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transdermal estrogen therapy

Nanette Santoro, Amanda Allshouse, Genevieve Neal-Perry, Lubna Pal, Rogerio A Lobo, Frederick Naftolin, Dennis M Black, Eliot A Brinton, Matthew J Budoff, Marcelle I Cedars, N Maritza Dowling, Mary Dunn, Carey E Gleason, Howard N Hodis, Barbara Isaac, Maureen Magnani, JoAnn E Manson, Virginia M Miller, Hugh S Taylor, Whitney Wharton, Erin Wolff, Viola Zepeda, S Mitchell Harman
OBJECTIVE: The objective of the present study was to compare the efficacy of two forms of menopausal hormone therapy in alleviating vasomotor symptoms, insomnia, and irritability in early postmenopausal women during 4 years. METHODS: A total of 727 women, aged 42 to 58, within 3 years of their final menstrual period, were randomized to receive oral conjugated estrogens (o-CEE) 0.45 mg (n = 230) or transdermal estradiol (t-E2) 50 μg (n = 225; both with micronized progesterone 200 mg for 12 d each mo), or placebos (PBOs; n = 275)...
October 24, 2016: Menopause: the Journal of the North American Menopause Society
Jelena Osmanovic-Barilar, Melita Salkovic-Petrisi
Hormone therapy (HT) is prescribed during or after menopausal transition to replace the decline in estrogen and progesterone levels. While some studies indicate that estrogen and progesterone depletion in postmenopausal women might carry a significant risk for developing sporadic Alzheimer's disease (sAD), which may be reduced by HT, recent clinical trials oppose this beneficial effect. This review points to possible reasons for these mixed data by considering the issues of both preclinical and clinical trials, in particular, the representativeness of animal models, timing of HT initiation, type of HT (different types of estrogen compounds, estrogen monotherapy vs...
October 6, 2016: Drugs & Aging
Emily A Southmayd, Mary Jane De Souza
Bone growth, development, and remodeling are modulated by numerous circulating hormones. Throughout the lifespan, the extent to which each of the hormones impacts bone differs. Understanding the independent and combined impact of these hormones on controlling bone remodeling allows for the development of more informed decision making regarding pharmacology, specifically the use of hormonal medication, at all ages. Endocrine control of bone health in women is largely dictated by the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis and the hypothalamic-pituitary-ovarian (HPO) axis...
September 13, 2016: Growth Hormone & IGF Research
Kejal Kantarci, Nirubol Tosakulwong, Timothy G Lesnick, Samantha M Zuk, Jeffrey L Gunter, Carey E Gleason, Whitney Wharton, N Maritza Dowling, Prashanthi Vemuri, Matthew L Senjem, Lynne T Shuster, Kent R Bailey, Walter A Rocca, Clifford R Jack, Sanjay Asthana, Virginia M Miller
OBJECTIVE: To investigate the effects of hormone therapy on brain structure in a randomized, double-blinded, placebo-controlled trial in recently postmenopausal women. METHODS: Participants (aged 42-56 years, within 5-36 months past menopause) in the Kronos Early Estrogen Prevention Study were randomized to (1) 0.45 mg/d oral conjugated equine estrogens (CEE), (2) 50 μg/d transdermal 17β-estradiol, or (3) placebo pills and patch for 48 months. Oral progesterone (200 mg/d) was given to active treatment groups for 12 days each month...
August 30, 2016: Neurology
Dahima Cintron, Rene Rodriguez-Gutierrez, Valentina Serrano, Paula Latortue-Albino, Patricia J Erwin, Mohammad Hassan Murad
Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency. Hence, long-term estrogen replacement therapy is the cornerstone treatment. The estimates of its effect and optimal use, however, remain uncertain. We aimed to summarize the benefits and harms of estrogen replacement therapy on bone, cardiovascular, vasomotor and quality of life outcomes in patients with Turner syndrome. A comprehensive search of four databases was performed from inception through January 2016...
July 29, 2016: Endocrine
Carter M Owen, Lubna Pal, Sunni L Mumford, Ruth Freeman, Barbara Isaac, Linda McDonald, Nanette Santoro, Hugh S Taylor, Erin F Wolff
OBJECTIVE: To measure skin wrinkles and rigidity in menopausal women of varying race/ethnicity with or without hormone therapy (HT) for up to four years. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Academic medical centers. PATIENT(S): Women (42-58 years of age) within 36 months of last menstrual period and enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). INTERVENTION(S): Treatment with 0...
October 2016: Fertility and Sterility
Maciej Lesiak, Ropacka-Lesiak Mariola, Natalia Podkowa
The results of large randomized trials such as the Women's Health Initiative (WHI), Heart and Estrogen / Progestin Replacement Study (HERS) or Estrogen Replacement and Atherosclerosis Study (ERAS) as well as the Million Women Study (MWS) which does not meet criteria RCT, concerning, among others the impact of HRT on breast cancer risk, thromboembolism, or the aging processes in the central nervous system caused the recent big confusion in the medical community , causing distrust about the safety and advisability of HRT in menopausal women...
