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4380
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Age at the menopause and onset of the climacteric in women of Martin District, Czechoslovkia. Statistical survey and some biological and social correlations.
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In this study, 6877 women were analysed whose ages ranged between 38 and 58 (born between 1909 and 1929) and who had had no artificial menopause. This is 88.04% of the total female population in this actual period of life, living in Martin District in 1967. The mean age at the menopause was found, by status quo method, to be 51.21 years (standard deviation 4.4), and by the method of weighted arithmetical means, 48.81 years, (standard deviation 3.9). The mean age at the onset of the climacteric, calculated by the same methods, was 47.55 years, or 46.74 years, respectively. The mean age at menarche was 14.6 years. The average birth-rate was 2.8. The mean period of fertility for the series as a whole was 36.6 years. Women with menstrual disturbances had their menopause about 1 year earlier. We have noted a similar tendency in nulliparas and primiparas. We could find no great difference in the age at menopause between those who had had an early or a late menarche. Menstrual disturbances also influenced the onset of the climacteric. It was at least one year earlier than with regular menstruation. Age at menarche and parity had no effect on the age at the onset of climacteric. Women working in agriculture and housewives had their menopause a little later than mean age of the series, whereas manual workers and those in other occupational categories had their menopause and onset of the climacteric about 1 year earlier. Furthermore, single women had their menopause about one year earlier than the married ones. Widows had their menopause twice so often as the married women and they got it very soon after the husbands's death.
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69066
|
Relation between smoking and age of natural menopause. Report from the Boston Collaborative Drug Surveillance Program, Boston University Medical Center.
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The relation of cigarette smoking to natural menopause has been evaluated in two independent sets of data. In both, at each age from 44 to 53 years, more current smokers were post-menopausal compared to "never" smokers. In the first set of data the age-standardised proportions of women who were postmenopausal were 35, 36, 43, and 49%, respectively, for never smokers, ex-smokers, and current smokers of 1/2 and greater than or equal to 1 pack per day. The corresponding proportions for the second set were 53, 59, 60 and 65%.
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74218
|
[Histochemical investigations of the biomorphosis of the tube epithelium in the postmenopause and in the senium (author's transl)].
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Probes of tube of 21 women in the age of 50-83 years old were investigated with histochemical techniques for detection of mucosubstances. It was found that the regressive changes in the tube epithelium run down by degrees. In the high age there is still evidenced some PAS-reactivity and alcianophilia.
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74610
|
Smoking and industrial pollution, and their effects on menopause and ovarian cancer.
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The rodent ovary contains an enzyme system(s) capable of metabolising poly-cyclic aromatic hydrocarbons to reactive electrophilic intermediates known to cause cytotoxicity, mutation, and cancer. If the human ovary contains similar enzyme systems, metabolic activation of environmental chemicals could explain the earlier menopause in cigarette smokers and the higher incidence of ovarian cancer in industrialised areas.
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75706
|
Management of the Menopause.
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Menopause is merely a clinically discernible clue symbolic of the multitude of changes preceding or following the cessation of menses by many years. Because of the time span involved, separating changes observed in the menopausal transition from other age-related maturational events presents serious methodologic problems. Of the host of psychologic and psychosomatic symptoms, only hot flushes and associated sweats occur more frequently in this epoch, while an interplay between hormonal and age-related maturational events presents serious methodologic problems. Of the host of psychologic and psychosomatic symptoms, only hot flushes and associated sweats occur more frequently in this epoch, while an interplay between hormonal and age-related effects is assumed in atrophic changes involving the genitourinary organs. The relation between menopause and osteoporosis is suggestive but by no means proven, as is the risk for cardiovascular disease. Empiric evidence points to the usefullness of estrogen for the management of vasomotor instability, the symptoms associated with atrophy of the genitourinary tract, and in the prophylaxis of osteoporosis, but not in the treatment of anxiety, depression, and other psychiatric disorders.
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140032
|
Coagulation, oestrogen and the menopause.
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The objective of oestrogen replacement therapy in the menopause is the prevention of pathology attributable to oestrogen lack. Care should be taken to ensure that such therapy is free from harmful side effects. To date, there have been no long-term longitudinal studies or clinical reports that have positively identified oestrogen usage in "normal" postmenopausal women, with inappropriate thrombosis directly attributable to an oestrogen-induced alteration in the coagulation mechanism. This is surprising since certain coagulation factors change and the peripheral blood flow decreases in the elderly, predisposing them to enhanced clot formation. There is also the well-documented (but controversial) association between oestrogens, oral contraceptives and thrombosis. Whether this paradox can be explained by differences in the type and/or potency of the oestrogens used in ORT, remains to be determined. At present it may be concluded that ORT per se does not place the postmenopausal women at greater risk from developing arterio-venous thrombosis.
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184538
|
[Calcium metabolism after the menopause].
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The authors recall the antagonism between estradiol and parathormone. Estradiol tends to lower serum calcium and fix calcium in the bones as shown by one of us 25 years ago. The mechanism of this action of estrogen on calcium metabolism has been determined by numerous authors but some points are still not clear, e.g. the interferences between estrogen and calcitonin. Classically, parathormone is known to increase bony reabsorption and raise serum calcium. After the menopause the gradual reduction in estradiol secretion leads to post-menopausal osteoporosis. It is better to administer estrogens prophylactically to women after the menopause provided a cervical smear and mammography have been carried out to eliminate latent carcinoma of the breast or uterine cervix.
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190701
|
[Treatment of the menopause].
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The immediate complications of the menopause should be treated. These symptoms must be due to the menopause and the treatment should be without side effects. The object is above all to obtain a sense of well-being. More important than the immediate signs are the later trophic disorders, whether local or general. Thus a long term substitution treatment may be considered under strict supervision.
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197509
|
Estrogens for the menopause. Maximizing benefits, minimizing risks.
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There is a definite place for estrogen replacement in symptomatic menopausal women. Requisites of such therapy are a through history to establish a real need, a complete gynecologic examination with a Pap smear before therapy begins and annually afterward, use of the smallest daily dose of estrogen that gives the desired effect, and periodic attempts to reduce the dosage or stop the hormone. Endometrial biopsy should be done regularly if this is feasible, and any uterine bleeding should be investigated. If the suggestions outlined are followed, maximal benefit can be achieved with minimal risk to the patient.
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219937
|
Relation between plasma hormone profiles, symptoms, and response to oestrogen treatment in women approaching the menopause.
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Out of a consecutive series of 300 patients seen at a menopause clinic, 82 complained of symptoms generally associated with the climacteric, although they were still menstruating. Vasomotor disturbances were absent in 42 of these patients (group 1) and present in 40 (group 2). Headaches, insomnia, and dyspareunia were the most common complaints among the women with vasomotor symptoms, whereas loss of libido and depression predominated in those without. Conjugated equine oestrogens (Premarin) 1.25 mg daily given for three weeks out of four relieved nearly all symptoms in group 2, but in group 1 the response was disappointing. The mean plasma oestradiol concentration in women with vasomotor symptoms was significantly lower than that observed during days 1-10 of the menstrual cycle, but plasma testosterone values were not significantly different from those observed in younger women. Plasma follicle-stimulating hormone (FSH) and luteinising hormone (LH) concentrations were similar to those seen after the menopause. Concentrations of these hormones in the women without vasomotor symptoms were similar to those in the younger, regularly menstruating women. After six months of oestrogen treatment patients in group 2 had a 2.1-fold increase in mean plasma oestradiol concentration, and plasma FSH and LH concentrations were reduced to 39% and 66% of their pretreatment values respectively; in group 1, however, no such pronounced changes occurred. High concentrations of FSH were present in patients with oestrogen-responsive symptoms, 15 U/1 being the diagnostic cut-off point. This measurement in the presence of characteristic symptoms therefore constitutes the best method of selecting patients for oestrogen-replacement therapy.
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224354
|
Premature menopause: a reversible entity?
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Secondary hypergonadotropic, hypoestrogenic amenorrhea, or premature menopause, is usually considered an irreversible process. Four patients with this entity were observed to have evidence of ovulation. Three of these patients became pregnant while they were treated with estrogen replacement therapy (ERT) for their hypoestrogenic symptoms. Estrogen replacement may be effective in reversal of this process.
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228157
|
Plasma concentrations of unconjugated and conjugated estrogens and gonadotrophins following application of various estrogen preparations after oophorectomy and in the menopause.
