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Menopausal hormonal therapy

Raffaele Nuzzi, Simona Scalabrin, Alice Becco, Giancarlo Panzica
Aim: Gonadal hormones are essential for reproductive function, but can act on neural and other organ systems, and are probably the cause of the large majority of known sex differences in function and disease. The aim of this review is to provide evidence for this hypothesis in relation to eye disorders and to retinopathies in particular. Methods: Epidemiological studies and research articles were reviewed. Results: Analysis of the biological basis for a relationship between eye diseases and hormones showed that estrogen, androgen, and progesterone receptors are present throughout the eye and that these steroids are locally produced in ocular tissues...
2018: Frontiers in Endocrinology
Roberto Angioli, Daniela Luvero, Grazia Armento, Stella Capriglione, Francesco Plotti, Giuseppe Scaletta, Salvatore Lopez, Roberto Montera, Alessandra Gatti, Giovan Battista Serra, Pierluigi Benedetti Panici, Corrado Terranova
As growing of old women population, menopausal women will also increase: an accurate estimation of postmenopausal population is an essential information for health care providers considering that with aging, the incidence of all cancers is expected to increase. Hormone replacement therapy (HRT) has proven to be highly effective in alleviating menopausal symptoms such as hot flashes, night sweats, dyspareunia, sexual disorders, and insomnia and in preventing osteoporosis. According to preclinical data, estrogen and progesterone are supposed to be involved in the induction and progression of breast and endometrial cancers...
April 2018: Critical Reviews in Oncology/hematology
Anita H Clayton, Irwin Goldstein, Noel N Kim, Stanley E Althof, Stephanie S Faubion, Brooke M Faught, Sharon J Parish, James A Simon, Linda Vignozzi, Kristin Christiansen, Susan R Davis, Murray A Freedman, Sheryl A Kingsberg, Paraskevi-Sofia Kirana, Lisa Larkin, Marita McCabe, Richard Sadovsky
The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines...
March 9, 2018: Mayo Clinic Proceedings
L Gao, H Zuo, T Zheng, W Xue, Y Wang, Y Deng, A Sun
OBJECTIVE: To evaluate the prevalence of breast tenderness in a population treated with menopausal hormone therapy (MHT) or Cimicifuga foetida extract. METHODS: A prospective, randomized, controlled trial was conducted. Ninety-six postmenopausal women were randomly assigned to three groups: group A, 1 mg estradiol valerate daily plus 4 mg medroxyprogesterone acetate (MPA), days 19-30; group B, 1 mg estradiol valerate daily plus 100 mg micronized progesterone (MP), days 19-30; group C, 100 mg C...
March 15, 2018: Climacteric: the Journal of the International Menopause Society
Cmg van Driel, A S Stuursma, M J Schroevers, Mje Mourits, G H de Bock
BACKGROUND: During menopause women experience vasomotor and psychosexual symptoms that cannot entirely be alleviated with hormone replacement therapy (HRT). Besides, HRT is contraindicated after breast cancer. OBJECTIVES: To review the evidence on the effectiveness of psychological interventions in reducing symptoms associated with menopause in natural or treatment-induced menopausal women. SEARCH STRATEGY: Medline/Pubmed, PsycINFO, EMBASE and AMED were searched until June 2017...
March 15, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
James H Pickar, Matthieu Boucher, Diana Morgenstern
OBJECTIVE: This review describes historical development of selective estrogen receptor modulators (SERMs) and their combination with estrogens, termed a tissue selective estrogen complex (TSEC), and considers the potential for future TSEC development. METHODS: This narrative review is based on literature identified on PubMed and the TSEC research and development experience of the authors. RESULTS: SERMs have estrogenic and antiestrogenic effects in various tissues; however, no single agent has achieved an optimal balance of agonist and antagonist effects for the treatment of menopausal symptoms...
March 12, 2018: Menopause: the Journal of the North American Menopause Society
Jessica R Zolton, Toral P Parikh, Dennis D Hickstein, Steven M Holland, Micah J Hill, Alan H DeCherney, Erin F Wolff
PURPOSE: To describe controlled ovarian stimulation (COS) in a population of women with GATA2 deficiency, a genetic bone marrow failure syndrome, prior to allogeneic hematopoietic stem cell transplant METHODS: This is a retrospective case series of nine women with GATA2 deficiency who underwent oocyte preservation at a research institution. Main outcomes measured include baseline fertility characteristics ((antimullerian hormone (AMH) and day 3 follicle-stimulating hormone (FSH) and estradiol (E2)) and total doses of FSH and human menopausal gonadotropins (HMG), E2 on day of trigger, and total number of metaphase II oocytes retrieved...
