidence, and the frequency of sexual assault in postmenopausal rape victims from 1986-1991. METHODS: Medical and forensic records were reviewed from 129 postmenopausal women (50 years of age or older) and 129 women from a comparison group (14-49 years of age) who reported having been sexually assaulted. Statistical analysis was performed by Student t test, chi 2, multiple logistic regression, or Fisher exact test. RESULTS: Postmenopausal women represented 2.2% of women reporting sexual assault in Dallas County. The postmenopausal victim was more often white (64%), whereas the younger victim was more often black (53%). Drug or alcohol use within the previous 24 hours was more common in the younger group. Trauma, in general, was common, occurring in 67% of the postmenopausal women and 71% of the younger group (P = not significant). Genital trauma was more common in the postmenopausal group (43 versus 18%; P < .001). Nearly one in three postmenopausal women had genital abrasions or edema. Almost one in five older women had genital lacerations, with one in four severe enough to require surgical repair. In contrast, the frequency of extragenital trauma was more common in younger victims (66 versus 49%; P < .01). Forensic findings were similar in both groups; however, in postmenopausal women motile spermatozoa were seen only in those examined within 6 hours of the assault. CONCLUSION: Postmenopausal women who have been sexually assaulted are more likely to sustain genital trauma than younger victims.

Adolescent↗

PubMed2004

Modulation of survival in osteoblasts from postmenopausal women.

Osteoblast survival is one of the determinants of postmenopausal osteoporosis development. Recent data from animal experiments suggest that cytokines, in particular Fas ligand (FasL), contribute to postmenopausal osteoporosis. We now address the effect of Fas activation in postmenopausal osteoblast survival and the potential modulatory effect of estrogen and raloxifene analog (LY117018). The expression of Fas mRNA, Fas protein, and the sensitivity to Fas-induced apoptosis were studied in primary cultures of human osteoblasts from postmenopausal women and in osteoblastic MG-63 cells. Human postmenopausal osteoblasts constitutively expressed Fas receptors in the cell surface. TNFalpha increased the expression of Fas mRNA and cell surface Fas expression. Neither estradiol nor raloxifene analog prevented this increase in Fas expression. In addition, activation of Fas receptor resulted in apoptosis of postmenopausal osteoblasts. While TNFalpha did not induce human osteoblast apoptosis, it did increase the lethal effect of Fas activation. Therapeutic concentrations of estradiol or raloxifene analog did not modulate lethal cytokine-induced apoptosis. Both postmenopausal osteoblasts and MG-63 cells express FasL. FasL expression was not modulated by TNFalpha. In conclusion, estrogen and raloxifene analog do not appear to affect the sensitivity of postmenopausal osteoblasts to Fas-mediated apoptosis.

Aged↗