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In 55 patients after oophorectomy and 20 women after natural menopause an oral estrogen replacement therapy was performed with estrone-sulfate, estradiol 17-valerate, estriol-succinate, a combination of micronized estradiol and estriol (Estrifam, Trisequens), and natural conjugated estrogens. In 4 patients a 3 mg estradiol per 5 g ointment substance was applied on the abdominal skin. The interindividual variations of estrogen increments during therapy were considerably high. Oral intake of 2 mg estriol-succinate daily was followed by a 500% increase of total (conjugated + unconjugated) estriol. Concentrations of unconjugated estrogens were not altered by this dosage. Following oral application of the other above mentioned preparations, prominent rises--especially of unconjugated estrogens in plasma--were noted. The concentration peaks occurred within 3--6 h after application. Unconjugated estradiol-17 beta in plasma was comparable with values of the follicular phase of a normal menstrual cycle, unconjugated estrone, however, was nonphysiologically high. Consequently, the E1/E2 ratio was greater than one whereas it is normally below one. 12 h after oral estrogen application, plasma estrogens dropped to almost initial values, so that a second medication seems to be necessary in order to guarantee an adequate supplementation over the course of the day. The hormone values determined in this study did not show significant differences between patients after a natural menopause and after oophorectomy. There was a positive correlation between rising estrogen levels and suppressed gonadotrophins during replacement therapy. The occurrence of climacteric symptoms did not exclusively depend on low estrogen and high gonadotrophin levels. Good tolerance of estrogen therapy with significantly elevated estrogen concentrations in plasma can be obtained transcutaneously in the form of estrogen ointments. Such therapy might simulate the physiological estrogen pattern even better than oral application does because of delayed and diluted steroid flow to the liver.
|
233111
|
Changes in psychological well-being during postmenopause as a result of estrogen therapy.
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A study of the effects of a conjugated estrogen (Femipren) upon various climacteric symptoms, depression and anxiety scores and psycho-social factors in 120 women around the menopause, was carried out in a Menopause Clinic. In order to participate in this study, the women had to meet very strict criteria. A climacteric symptom list, the MMPI and a psycho-social questionnaire were used for assessment, and were employed before, during and at the end of 1 yr of hormone replacement therapy. Typical vasomotor and psychic symptoms changed significantly as did such factors as self-image, optimism, perception of the future and satisfaction with personal appearance, in those patients who received hormonal replacement therapy for 1 yr. As the psychological factors changed only in those patients who received long-term estrogen therapy, a tentative hypothesis of direct psychotropic effect of estrogen was formulated.
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258817
|
Psychological aspects of menopause.
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There are no psychological symptoms specific to menopause, though minor psychological complaints such as irritability may increase in women aged 45 to 55. These symptoms seem to be related to psychosocial stress, social class, or cultural group rather than to hormone imbalance alone. Management requires careful assessment of the medical as well as the psychosocial situation.
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264163
|
Age at menarche and menopause of uterine cancer patients.
|
An investigation was undertaken of the ages at menarche and at menopause of cervical and endometrial cancer patients for the years 1950-55 and 1960-65. Analysis of the ages at menarche in relation to the year of birth did not show a difference between the uterine cancer groups, whereas the age at menopause did show such a difference. The menopause occurred later in the endometrial than in the cervical cancer group. There was an earlier mean age at menarche and a later mean age at menopause per decade. Therefore, the menopause seems a constitutional factor involved in the development of endometrial cancer and perhaps also cervical cancer.
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264752
|
Vaginal cytology in the postmenopause. A study into some correlates.
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A considerable number of women continue to have proliferative vaginal smears indicating a certain level of endogenous estrogen production. Some correlates of this were studied. No significant correlation was found with age since menopause or with overweight. No correlation was found between the proliferation of the vaginal smear and climacteric complaints, circulatory or nervous. The implications of a proliferative smear for the postmenopausal woman and of the postmenopausal estrone production are briefly discussed. They appear at least to be ambiguous, because, although they protect against some facets of the estrogen deficiency syndrome, the factors which are correlated to a high level of endogenous estrone production are known as risk factors, predisposing for a higher incidence of uterine bleedings and perhaps malignant degeneration of some target cell tissues.
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266332
|
Cytologic evaluation of the effect of various estrogens given in postmenopause.
|
The cytologic evaluations of the hormonal (mainly estrogenic) treatment of 263 postmenopausal women are presented. Though estriol has a considerably weaker action than estradiol derivatives (and especially ethinyl estradiol) it has to be recommended for the oral treatment of local changes due to atrophy since this steroid is effective at the vaginal level in doses three to five times smaller than those necessary to induce endometrial proliferation.
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269627
|
The perception of menopause in five ethnic groups in Israel.
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An investigation was made into the menopausal symptoms and attitudes of 1, 148 Israeli women of five different ethnic origins. The results show that, while some of the somatic menopausal symptoms are independent of ethnic origin, psychic and psychosomatic symptoms are more closely associated with this variable. Similarly, attitudes to the climacteric vary across cultural origins, especially with regard to husband-wife relationships. This study underlines the necessity of a multi-factorial, biological, sociological, psychological and anthropological approach to problems of menopause.
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283784
|
Clinical features and plasma hormone levels after surgical menopause.
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This study reports the plasma levels of follicle stimulating hormone, luteinising hormone, oestradiol and testosterone in 43 women who had undergone bilateral oöphorectomy. Age was the only variable of those investigated which appeared to influence a hormone level; testosterone levels were found to decrease with increasing age. Two significant associations were found between clinical features of the menopause and the plasma hormone levels measured. Low levels of oestradiol were associated with pruritus vulvae and high levels of testerone were associated with headaches.
|
299558
|
Age at menopause in relation to reproductive history in Japanese, Caucasian, Chinese and Hawaiian women living in Hawaii.
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A multiple regression analysis was undertaken to examine the relationship between age at menopause and selected biological and sociological variables in the reproductive history of Caucasian, Japanese, Chinese and part-Hawaiian post-menopausal women living in Hawaii. The analysis was conducted using the medical history records of 196 Caucasian, 181 Japanese, 72 Chinese and 60 Hawaiian women. Age at menarche, parity and months spent breast-feeding were found to have no significant effect on age at menopause. Regression models were not found to be heterogeneous among ethnic groups and no substantial interaction of ethnic group was found with age at menarche, parity or months spent breast-feeding.
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302162
|
Plasma lipid changes in the female in aging and the menopause. Results from three population studies.
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Postabsorbtive plasma lipid levels have been analyzed in studies of the female population in the Swedish city of Gothenburg. The population samples cover the ages 15, 23, 30, 38, 40, 45, 46, 50, 54, 60 and 70. In some groups data are available from both cross-sectional and prospective longitudinal studies. Cross-sectional studies showed a successive increase in total plasma cholesterol from 15 to 54 years of age. Longitudinal studies showed a further increase at least up to 60 years of age. The triglyceride level remained rather constant between 15 and 30 years of age, then increased but was again rather similar in the 40--50-year olds and reached the highest level in the 60- and 70-year samples. The total phospholipid curve was approximately parallel with the cholesterol curve at younger ages but nearer the cholesterol curve at higher ages. The composition of the plasma phospholipid fraction apparently changed at the ages around the menopause, mainly due to an increase in the proportions of lecithin and lysolecithin. Data available allowed considerations concerning possible influences on plasma lipids by age, by changes in dietary habits and body composition, as well as by gonadal steroid hormones.
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402812
|
Menopause in rhesus monkeys: model for study of disorders in the human climacteric.
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Hormonal and menstrual patterns were studied in rhesus monkeys 22 years of age or older. Sustained elevations of serum gonodotropins, low circulating levels of estradiol and progesterone, associated with oligomenorrhea or amneorrhea, were similar to changes reported for peri- and postmenopausal women. During the menopausal transition, pituitary FSH appears to be modulated independently of LH. These observations suggest that the rhesus monkey may be a suitable model for study of disorders afflicting women in the climacteric.
|
426019
|
Premature menopause. I. Etiology.
|
The premature menopause syndrome has been regarded as one of the organ-specific autoimmune disorders because circulating antibodies to ovarian tissue have been demonstrated. Fifteen women with spontaneous cessation of menses after initial menarche before they were 35 years old were seen between 1975 and 1977. Increased serum levels of gonadotropin and failure of estrogen secretion were documented. Serum from each woman was examined for antibodies to normal ovary. Proteins from ovaries of normal premenopausal women were extracted and iodinated with 125I. The labeled proteins were incubated with sera for 48 hours, after which goat antihuman gamma-globulin was added and allowed to incubate for 72 hours. The precipitate was washed and evaluated for radioactive label. The binding of antibodies increased in the sera of patients with the premature menopause syndrome, compared with the control sera. This suggests that the etiology of premature menopause may be mediated by circulating antibodies to ovarian tissue.
|
443240
|
Relationship of relevant factors of atherosclerosis to menopause in Japanese women.
|
The relationship of menopause to associated factors of atherosclerosis was investigated during October 1973 to December 1976. The subjects were 1674 premenopausal and 428 postmenopausal women aged 35 to 54, who were living in Toda city, an urban area of Japan. Serum cholesterol and triglyceride were higher in postmenopausal women than in premenopausal women. This trend was also observed in serum uric acid and blood hemoglobin. On the other hand, systolic and diastolic blood pressure and relative body weight had no consistent relationship to menopause.