March 13, 2018: Journal of Assisted Reproduction and Genetics
J Niro, P Panel
OBJECTIVE: In women with symptomatic endometriosis and no desire for pregnancy, hysterectomy with or without bilateral oophorectomy is often presented as a definitive solution to their symptoms. Despite this radical treatment, it should be known that nearly 15% of these patients will have persistent pain. Thus the objective of this review was to determine the interest of total hysterectomy with or without bilateral oophorectomy for the treatment of deep endometriosis. METHOD: The research was conducted from the US National Library of Medicine's National Institutes of Health from the following keywords: endometriosis, hysterectomy, oophorectomy, ovariectomy, radical treatment...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Kavitha Vellanki, Susan Hou
Most women with dialysis-dependent chronic kidney disease (CKD) stage 5 (CKD stage 5D) are in the postmenopausal age group. Early menopause is reported for all CKD stages (stages 3-5D). The traditional definition of menopause is not applicable in CKD stage 5(D) because menses can resume with hormone replacement therapy or kidney transplantation. Treatment of vasomotor symptoms continues to be the primary indication for hormone replacement therapy, with no dosing studies done specifically for CKD or kidney transplantation populations...
March 9, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
D A Davey
Major advances in menopause hormone therapy (MHT) hold promise in the future of better and safer care for women at and after the menopause. The principal advances are: (1) the critical window or 'window of opportunity' in the 10 years or so after the menopause, during which the benefits of MHT in healthy women exceed any risks; (2) use of transdermal instead of oral administration of estrogen to reduce the risk of venous thromboembolism; (c) investigation of the use of oral micronized progesterone (MP) and vaginal MP to prevent endometrial hyperplasia and carcinoma without any increased risk of breast cancer and venous thromboembolism in postmenopausal women receiving estrogens; vaginal MP prevents endometrial proliferation in the short term but the long-term effects in MHT remain to be established; (4) investigation into the use of intrauterine levonorgestrel-releasing devices (LNG-IUDs), which are an attractive form of MHT in perimenopausal women, providing contraception and reducing uterine bleeding, although the risk of breast cancer with LNG-IUDs requires clarification...
March 11, 2018: Climacteric: the Journal of the International Menopause Society
Shanshan Shao, Zhenyu Yao, Jiayu Lu, Yongfeng Song, Zhao He, Chunxiao Yu, Xiaoming Zhou, Lifang Zhao, Jiajun Zhao, Ling Gao
Increasing prevalence of non-alcoholic fatty liver disease (NAFLD) worldwide has necessitated a more thorough understanding of it and expanded the scope of research in this field. Women are more resistant to NAFLD than men despite equal exposure to major risk factors, such as obesity or hyperlipidemia. Female resistance is hormone-dependent, as evidenced by the sharp increase in NAFLD incidence in post-menopausal women who do not take hormone replacement therapy. Here, we found that the estrogen-responsive pituitary hormone prolactin (PRL), through specific PRL receptor (PRLR), down-regulates hepatic triglyceride (TG) accumulation...
March 7, 2018: Biochemical and Biophysical Research Communications
Katherine Ward, Angela Deneris
Menopause-related symptoms frequently lead women to seek health care. Recommendations for prescribing hormone therapy have changed significantly since the publication of initial results from the Women's Health Initiative (WHI) study in 2002. The North American Menopause Society and the American College of Obstetricians and Gynecologists have newer guidelines based on long-term analyses of the WHI participants as well as emerging data from other clinical trials. Women with an intact uterus who are using systemic estrogen must also use a progestogen; however, there are 2 new selective estrogen receptor modulators on the market for use without a progestogen...
March 9, 2018: Journal of Midwifery & Women's Health
M A Hipolito Rodrigues, L Maitrot-Mantelet, G Plu-Bureau, A Gompel
Migraine is a common, disabling and incapacitating headache disorder that may be triggered by many factors, such as hormones especially during the perimenopausal period, where large alterations in estradiol levels can occur. The evidence implies that hormonal fluctuations are one of the important triggers of migraine. During reproductive life and during hormonal contraception, the course of migraine can be impacted. Different types of migraine with and without aura can be variously influenced by hormones. Migraine can constitute a risk factor for stroke and this must be taken in account for menopause hormone therapy...