2016: Ginekologia Polska
Ann M Moyer, Mariza de Andrade, Richard M Weinshilboum, Virginia M Miller
OBJECTIVE: Onset and symptoms of menopause, and response to hormone therapy (HT) show large interindividual variability. SULT1A1 encodes for a highly expressed enzyme that metabolizes estrogens. We evaluated the relationship between genetic variation in SULT1A1, menopause age, symptoms, and response to HT. METHODS: Women enrolled in the Kronos Early Estrogen Prevention Study at Mayo Clinic were randomized to 48 months of treatment with oral conjugated equine estrogen (n = 34), transdermal 17β-estradiol (E2) (n = 33), or placebo (n = 35)...
August 2016: Menopause: the Journal of the North American Menopause Society
P Stute, J Neulen, L Wildt
Postmenopausal women with an intact uterus using estrogen therapy should receive a progestogen for endometrial protection. International guidelines on menopausal hormone therapy (MHT) do not specify on progestogen type, dosage, route of application and duration of safe use. At the same time, the debate on bioidentical hormones including micronized progesterone increases. Based on a systematic literature review on micronized progesterone for endometrial protection, an international expert panel's recommendations on MHT containing micronized progesterone are as follows: (1) oral micronized progesterone provides endometrial protection if applied sequentially for 12-14 days/month at 200 mg/day for up to 5 years; (2) vaginal micronized progesterone may provide endometrial protection if applied sequentially for at least 10 days/month at 4% (45 mg/day) or every other day at 100 mg/day for up to 3-5 years (off-label use); (3) transdermal micronized progesterone does not provide endometrial protection...
August 2016: Climacteric: the Journal of the International Menopause Society
Marianne Canonico, Laure Carcaillon, Geneviève Plu-Bureau, Emmanuel Oger, Archana Singh-Manoux, Pascale Tubert-Bitter, Alexis Elbaz, Pierre-Yves Scarabin
BACKGROUND AND PURPOSE: The benefit/risk analysis of hormone therapy in postmenopausal women is not straightforward and depends on cardiovascular disease. Evidence supports the safety of transdermal estrogens and the importance of progestogens for thrombotic risk. However, the differential association of oral and transdermal estrogens with stroke remains poorly investigated. Furthermore, there are no data regarding the impact of progestogens. METHODS: We set up a nested case-control study of ischemic stroke (IS) within all French women aged 51 to 62 years between 2009 and 2011 without personal history of cardiovascular disease or contraindication to hormone therapy...
July 2016: Stroke; a Journal of Cerebral Circulation
L H A da Silva, D G Panazzolo, M Ferreira Marques, M G C Souza, B Dias Paredes, J F Nogueira Neto, L M C S M Leão, V Morandi, E Bouskela, L G Kraemer-Aguiar
OBJECTIVE: We aimed to investigate the effects of low-dose transdermal estrogen on endothelial and inflammatory biomarkers in menopausal overweight/obese women. METHODS: We recruited 44 menopausal women (47-55 years; body mass index 27.5-34.9 kg/m(2)) and divided them into estradiol (1 mg/day; n = 22) or placebo groups (n = 22). They were double-blinded, followed and treated for 3 months. At baseline and post-intervention, inflammatory biomarkers (hs-CRP, IL-1β, IL-6, MCP-1 and TNF-α) and of vascular injury (activated circulating endothelial cells, CEC-a) and repair (endothelial progenitor cells, EPC) were quantified...
August 2016: Climacteric: the Journal of the International Menopause Society
Kejal Kantarci, Val J Lowe, Timothy G Lesnick, Nirubol Tosakulwong, Kent R Bailey, Julie A Fields, Lynne T Shuster, Samantha M Zuk, Matthew L Senjem, Michelle M Mielke, Carey Gleason, Clifford R Jack, Walter A Rocca, Virginia M Miller
BACKGROUND: It remains controversial whether hormone therapy in recently postmenopausal women modifies the risk of Alzheimer's disease (AD). OBJECTIVE: To investigate the effects of hormone therapy on amyloid-β deposition in recently postmenopausal women. METHODS: Participants within 5-36 months past menopause in the Kronos Early Estrogen Prevention Study, a randomized, double blinded placebo-controlled clinical trial, were randomized to: 1) 0...
May 7, 2016: Journal of Alzheimer's Disease: JAD
Annica Bergendal, Helle Kieler, Anders Sundström, Angelica Lindén Hirschberg, Ljiljana Kocoska-Maras
OBJECTIVE: The aim of the study was to assess the risk of venous thromboembolism (VTE) associated with systemic hormone therapy according to type and to route of administration and the risk of VTE associated with locally administered estrogen. METHODS: In this case-control study, conducted in Sweden between 2003 and 2009, we included 838 cases of VTE and 891 controls with a mean age of 55 years. Controls were matched by age to the cases and randomly selected from the population...