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459543
|
[Tuberculous endometritis in the post-menopause].
|
During a period of 15 years, 71 cases of genital tuberculosis were diagnosed. Out of the two had postmenopausal tuberculous endometritis and were hospitalized for postmenopausal bleeding. The diagnosis was confirmed by the histological examination of the tissue obtained from the uterus.
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462847
|
[Use of hormone loading tests for assessing the source of hyperestrogenism and the functional state of the ovaries in breast cancer patients in menopause].
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The source of hyperestrogenia was ascertained in 12 patients by dexametasone-infecundin test, and the ovarian hormonal activity in 5 patients by dexametasone-choriogonin test. The source of hyperestrogenia was found to be the adrenal glands in 50%, ovaries--in 30% and the adrenal together with ovaries--in 20%. Ovarian hormonal activity was retained in 3 of 5 patients under examination. The response to the test concerned was changed in two of them. It is felt that application of hormonal stress tests will make it possible to get detailed indications to castration in menopausal patients with breast cancer.
|
463997
|
Identification of differing etiologies of clinically diagnosed premature menopause.
|
Investigations were performed in eight young women to determine if the findings of secondary amenorrhea and high follicle-stimulating hormone levels were due to primary ovarian follicular atresia or to other causes. Karyotypes were determined from both peripheral leukocytes and ovarian tissue; one woman had XXX/XX/XO mosaicism. Another woman had normal ovarian histology and probably had the "gonadotropin-resistant ovary syndrome." No autoimmune antibodies were detected, but one woman with myasthenia gravis also had ovarian histology that demonstrated primary ova and a developing follicle. Only five of eight women had primary ovarian follicular atresia, and two of the other three women had conditions theoretically compatible with subsequent pregnancy.
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469151
|
The vaginal flora after natural or surgical menopause.
|
A study was made of the cervical and upper vaginal flora in menopausal women, in an attempt to determine whether such women are predisposed to infections when undergoing gynecologic operations. The series comprised 72 women (age range, 44-80 years) classified as follows: a) 35 with a natural menopause, b) 18 with a surgical menopause induced by abdominal panhysterectomy, and c) 19 postmenopausal women after vaginal hysterectomy performed for genital prolapse. The vaginal flora of these menopausal women consisted predominantly of Gram-positive bacteria which, together with the Gram-negative bacteria, conformed to the normal pattern of microorganisms in the vagina. Such bacteria also are found in women of child-bearing age, but occasionally they can be pathogenic. Despite the inherent biohormonal changes of the memopause, expressed especially by the low estrogen level, 26.4 percent of the cultures in our study were sterile, even after major vaginal operations. Thus, the pattern of the vaginal flora, even though occasionally pathogen, should not be a contraindication to gynecologic surgical procedures in postmenopausal women. Even when vaginal cultures show the presence of these bacteria, it does not seem necessary to use prophylactic antibiotic and hormonal therapy routinely. Rather, it should be given selectively, depending upon the local state of the tissues and upon the postoperative course.
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469196
|
[A histological and hormonal study of 399 women near the menopause or with confirmed menopause (author's transl)].
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This work is concerned with 399 women who were either near the menopause or had had the menopause and on whom 476 hormone levels and 169 examinations of the endometrium had been carried out. It is possible to put the women into three groups. 13 p. 100 showed a diphasic cycle, with more or less normal ovarian function. Among the group of women whose cycle was not diphasic an appreciable number had normal oestrogenic activity, or were indeed hyperoestrogenic. The others were hypo-oestrogenic. Several facts can be derived from this study. Raised levels of E.2 can be found even when there is no cyclical activity and even in women who have raised levels of FSH. Normal ovarian function may be resumed several months after the menopause, although when the levels of FSH are raised the occurrence of the postmenopausal state would seem to be confirmed. The presence of hot flushes does not seem to correspond to a particular hormonal state. Marked differences seem to exist between the levels of the plasma hormones and the endometrial biopsy results. It is possible to have an atrophic endometrium with a raised level of oestradiol-17 beta, or on the other hand a polypoidal endometrium in women who are hypo-oestrogenic. The presence of levels of progesterone such as are found in a normal luteal phase does not indicate that the endometrium will necessarily be secretory. These contradictions cannot be resolved by studying the intra-cellular concentrations of the hormone receptors. The approach of the menopause is not always characterized by a progressive and continuous state of oestrogen deficiency or by hypophysial overactivity. This classical picture can be heavily shaded. All kinds of hormone profiles and responses by the receptor organs may be met and the clinician should be aware of these facts when he chooses therapy.
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484721
|
Midlife concerns of women: implications of the menopause.
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Midlife has received recent attention but is still difficult to define. Women's developmental phases are most appropriately understood as different from men's, with a complex integration of biological context, family development and roles, and individual development. Menopause has been considered a determining event, and a variety of symptoms have been attributed to menopausal changes. Emerging data indicate that menopause does not appear to be responsible for most of the symptoms. Midlife stresses are the result of a combination of personal, family, social, and biological variables, with postmenopausal development an important phase.
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502875
|
Age at menopause and its relation to osteoporosis.
|
As one phase of a comprehensive population study of women, bone density was determined in the third lumbar vertebra by dual photon absorptiometric technique. The method involves the use of two radionuclides, which both emit gamma radiation but with different energies (241Am with 59.6 keV and 137Cs with 662 keV). Women in three age strata were studied: 46, 54 and 62 yr. All women aged 46 were still menstruating, while the age strata 54 and 62 were subdivided into two groups: those who still menstruated or had been postmenopausal for a short time and those who had been postmenopausal for many years. The bone mineral content was higher in premenopausal or recently postmenopausal 54-yr-old women than in women of the same age who had been postmenopausal for a long time (P less than 0.01). A similar trend was found for women aged 62 (P less than 0.10). The differences could not be explained by differences in other factors studied, such as body weight, body height, smoking habits or physical activity. No significant differences were found when women with similar menopausal status in different age groups were compared.
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502876
|
Life stresses and depression in the menopause.
|
Research on the climacteric has largely concentrated on relationships between ovarian insufficiency, oestrogen deficiency, and climacteric symptoms. Little attention has been paid to those who have no symptoms. It is proposed, in addition to these relationships, that the life events of this period are significantly involved; and that resultant stress may contribute to oestrogen deficiency as opposed to physiologically normal postmenopausal oestrogen levels. In this preliminary study, two groups of women under conditions of relatively low stress and high stress were tested over a period of 15 mth. They were rated on the Hamilton Rating Scale for depression and anxiety and results were compared with the corresponding total urinary oestrogen output. The results, which suggest a significant relationship between stress related to depression and oestrogen levels in the menopause, are discussed and compared with differing life circumstances of the subjects.
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517585
|
Probability of menopause with increasing duration of amenorrhea in middle-aged women.
|
The empirical percent probability that natural menopause has occurred after first presentation of amenorrhea of various durations in women greater than or equal to 45 years of age has been calculated using data from a cohort of subjects who prospectively recorded menstrual flow and related gynecologic events. The probability that menopause has occurred increases with the amenorrheal interval (duration), and for a given interval, the probability increases with age. After 180 days of amenorrhea, 45% to 72% of subjects were menopausal; after 360 days, 90%. These data may offer assistance in advising patients on the probability of menopause and the continuance of contraceptive practices, and in considering whether late genital bleeding after amenorrhea represents a physiologic or pathologic process.