March 9, 2018: Climacteric: the Journal of the International Menopause Society
V A Levin, X Jiang, R Kagan
Menopause predisposes women to osteoporosis due to declining estrogen levels. This results in a decrease in bone mineral density (BMD) and an increase in fractures. Osteoporotic fractures lead to substantial morbidity and mortality, and are considered one of the largest public health priorities by the World Health Organization (WHO). It is therefore essential for menopausal women to receive appropriate guidance for the prevention and management of osteoporosis. The Women's Health Initiative (WHI) randomized controlled trial first proved hormonal therapy (HT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women...
March 8, 2018: Osteoporosis International
Mihir M Sanghvi, Nay Aung, Jackie A Cooper, José Miguel Paiva, Aaron M Lee, Filip Zemrak, Kenneth Fung, Ross J Thomson, Elena Lukaschuk, Valentina Carapella, Young Jin Kim, Nicholas C Harvey, Stefan K Piechnik, Stefan Neubauer, Steffen E Petersen
BACKGROUND: The effect of menopausal hormone therapy (MHT)-previously known as hormone replacement therapy-on cardiovascular health remains unclear and controversial. This cross-sectional study examined the impact of MHT on left ventricular (LV) and left atrial (LA) structure and function, alterations in which are markers of subclinical cardiovascular disease, in a population-based cohort. METHODS: Post-menopausal women who had never used MHT and those who had used MHT ≥3 years participating in the UK Biobank who had undergone cardiovascular magnetic resonance (CMR) imaging and free of known cardiovascular disease were included...
2018: PloS One
Sultana Monira Hussain, Yuanyuan Wang, Graham G Giles, Stephen Graves, Anita E Wluka, Flavia M Cicuttini
OBJECTIVES: To examine the associations of female reproductive and hormonal factors with incidence of total knee arthroplasty (TKA) for osteoarthritis, and whether the associations differ according to overweight/obesity status. DESIGN: This study included 22,289 women in the Melbourne Collaborative Cohort Study. Data on age at menarche, pregnancy, parity, years of menstruation, oral contraceptive pill (OCP), menopausal status and hormone replacement therapy (HRT) were collected in 1990-1994...
March 7, 2018: Arthritis & Rheumatology
Alex Tsui, Diana Kuh, Linda Cardozo, Daniel Davis
OBJECTIVE: To investigate the prevalence of urgency urinary incontinence (UUI) at age 68 years and the contribution of vascular risk factors to male and female UUI pathogenesis in addition to the associations with raised body mass index (BMI). SUBJECTS AND METHODS: In all, 1 762 participants from the Medical Research Council (MRC) National Survey for Health and Development birth cohort who answered the International Consultation on Incontinence Questionnaire short form (ICIQ-SF), at age 68 years, were included...
March 7, 2018: BJU International
Marzana Chowdhury, David Euhus, Maureen O'Donnell, Tracy Onega, Pankaj K Choudhary, Swati Biswas
PURPOSE: Increased mammographic breast density is a significant risk factor for breast cancer. It is not clear if it is also a risk factor for the development of contralateral breast cancer. METHODS: The data were obtained from Breast Cancer Surveillance Consortium and included women diagnosed with invasive breast cancer or ductal carcinoma in situ between ages 18 and 88 and years 1995 and 2009. Each case of contralateral breast cancer was matched with three controls based on year of first breast cancer diagnosis, race, and length of follow-up...
March 6, 2018: Breast Cancer Research and Treatment
Edward L Melanson, Kate Lyden, Ellie Gibbons, Kathleen M Gavin, Pamela Wolfe, Margaret E Wierman, Robert S Schwartz, Wendy M Kohrt
PURPOSE: To determine the effects of 5 months of ovarian hormone suppression in pre-menopausal women on objectively measured physical activity (PA). METHODS: Participants (age = 35±8 yr; body mass index = 27±6 kgm) received monthly intramuscular injections of gonadotropin releasing hormone agonist therapy (GnRHAG) which suppresses pituitary gonadotropins and results in suppression of ovarian sex hormones. Women were randomized to receive concurrent transdermal E2 (GnRHAG+E2; n=30) or placebo (GnRHAG+PL, n=31)...
March 5, 2018: Medicine and Science in Sports and Exercise
Riina Katainen, Janne R Engblom, Päivi Polo-Kantola
OBJECTIVE: Only a few extended follow-up studies have investigated the natural progress of climacteric-related symptoms. The results have been conflicting. Thus, our aim was to evaluate, through a 19-year longitudinal study, whether these symptoms decrease or disappear as time elapses after menopause. METHODS: Our study was a prospective follow-up survey of 65 hysterectomized peri or postmenopausal women. The women were interviewed at the baseline, and at 6 and 19 years thereafter...
March 5, 2018: Menopause: the Journal of the North American Menopause Society
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