June 2016: Menopause: the Journal of the North American Menopause Society
T Fait
OBJECTIVE: To show possibilities of new application method of estrogen replacement therapy - mettered-dose transdermal spray. DESIGN: Review articleResults: Transdermal spray contains 1.53 mg estradiol in one dose. It gives possibility of individual aproach in estradiol application 1, 2 or 3 doses daily. About 85% of patients showed the significant reduction of hot flushes. Perfect safety profile is predicted especially in cardiovascular point.
January 2016: Ceská Gynekologie
James A Simon, François Laliberté, Mei Sheng Duh, Dominic Pilon, Kristijan H Kahler, Judit Nyirady, Pamela J Davis, Patrick Lefebvre
OBJECTIVE: To evaluate the risk of venous thromboembolism (VTE) and cardiovascular disease (CVD) complications, and assess healthcare costs in menopausal women using an estradiol transdermal system versus oral estrogen therapy (ET). METHODS: Health insurance claims from 60 self-insured US companies from 1999 to 2011 were analyzed. Women at least 50 years of age, newly initiated on transdermal or oral ET, were included. Cohorts were matched 1:1 based on exact factors and propensity score-matching methods...
June 2016: Menopause: the Journal of the North American Menopause Society
Jenny Pena Dias, Denise Melvin, Michelle Shardell, Luigi Ferrucci, Chee W Chia, Mohsen Gharib, Josephine M Egan, Shehzad Basaria
Results of this trial suggest that the tropic effects of testosterone on the prostate are mediated via its aromatization to estradiol.
April 2016: Journal of Clinical Endocrinology and Metabolism
Shota Nii, Koichi Shinohara, Hiroshi Matsushita, Yasuyuki Noguchi, Kazushi Watanabe, Akihiko Wakatsuki
AIM: Hepatic effects of estrogen therapy on low-density lipoprotein (LDL) subfraction or oxidative stress have not been previously evaluated. The purpose of the present study was to investigate whether the differential hepatic effects of estrogen affect plasma distribution of small dense LDL and free radical production in postmenopausal women. METHODS: In all, 45 postmenopausal women were given 0.625 mg/day of oral conjugated equine estrogen (CEE) (n=15), 1.0 mg/day of oral 17β estradiol (E2) (n=15), or 50 μg/day of transdermal 17βE2 (n=15) for 3 months...
July 1, 2016: Journal of Atherosclerosis and Thrombosis
Yu-Ling Lin, Chia-Hung Chen, Hsin-Yi Wu, Nu-Man Tsai, Ting-Yan Jian, Yuan-Ching Chang, Chi-Hsin Lin, Chih-Hsiung Wu, Fei-Ting Hsu, Ting Kai Leung, Kuang-Wen Liao
BACKGROUND: Tamoxifen is currently used for the treatment of both early and advanced estrogen receptor (ER) positive breast cancer in pre- and post-menopausal women. However, using tamoxifen routinely to inhibit endogenous or exogenous estrogen effects is occasionally difficult because of its potential side effects. OBJECTIVES: The aim of this study is to design a local drug delivery system to encapsulate tamoxifen for observing their efficacy of skin penetration, drug accumulation and cancer therapy...
2016: Journal of Nanobiotechnology
Agnieszka Rajtar-Ciosek, Olga Kacalska-Janssen, Andrzej Zmaczyński, Jakub Wyroba, Rita Tomczyk, Joanna Wiatr, Anna Gałuszka-Bednarczyk, Tomasz Bereza, Tomasz Milewicz, Józef Krzysiek
INTRODUCTION: In current literature, the immune-inflammatory theory of atherosclerosis is widely discussed. The role of how heat shock proteins 60 (HSP60) lead to the development of the atheromatous plaque is especially underlined. The aim of the study is to estimate the influence of three hormonal protocols on behavior of antibodies against HSP60. It determines the state of endothelium in postmenopausal women. MATERIAL AND METHODS: The study was carried out on 90 women between 2007 and 2012...
December 2015: Przeglad Menopauzalny, Menopause Review
Miriam Reuter, Martin Fassnacht
Despite several studies in the last years, only women with menopausal symptoms who desire therapy are treated. There is still no recommendation for menopausale hormone therapy for primary prevention of diseases such as coronary artery disease, osteoporosis or depression. The risk of thrombosis, pulmonary embolism and stroke is elevated especially for elderly women with oral hormone therapy. Benefits may exceed risks in younger, early-menopausal women, for whom hormone therapy may be prescribed more liberally...
February 2016: Deutsche Medizinische Wochenschrift
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