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521730
|
Hormone replacement therapy in the menopause: a suitable animal model.
|
Female CBA mice, aged 11 months, were treated cyclically with oral ethynyl oestradiol or oestrone sulphate for 3 months. The ovaries of all animals appeared to be atrophied. Target tissues throughout the genital tract showed a response to both oestrogens. Electron microscopy of both the endometrium and the urothelium demonstrated morphological changes characteristic of increased cellular metabolic activity in the treated mice. Endometrial hyperplasia developed in both treatment groups but more pronounced epithelial changes occurred with oestrone sulphate. This hyperplasia was accompanied by a doubling in the number of uterine cytoplasmic oestrogen receptors. A 50% fall in serum levels of luteinizing hormone in the treated mice revealed that the hypothalamic-pituitary system was still intact. Both oestrogens improved skeletal balance by changes in cortical-endosteal bone remodelling. The results suggest that the CBA strain of mouse is a suitable model for the study of the human climacteric and its response to hormone replacement therapy.
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526457
|
Relation between the karyopyknotic index and plasma oestrogen concentrations after the menopause.
|
The karyopyknotic index correlated significantly (p less than 0.001) with the plasma oestradiol but not plasma oestrone concentration in 38 postmenopausal women. This ties with previous findings that postmenopausal women with superficial dyspareunia have a more severe degree of vaginal atrophy than asymptomatic women, and that oestradiol is probably more important biologically than oestrone.
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533246
|
Maternal age, dizygotic twinning rates and age at menopause.
|
The dizygotic (DZ) twinning rate declines after about maternal age 38 in Caucasian populations. Bulmer (1970) offered the explanation that waning ovarian function causes a decline in rates of double ovulation in originally twin-prone women. The present note suggests that some small part of the decline is caused by the earlier cessation of ovulation altogether in these women (presumably also as a result of waning ovarian function).
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551237
|
Cytologic evaluation of hormonal dynamic in the postmenopause.
|
There is increasing evidence that the postmenopausal ovary retains some endocrine function and thus can contribute a certain extent to the persistence of the vaginal epithelium proliferation a long time after the cessation of menstruations. Vaginal cytology plays an important role in the assessment of the vaginal epithelium response to hormonal stimuli, though less accurate than the blood and the urine estimations. It was established that there was a good correlation between the vaginal cytology and the biochemical estimations [2]. The fact that vaginal cytology cannot distinguish the proliferative patterns induced by estrogens, progesterone and androgens is true. With this in mind we did a cytological study in postmenopausal women, using our classification for the cytological typing based on the depth of the epithelial atrophy. The findings are discussed with special reference to the ethnic origin, reproductive life and concurrent illnesses.
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579299
|
[Hormonal pattern in premenopauseal cycles (author's transl)].
|
By serial determinations of plasma LH, FSH, progesterone and estradiol-17beta as well as total gonadotropines, total estrogens and pregnanediol in 24 h urine samples it was possible to classify 19 cycles of premenopauseal women, aged 44-50 years, into two groups. The first group showed ovulatory cycles with partially shortened hyperthermic phases in the basal body temperature curves, slightly elevated levels of FSH and diminuished estradiol-17beta, pregnanediol and progesterone concentration, indicating the beginning insufficiency of the ovarian function. The second group was characterized by several times above normal elevated FSH and somewhat less elevated LH levels significantly lowered estradiol-17beta and only basal progesterone and pregnanediol concentrations. The ovulatory transitional cycles explicated a nearly normal fluctuation pattern which was completely abolished in the anovulatory cycles.
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583195
|
The spontaneous urinary excretion of tryptophan metabolites "via kynurenine" in women with regards to the prepuberty, sexual maturity and menopause.
|
High values of anthranilic acid, 3-OH-kynurenine, xanthurenic acid and 3-OH-anthranilic acid are observed in the spontaneous urinary excretion of tryptophan metabolites in girls in the prepubertal age. The highest differences are between the 3-hydroxy metabolites especially the 3-hydroxykynurenine. On the other hand, this metabolic excretion in postmenopausal women is statistically identical to that of women in sexual maturity.
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610316
|
Endocrine modifications in women with premature menopause.
|
The Authors have found 9 cases of premature menopause out of a total of 159 observations of gynecological disfunctional disorders for a 3 year period. The functional investigation has been carried out by radioimmunoassay for PRL, FSH, LH, 17beta-estradiol, progesterone and, in those cases in which it was possible, the spontaneous pulsatility of PRL and gonadotropins has also been studied. The basal PRL was found always in normal range and the pulsatility was sufficiently flat. On the other hand a pool of gonadotropins can still be released by 100 microgram of LH-RH i.v. in spite of high basal levels of pituitary gonadotropins. The pulsatility, especially for FSH, appears like to those of postmenopausal women. 17beta-estradiol and progesterone were at low levels and could not be alterated by HMG-HCG tests. As a conclusion the Authors think that the evaluation of the above reported parameters is an unfailing diagnostic precision in many cases of secondary protovarian amenorrhea for a premature menopause syndrome.
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626838
|
Coronary heart disease in relation to age, sex, and the menopause.
|
Examination of the Registrar General's mortality data suggested that women do not lose protection from coronary heart disease (CHD) after the menopause. Apparently, at around the age of 50 men begin to lose a factor that had previously put them at increased risk of developing CHD compared with women. Male sex hormones may be risk factors for CHD, and further studies are needed to clarify their role in the aetiology of CHD in men.
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633576
|
Estriol in the management of the menopause.
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Estriol was administered for a six-month period as estrogen replacement therapy to 52 symptomatic postmenopausal women. Assays of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrone, and estradiol were performed before and during therapy. During this period of administration, vaginal cytology, cervical mucus, and endometrial studies were performed. Clinical effectiveness was directly related to dosage (2 to 8 mg/day). Estriol (8 mg/day) failed to induce endometrial proliferation and proved a poor suppressor of FSH and LH. This agent's capacity to relieve vasomotor instability and improve vaginal maturation without notable side effects is sufficient reason to include this drug in the management of the postmenopausal syndrome.
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677576
|
Menopause and coronary heart disease. The Framingham Study.
|
A rise in coronary heart disease incidence after menopause and a dramatic increase in the severity of the presenting diseases are noted in a cohort of 2873 Framingham women who were followed up for 24 years. No premenopausal woman developed a myocardial infarction or died of coronary heart disease. Such events were common in postmenopausal women. Even in women under 55, 40% of the postmenopausal coronary heart disease presented in these more serious forms, whether menopause was natural or surgical. The contrast was especially marked in the age group 40 to 44 years. In the age groups 45 to 49 and 50 to 54 years, incidence rates in menopausal and postmenopausal intervals were more than double those in premenopausal intervals, whether menopause was natural or surgical. In surgical menopause there was excess incidence whether the ovaries were removed or not. Postmenopausal women on hormones had a doubled risk of coronary heart disease.
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686640
|
Oestrogenic activity associated with ovarian cystadenomas after the menopause.
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In a group of 59 patients over the age of 55 years with ovarian serous and mucinous cystadenomas, a total of 29 (49%) showed moderate or strong oestrogenic activity as determined by maturation index in vaginal cytologic smears, in contrast to nine (13%) of 70 control patients with other gynecological disorders than ovarian tumours. The bacterial flora was dominated by Döderlein type bacilli in 24 of the 27 test patients with an elevated maturation index, also reflecting the abnormal oestogenic activity in these patients. When the serous and mucinous cystadenoma groups were compared, a striking difference was found: of the 30 patients with mucinous cystadenomas, 23 (77%) displayed moderate of strong oestrogenic activity, while this was the case with only six (21%) of the 29 patients with serous cystadenomas. These findings stress the importance of an abnormal oestrogenic activity, revealed by an elevated cytologic maturation index, as memento for the possibility of post-menopausal ovarian cystadenoma.
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696251
|
Ultrastructure and variations of human cervical mucus during pregnancy and the menopause.
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Ultrastructural aspect and variations of cervical mucus have been studied by scanning electron microscopy in 58 pregnant and 29 menopausal women. In both groups, a striking tightening of the ultrastructural glycoprotein framework was demonstrated. The phenomenon appears to occur very rapidly at the beginning of pregnancy while patients near the menopause show more variable patterns. The results are compared to the known evolution of cervical mucus ultrastructure during the ovarian cycle and discussed from a rheological point of view. Particular attention was paid to the eventual antibacterial role of cervical mucus in pregnancy, which was found to be very plausible.
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723726
|
The age of the menopause of Australian women.
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The mean age of the menopause by probit analysis in a group of apparently healthy Australian women was 50.4 years. No relationship was found between this value and the age of the menarche or the number of children born or the age at the time of birth of the first child. The mean duration of the menstruating life was 26.3 years with a range of from 17 to 44 years.
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726877
|
Changes in bone mineral content in women with natural menopause during treatment with female sex hormones.
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The bone mineral content was determined in eleven women with a natural menopause by X-ray spectrophotometry during treatment with a combinations of estrogens and a gestagen. During a three-year follow-up period the hormone treated women significantly increased (P less than 0.05) their mineral content by 3% a year on average, as compared with a control group. Even in patients who had passed the menopause several years previously, the increase occurred and was particularly great during the first year of treatment.
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740579
|
Effects of progestogens on serum lipids in the post-menopause.
|
Measurement of serum cholesterol, triglycerides, and phospholipids was undertaken in patients with a natural menopause or following oöphorectomy who received cyclical oestrogen regimens for six consecutive months. The regimen employed was either a 'high' or 'low' dose of equine conjugated oestrogens, piperazine oestrone sulphate or oestradiol valerate. After six months a change was made to cyclical sequential oestrogen/progestogen regimens for varying periods. Patients with a natural menopause given either 'high' or 'low' dose regimens showed no significant changes in serum cholesterol, triglyceride or phospholipid levels compared to baseline values. However, the serum cholesterol levels of the oöphorectomized subjects were significantly elevated in comparison with the perimenopausal group. The addition of progestogen to the oestrogen did not cause any significant alterations.
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740583
|
Clinical considerations in the management of the menopause: the endometrium.
|
Exogenous oestrogens prescribed for the relief of menopausal symptoms are being given in pharmacological doses and the term 'hormone replacement therapy' is inappropriate. The frequent development of endometrial hyperplasia during unopposed cyclical oestrogen therapy is therefore to be expected, but no single pattern of vaginal bleeding accurately reflected the histology of the endometrium. As such doses of oestrogens are required for effective relief of symptoms, progestogens must be given to protect against endometrial hyperstimulation. Patient acceptability of sequential oestrogen/progestogen therapy is high (90%) and with such therapy breakthrough bleeding may subsequently be shown to be a reliable indicator of underlying endometrial pathology.
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742255
|
[Hemorrhage in menopause and its histological correlation].
|
In an evaluation of 200 histological endometrial findings of female patients having postmenopausal haemorrhage malign changes were noticed in five per cent of the cases. This figure is much smaller than that which is usually mentioned in literature. However it corresponds in its proportion with the known clinical and anamestic risk factors.
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755954
|
A review of studies of the psychological symptoms found at the menopause.
|
The scientific literature was reviewed in order to determine whether psychological symptoms were directly associated with the menopause. Aetiology theories of symptoms include biological, psychological, sociological and multifactorial. There is evidence that psychological symptoms do occur in increased frequency in relationship to declining ovarian function. The severity of these symptoms may be affected by sociological variables. Administration of oestrogens alone or in combination with progestogens appear to alleviate some of the symptoms. More detailed research is needed into the relationship between psychological symptoms and the menopause.
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755957
|
A new way of looking at environmental variables that may affect the age at menopause.
|
Environmental variables that might affect the age at menopause were analysed by means of the segmentation method AID. Marital status, occupation, smoking habits, age at last pregnancy and height were shown to be significant discriminating variables. The material and design of the study and the method of analysis are given and its results are discussed. A proposal is made concerning the nature of a 'secular trend'.
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755958
|
Is there a secular trend in age of menopause?
|
A review of the difficulties encountered in analyzing a secular trend in age of menopause is given with emphasis on the advantages and disadvantages of the recollective and "status quo" methods. It is suggested that no methodology except that which is prospective will give accurate ages of menopause. Accepting this given, a review of the literature from 1864 to 1964 is undertaken, that suggests there may be a secular trend in Denmark, England, France, Germany, Russia and the USA. This must, however, be corroborated by longitudinal, cross cultural, generational research of mothers' and daughters' ages at menopause, or at least, cohort analysis of specific populations.
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809684
|
[The future of estrogen substitution in the menopause. Psychological and sociological aspects (author's transl)].
|
The future of estrogen substitution (ES) in the menopause was examined in 425 patients in our clinic from the psychological and sociological aspects. Of the women questioned, one fourth would not consider estrogen substitution from the menopause onwards another fourth would only accept this for one year, one quarter for up to six years and the remaining quarter for longer than six years. The reasons for this decision were sought. The positive attitude towards estrogen substitution was seen to depend on age, education level, intelligence, knowledge of sexual hormones, experience with the pill, history of abortion, parity and personality factors.
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835634
|
Menopause and myocardial infarction.
|
Age and circumstances of menopause (natural or artificial) are detailed in 104 cases of recent myocardial infarction (MI). The results of this study with statistical analysis show no correlation between the age at menopause and the age at onset of MI; so for this study, an early menopause, cannot be considered, whatever circumstances, as a risk factor for coronary heart disease.
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850056
|
Patterns of menopause: a study of certain medical and physiological variables among Caucasian and Japanese women living in Hawaii.
|
Comparisons were made between menopausal women and nonmenopausal controls among Caucasians and Japanese living in Honolulu, to investigate the extent of physical changes and clinical symptoms associated with menopause. The analysis was conducted using the multiphasic screening records of 170 menopausal cases and 162 nonmenopausal controls in Caucasians, and of 159 menopausal women and 187 nonmenopausal controls in Japanese. Discriminant function analysis was employed with relevant anthropometric, medical, and physiological variables. After adjusting for the linear and non-linear effects of age, only surgery and medication were retained as significant discriminant variables. Discriminant functions for Caucasian and Japanese groups were not found to be significantly heterogeneous. With regard to the discrimination of the menopausal and nonmenopausal groups, the data suggested that, while no clinical conditions other than those attributable to the effects of aging were significantly associated with the menopausal state, medication and surgical procedures for female disorders were significantly related to menopause.
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850624
|
[Coronary insufficiency in the female: possible effect of menopause].
|
A population of 239 women suffering from chronic coronary disease was divided into two groups according to whether or not they had sustained a myocardial infarction. For the 226 post-menopausal women, the type of menopause (natural or artificial) and their age at its onset were determined, together with the age of onset of the infarction or angina, and possible correlations with other risk factors in atherosclerosis. Whilst the average age at the time of artificial menopause was markedly less than that of natural menopause, the age of onset of coronary complications was comparable regardless of the type of menopause, this applying to both groups. Contrary to a classically accepted opinion, early menopause would not appear to favourise the premature development of atherosclerotic coronary problems, and, in addition, would not appear to affect other coronary "risk factors".
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855249
|
[Determination of the metabolic clearance and production of estradiol in breast cancer patients at menopause].
|
A method for the determination of estradiol metabolic clearance rate (MCR) and production rate (PR) in blood, using radioactive isotope dilution techniques, has been described. In a group of 5 normal menopausal females and 10 menopausal patients with disseminated cancer of the breast the values of MCR and PR were not found to differ significantly, but they diminished after oophorectomy.
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878981
|
Estrogen and the menopause.
|
Currently popular dosage schedules of estrogens are not physiologic. Daily large peak fluctuations of circulating estrogen may induce unfamiliar patterns of target cell stimulation which may ultimately be expressed in abnormal cellular activity. For women who require estrogen to control menopausal symptoms, ethinyl estradiol or 17 beta-estradiol is recommended in small daily doses for three weeks (followed by one week off), with the addition of medroxyprogesterone in a small dose in the third week of estrogen treatment.
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884425
|
Psychiatric morbidity and the menopause: survey of a gynaecological out-patient clinic.
|
Two hundred and seventeen women between the ages of 40 and 55 years referred to a gynaecological out-patient clinic were screened for psychiatric illness by means of the General Health Questionnaire (GHQ) and a brief special questionnaire. Of the 114 women identified as possible psychiatric 'cases' 104 were interviewed. A standardized psychiatric interview schedule was used. Compared with a general population sample from the same geographical area and in the same age range, women presenting at the gynaecological out-patient clinic were predominantly pre-menopausal and from the lower end of the 15-year age range, and were more likely to be separated or divorced, less likely to be single, and more likely to have had previous or to have subsequent contact with the local psychiatric services. A higher proportion of women were identified as psychiatric 'cases' in the clinic population than in the general population, and their psychiatric disorder appeared to be severe and more depressive in nature. The findings for this age group support the view that among women presenting for hysterectomy there is already an excess of psychiatric illness before the operation. The association of gynaecological complaints and psychiatric morbidity in the pre-menopausal years is discussed.
|
910845
|
Pituitary-ovarian relationships preceding the menopause. I. A cross-sectional study of serum follice-stimulating hormone, luteinizing hormone, prolactin, estradiol, and progesterone levels.
|
Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, and progesterone concentrations were measured in 58 ovulating women in different age groups (20 to 29, 34 to 39, 40 to 44, and 45 to 50 years) at five- to seven-day intervals through a single menstrual cycle and in 18 postmenopausal women sampled weekly five to six times. The over-all hormone patterns were similar in four premenopausal groups. However, mean serum FSH levels increased with age and significantly higher concentrations were found in the 40 to 50 years group than in the 20 to 29 year group. Serum LH levels did not show a similar rise with age, although follicular LH levels in the oldest group were higher than in the 20 to 29 year group. Prolactin and estradiol concentrations did not change with age prior to the menopause, but luteal progesterone levels were lower in the three older premenopausal groups than in the 20 to 29 year group. Postmenopausal women showed elevated FSH and LH, decreased prolactin, and negligible estradiol and progesterone levels. There was an over-all significant linear correlation between prolactin and estradiol concentrations. It appears that the menopause is preceded by several years of rising gonadotropin, predominantly FSH, levels. During this period, ovarian estrogen production appears to be maintained and ovulation continues, but luteal progesterone levels decline. It is likely that these premenopausal alterations in pituitary-ovarian relationships reflect depletion of ovarian follicles.
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952138
|
[Influence of ethinyl estradiol sulfonate on the decreased urinary bladder tonus in the menopause].
|
In 40 women with hypotonic urinary bladder the influence of 17alpha-Athinyl-3-isopropyl-sulfonyloxy-Ostradiol (Athinylöstradiol) (3 X 15 mug/die without weekend) was examined concerning the intravesical pressure; The cystotonometry has been done just before as well in intervalls of 2 months during half year's period of treatment. The authors used the fill-up-cystotonometry of Hartl. The intra-vesical pressure rose significantly by the influence of Athinylöstradiolsulfonat after 2 months treatment already. In comparison to the hypotonic value before treatment there was an average normotonic urinary bladder after application of Athinylöstradiolsulfonat past 4 and 6 months. Incidence on clinical relevance of these results.
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961757
|
Vasomotor symptoms, serum estrogens, and gonadotropin levels in surgical menopause.
|
Hormonal parameters of young women who developed vasomotor symptoms in the immediate postoperative period following castration are compared to those who remained asymptomatic. Only 37.5 per cent of 16 premenopausal women developed "hot flushes" after operation. Perimenopausal women with vasomotor symptoms and elevated follicle-stimulating hormone levels demonstrated normal luteinizing hormone and estrogen values preoperatively. There were no statistically significant differences in total serum estrogen, follicle-stimulating hormone, or luteinizing hormone concentrations between the group of patients with symptoms and the group withoyt symptoms. The results of the study indicate that rising gonadotropin or declining estrogen values appear to have no direct correlation to the onset of vasomotor symptoms in the immediate postoperative period. Thus, the precise etiology of the "hot flush" remains to be elucidated.
|
970770
|
Menopause and risk of cardiovascular disease: the Framingham study.
|
The relation of menopause to cardiovascular disease incidence was examined in women less than 55 years old from the cohort of 2873 women in the initial Framingham examination. Although the number of person-years of experience during the 20 years of observation was nearly the same for premenopausal and postmenopausal status, there were only 20 cardiovascular events among the premenopausal women in this age group whereas 70 events occurred among the postmenopausal women of the same age. In each specific age group studied incidence rates were lower in premenopausal than postmenopausal women. This was also true for coronary heart disease. Contrast for "hard" diagnoses of cardiovascular disease (excluding diagnoses of angina pectoris and intermittent claudication) was in the same direction. Although cholesterol and hemoglobin did rise somewhat more steeply in women undergoing the menopause, this greater incidence of cardiovascular disease in postmenopausal women could not be explained by the influence of the menopause on the usual cardiovascular risk factors.
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974609
|
Hormonal profiles after the menopause.
|
The endocrinological changes of the climacteric have been defined by studying the concentrations of follicle-stimulating hormone (FSH), luteinising hormone (LH), androstenedione, testosterone, oestrone, and oestradiol in 60 normal postmenopausal women of different menopausal ages. The women were studied in six groups, according to the number of years since their menopause. One year after the menopause androstenedione, oestrone, and oestradiol concentrations were reduced to about 20% of the values recorded during the early proliferative phase of the menstrual cycle. At the same time the mean concentration of FSH had risen by a factor of 13-4 and that of LH by a factor of 3-0. Concentrations of both gonadotrophins reached a peak of 18-4 and 3-4 times the proliferative phase value respectively after two to three years, and then gradually declined in the next three decades to values that were 40-50% of these maximal levels. Testosterone concentrations remained mostly in the normal range for premenopausal women but were depressed to 60% of these levels two to five years after the menopause, and the mean androstenedione levels showed a significant increase in the same group of women. The concentrations of both oestrone and oestradiol remained consistently low for 10 years after the menopause, but oestradiol concentrations inexplicably increased in the last two decades, with levels at the lower end of normal range for reproductive women in six patients.
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986962
|
[Further studies on serum calcium and inorganic phosphorus in postmenopause (author's transl)].
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The author previously reported that the serum calcium (Ca) and inorganic phosphorus (P) levels were gradually decreased with advance in age in regularly menstruating women, but that they were rapidly increased soon after the menopause. In this experiment the changes of the serum Ca and P levels in postmenopausal women were studied more precisely in 410 peri- or post-menopausal subjects and 534 controls with regular menses. They were classified into 12 groups according to age or period since last menses. The clavicular cortical thickness was also measured as an index of bone resorption. Blood samples were taken between 9-11 A.M. after an overnight fast and the separated sera were applied to a Technicon Autoanalyzer SMA 12/60 and analyzed. The mean levels of Ca and P in serum were both increased following the menopause and reached a plateau in Groups F-3 (12-24 months since last menses) and G (2-5 years since last menses). In Group G (5-10 years since last menses) both the levels were slightly declined. Then a dissociation was observed in Groups I-1 and I-2. This was a successive decrease of Ca and a re-increase of P. This dissociation might be explained partly by the physiologic fall of parathyroid function. Furthermore the clavicular cortical thickness was measured with a micrometer in the middle of the clavicle on the chest X-ray film of the same subjects and the clavicular score was computed as Cortical width X 100/Whole width. The score was gradually but steadily reduced with the lapse of time after the menopause and in Group I-2 it was lowered to approximately 45% of that in the premenopausal groups. From these results it is certain that the decline of estrogen secretion led to the elevation of the serum Ca and P levels and subsequently to the reduction in the clavicular score.
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1049133
|
Social factors in the psychology of menstruation, birth, and menopause.
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Information about possible social influences on the psychology of reproduction, supplemented by a clinical understanding of the psychodynamics of the individual and scientific knowledge about the effects of hormones on behavior, provides insight into the experience of a particular woman in a particular social milieu. Such insight is an appropriate basis for effective treatment of many of the clinical problems in the area of psychosomatic obstetrics and gynecology.
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1080357
|
The effect of menopause on serum cholesterol in American (Pima) Indian women.
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Serum cholesterol levels in Pima Indian women were investigated to determine if menopause caused these levels to rise. The mean cholesterol values of 148 pre-menopausal women aged 34-54 when age-matched with 75 post-menopausal women were not significantly different. Sixty-five women passed through menopause while under observation and were examined sequentially for an average of 6.1 years. Their mean pre- and post-menopausal cholesterol levels of 182 +/- 5 mg/100 ml and 180 +/- 5 mg/100 ml were similar. Nor did menopause alter cholesterol levels in the subgroups of these patients with diabetes mellitus. Cholesterol levels in both Pima males and females showed no age-related rise, and were 20-30% lower than white populations. This study provides additional evidence against the postulated relationship between menopause and serum cholesterol.
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1094253
|
[New sequential therapy in the premenopause (author's transl)].
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A report about the treatment of 85 women in the premenopause during 387 cycles is given. The treatment consisted in sequential therapy in form of conjugated Estrogens (Presomen) and a new synthetic Gestagen, which was given in three different modifications: from the fifth to the 24-th day of the cycle 1,25 mg Presomen a day, additionally on the last five, seven or ten days, during each period 6 respectively 5 mg Gestagen a day. It proved that both, the disfunctional haemorrhages as well as the climacteric syndrome, were favourably influenced. The mode 10+10, that is, 10 days Estrogens alone + 10 days combined with ;estagen, proved best. A sufficiently secure contraception is not guaranteed. This can be recognized by the occurence of biphasic basal temperature curves.
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1119901
|
Human growth hormone response to levodopa. Relation to menopause, depression, and plasma dopa concentration.
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After ingestion of 500 mg of levodopa, postmenopausal women had significantly diminished human growth hormone (HGH) responses (mean, 4.6 ng/ml), as compared with those of age-matched men (mean, 9.1 ng/ml; P smaller than .05). The differences between the groups were not related to plasma dopa concentrations. The HGH responses to levodopa of age-matched unipolar and bipolar depressed men, and of unipolar depressed postmenopausal women, did not differ significantly from their respective normal control groups. Depressive illness of these types does not appear to affect the HGH response to levodopa, once the effect of the menopause is taken into account.
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1124713
|
Psychohormonal treatment during the menopause.
|
Today the physician who treats women with emotional problems during menopause cannot function solely as a psychotherapist; he must deal with both their soma and psyche. The interaction between the endocrine and emotional states has long been known. When the equilibrium of an essentially normal state--menopause--is disturbed, a multifaceted approach is essential to restore homeostasis. Hormone replacement, psychotherapy and psychotropic drugs may all be necessary. Serial vaginal smears are useful in monitoring therapy.
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1125147
|
The uterine cervix from adolescence to the menopause.
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During adolescence the physiological transformation zone of the cervix in the virgin undergoes limited change when compared to that of girls who are sexually promiscuous; the latter often show large areas of metaplastic squamous epithelium and the development of an atypical transformation zone. During pregnancy, particularly the first, the transformation zone increases in size and acquires increased amounts of squamous metaplastic epithelium, probably due to the effect of acidic vaginal fluid on endocervical columnar epithelium. Evidence exists for the development of an atypical transformation zone during pregnancy with its own variable neoplastic potential. After delivery the atypical epithelium of the cervix may be partly or completely removed with resulting regression of the lesion. Alternatively, neoplastic potential may alter or the lesion may remain static or recur in its previous form. After the childbearing era the physiological transformation zone undergoes minimal change until the menopause when the whole cervix shrinks. As the studies described above dramatically show, the sexually promiscuous woman at all ages has an increased risk of developing cervical neoplasia; this risk seems to be the highest in the third decade of life.
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1155445
|
Twinning rates among women at the end of their reproductive span and their relation to age at menopause;.
|
A review of studies on twinning has shown that dizygotic (DZ) twinning rates among women from general populations characteristically peak at ages 35-39, then decline sharply. Analysis of genealogical data from the Archives of the Mormon Church indicates that women who are dizygous twins themselves or the sibs of dizygous twins have a higher twinning rate among their offspring than do women from the general population. The dizygotic twinning rates of women who are twins or the sibs of twins classified by maternal age also peak at ages 35-39 but remain high at ages 40-44, then decline. It is well known that Negro women have high DZ twinning rates; a less well knwon finding is that the DZ twinning rates of Negro women also remain high after age 39. It has been suggested that high DZ twinning rates at later maternal ages may be related to a delayed age at menopause; However, published reports on age at natural menopause and analysis of our data from contemporary white US women indicate the contrary; Women who have borne unlike-sexed (DZ) twins and Negro women have a lower age at natural menopause then do white women from general populations, and a lower age in comparison with women who have borne like-sexed twins.
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1156748
|
Psychiatric morbidity and the menopause; screening of general population sample.
|
A survey of 539 women from the general population indicated a high prevalence of minor psychiatric illness in women aged 40-55 years. There was evidence of an increase in psychiatric morbidity occurring before the menopause and lasting until about one year after menstrual periods had ended. Vasomotor symptoms increased dramatically when periods stopped and persisted up to five years after the menopause. Both these features seemed to have a clear relation to the menopause but not the same relation. The findings suggested that further investigation of the relation between perimenopausal hormonal changes and psychiatric morbidity should be directed towards premenopausal women. Environmental factors, particularly in relation to children, seemed to be associated with increased psychiatric morbidity at this time of life.
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1171028
|
Mumps oophoritis: a cause of premature menopause.
|
One cause of secondary oligomenorrhea is ovarian infection. A rare type of infection related to the disturbance of menstrual function is mumps oophoritis. Three patients with premature menopause presumably caused by this agent were described. In one patient the symptoms coincided with a subclinical infection during the perinatal period, with subsequent infertility. Another patient seemed to have had a clinically mild oophoritis during the pubertal period, and the third patient became symptomatic following parturition. It appears that this aberration in menstrual function and fertility may be related to the time during which the infection occurs as well as to the severity of the infection. In addition, it is apparent that mumps oophoritis may be a more frequent cause of premature menopause than has heen previously suspected.
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1211708
|
[Menopause: apropos of some psychological and psychiatric aspects].
|
Menopause, begining of woman's involutional period, may (or must) be systematically treated by estrogens, preventing most of immediate or later menopausel complications and limitating effects of aging. This use of estrogens (which causes many controversies and resistances) has also probably a positive neuropsychic effect. The author reminds classical psychopathological explanations supporting mental troubles of this period which are usually considered as reaction to a crisis, instead properly psychiatric diseases are included in involutional pathology. A short review of psychiatric litterature indicates that psychiatrists refuse any specificity to menopausal psychic troubles. He points out also "the phobia of menopause", the increasing fear of old age in a "youth culture", in spite of progress of woman emancipation, social liberation following biological liberation (birth control, decrease of child mortality, etc). The reports of Jaszmann and Van Keep and Kellerhars are summarized. They show the main role of sociological, economical and familial factors in appearance, intensity and duration of climacteric troubles and progressive degradation with aging of: personnal integration, intellectual and cultural integration, and human relation-ships, and mental sanity. These reports seem to indicate that menopause is only a critical period of the slow process of aging and decadence. But systematic estrogen treatment and improvement of femine social condition should change drasticelly these troubles and this decadence.
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1227215
|
[Serum FSH and LH levels in women following surgical castration and during hormonal management of menopause symptoms].
|
Using the radioimmunological method, FSH and LH levels were determined in women immediately after surgical castration and after an elapse of 18 months to two years. A twofold increase in FSH was found already two days after castration, while an increase in LH only after six days. Increased FSH and LH levels were observed as late as after two years when upon the administraion of estrogens and androgens, the feed-back mechanism of the pituitary still plays a role. In women with pronounced menopausal disturbances the FSH and LH levels were followed up after the application of Folivirin and Agofollin-Depot over a period of two weeks. There was a constant decrease in FSH of all women immediately after the injection, while the responses in LH were subject to variation, the decreased LH levels being found in all the women only towards the end of the second week. Folivirin was found more suitable for mastering the menopausal disturbances.
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1230127
|
[The influence of menopause on prognosis of breast cancer (author's transl)].
|
Between 1949 and 1968, 1369 female patients received primary treatment for breast cancer in the Robert-Rössle-Clinic of the Central Institute for Cancer Research of the Academy of Sciences of the GDR. Using a sequential procedure based on decision theory, the influence of menopause on prognosis of breast cancer was investigated in clinical stage I--III. The following rank order of negative prognostic signs was found in the 365 patients of 46-55 years age (5-year survival rate in braquets): skin involved beyond breast (0%); inflammatory type of cancer (0%); fixation of chest wall (0%); radiation treatment only (10%); tumor diameter in surgical specimen 5 cm and more (26%); tumor diameter 10+ cm by clinical examination (31%); skin ulceration (0%); axillary lymph nodes considered to contain growth (40%); menopause (59.7%). 85% of menstrating patients without these adverse prognostic signs survived for more than 5 years. Taking into consideration other observations, it is suggested that breast cancer before menopause is mostly oestrogen-dependent. When the ovary ceases to produce oestrogens in the next future, the cancer looses hormonal stimuli necessary for growth. This interpretation is in agreement with the observations that younger menstruating women show a definitely worse prognosis (5-year survival rate 55,8%). In controlled clinical trials, patients before and after menopause should be randomized separately.
|
1234566
|
Vaginal cytology after the menopause.
|
The methods by which oestrogen activity can be assessed cytologically are described. Hormone production does not cease with the onset of the menopause. In about 10% of post-menopausal women there is evidence of high oestrogenic activity until far into old age and in a further 40-45% moderate levels of oestrogens are maintained. Oestrogen administration should, therefore, not carried out routinely under the illusion that it constitutes preservation of youth, but should be reserved for such women in whom serious hormone deficiency can be demonstrated.
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1236818
|
[The effect of menopause on serum levels of calcium and inorganic phosphorus (author's transl)].
|
Serum calcium, inorganic phosphorus and alkaline-phosphatase were determined in 3,191 women as a part of a multiphasic health testing program. A fasting sample of blood was drawn between 9 and 11 a.m. and the separated serum was applied to a Technicon Autoanalyzer SMA 12/60 and measured. In 527 women, who were found to have no abnormalities on the other laboratory tests or by the physical examination, were the results of determination studied in relation to age and menstrual status. The values obtained from 13,258 men were employed as a control. In regularly menstruating women the serum calcium level was decreased with the advance of age. Once the menstrual cycle had got irregular toward the menopause, the serum calcium level was rapidly increased, reached maximum in 2-5 years after the menopause, and was slightly decreased thereafter. The serum inorganic phosphorus level also varied in a similar attitude. On the other hand both the serum calcium and phosphorus levels in men were gradually reduced with the advance of age and no fluctuation was observed. Alkaline-phosphatase in serum was distinctly enhanced in the postmenopause. These data indicate that the decline in estrogen secretion results in hypercalcemia and hyperphosphatemia and that a prophylactic estrogen therapy may be considered at the early stage of the postmenopause for preventing the increased bone resorption.
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1255802
|
Exogenous estrogens and breast cancer in women with natural menopause.
|
Age, age at menopause, and calendar year at menopause were controlled as factors related to estrogen use. Data on 90 breast cancer patients and 83 conrols--all of whom had a natural menopause--showed no relationship between breast cancer and estrogen usage after the start of menopause symptoms.
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1258858
|
Some atherogenic concomitants of menopause: The Framingham Study.
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Longitudinal assessment of the effect of change in menopausal status on seven biologic concomitants was made in 40- to 51-year-old women from the cohort of 1686 women premenopausal at the initial Framingham examination and subsequently followed for nine biennial examinations. Within this age range, women of any specific age undergoing natural menopause were leaner at the exam prior to menopause than their controls; while women undergoing surgical menopause with bilateral oophorectomy were heavier. Hemoglobin levels rose after menopause. There was a rise in serum cholesterol levels between the premenopausal and menopausal examinations in natural menopause and in surgical menopause with bilateral oophorectomy. This rise was not seen in surgical menopause without bilateral oophorectomy. No significant changes in weight, blood pressure, blood glucose or vital capacity were found to accompany the menopause.
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1268616
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Psychiatric morbidity and the menopause: clinical features.
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A sample of 114 women from the general population aged 40-55 years were identified as possible psychiatric cases and subjected to a standardised psychiatric interview. Mean ratings for reported symptoms and observed abnormalities were assessed in relation to menopausal status. There was no evidence of any specific combination of symptoms and signs associated with the cessation of menstrual periods, though after the menopause insomnia and hypochondriacal preoccupations were more common. In comparison with matched normal controls have been previous psychiatric illness, and contact with general practitioners was more frequent. Many women developing psychiatric symptoms at the time of the menopause appear to belong to a vulnerable population who are likely to develop symptoms in relation to stress.
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1276564
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Anorexia nervosa after the menopause.
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A patient is described who developed the classical syndrome of anorexia nervosa at the age of 52. Her illness occurred in relation to the marriages of her daughters and showed an extreme preoccupation with her body shape and a determination to slim by diet, purging and vomiting, and the hiding of food to the extent of rendering herself too weak to cope with the demands of her life. It is suggested that anorexia nervosa, though predominantly a disease of onset in adolescence, may present at any age and should be considered in the differential diagnosis of anorexia in patients over the age of 50.
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1287204
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Effects of induced menopause on Burch colposuspension for urinary stress incontinence.
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The clinical and urodynamic short term results after colposuspension for urinary stress incontinence has been studied in a group of young patients in whom menopause was induced surgically and compared with a similarly treated group who did not undergo surgical castration. Clinically, no differences were found in the incidence of diurnal frequency, nocturia, urgency, urge incontinence or stress incontinence between the groups. No urodynamic changes in the cystometric, uroflowmetry and urethral pressure profile measurements were found post-operatively between the two groups. It is concluded that surgically induced menopause in the absence of aging has no effect on the results of colposuspension for urinary stress incontinence in the short term.
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1291557
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Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause.
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Menopause is triggered by the number of ovarian follicles falling below a threshold number and is irreversible because oogonial stem cells disappear after birth. Since it is the result of programmed disappearance of a limited store of follicles, menopause can be predicted using mathematical models based on total follicle counts at different ages. Our model shows follicle numbers decline bi-exponentially rather than as a simple exponential function of age, as had been assumed, with a first exponential rate parameter of -0.097 and a second of -0.237. The change occurred when numbers had fallen to the critical figure of 25,000 at age 37.5 years. The unexpectedly faster rate of ovarian ageing afterwards lowers the follicle population to 1000 at approximately 51 years, and was adopted as the menopausal threshold because it corresponds to the median age of menopause in the general population. Had the earlier rate persisted menopause would not be expected until 71 years. The impact of step reductions of follicle numbers on the prospective span of menstrual life was predicted by the model. A reduction by 50% before age 30 years resulted in the threshold being reached at 44 years and 0.6 year later for every subsequent year until age 37.5 years after which it is reached at 48 years. A reduction of 90% in childhood before age 14 years could result in menopause as early as 27 years, with increments of 0.6 year per year afterwards until after 37.5 years when it is expected at age 41 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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1303916
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[Excretion of free catecholamines in urine and activity of some enzymes involved in catecholamine metabolism with arterial hypertension during menopause].
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This study was performed in 60 women aged between 47-55 years (mean age 50.46 +/- 1.7), divided into two groups: premenopausal and postmenopausal. Each group was subdivided according to arterial pressure: with normal pressure and arterial hypertension. Daily urinary excretion of catecholamines was determined according to method of Euler and Lishajko, the activity of dopamine--beta-hydroxylase in serum according to Nagatsu et al. The activity of catechol-O-methyltransferase in erythrocytes according to Axelrod et al., the activity monoamineoxidase in serum according to Wurtman et al. Daily urinary excretion of vanilmandelic acid determined according to Pisano et al. It was found that women with menopausal arterial hypertension have significantly greater urinary excretion of adrenaline and noradrenaline (p < 0.001) in the premenopausal period, and adrenaline (p < 0.01) in the postmenopausal period. The activity of dopamine-beta-hydroxylase did not differ from the control group. The activity of COMT in erythrocytes of women and MAO in serum of women with menopausal arterial hypertension was significantly lower. Daily urinary excretion of vanillinmandelic acid in women with menopausal arterial hypertension was significantly lower.
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1305131
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[Levels of catecholamines and activity of the renin-aldosterone system in women with hypertension in the period before and after menopause].
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The examinations were carried out for 93 selected women divided into premenopausal group and the group in the early stage of postmenopausal period. Each of these groups was subdivided into two subgroups with normal blood pressure and arterial hypertension. The catecholamine level were determined fluorimetrically as per Euler and Lishajko, and the level of dopamine in plasma using Nagatsu's method. Angiotensin I and aldosterone concentration in serum was determined by radioimmunoassay using RIA set of Sorin. Free catecholamine excretion with urine for women with arterial hypertension in the premenopausal period is highly statistically (p < 0.001), and in the postmenopausal period only epinephrine is statistically higher (p < 0.01), whereas the dopamine level in plasma is smaller, statistically significant only in premenopausal period (p < 0.05). Also for women with the arterial hypertension compared with the control group the angiotensin I and aldosterone concentration in serum is statistically smaller.
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1305625
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Pineal calcification in relation to menopause in schizophrenia.
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I have suggested that critical changes in melatonin secretion, as mediated by the pineal gland, may exert a crucial role in the onset and pathogenesis of schizophrenia. Since pineal calcification (PC) is thought to reflect the metabolic and secretory activity of the gland, I investigated in 29 randomly selected chronic institutionalized female schizophrenic patients the association of PC on CT scan with premenopausal (prior to age 40) versus menopausal (ages 40-55) onset of illness. The premenopausal patients were found to show a significantly higher prevalence of PC than the menopausal patients (55.5% vs. 18.1%; X2 = 3.93, df = 1, p < .05). Since PC was unrelated to historical, demographic, and treatment variables, these findings highlight the importance of the pineal gland for the timing of the onset of schizophrenia, particularly in relation to the female reproductive state. The results carry theoretical implications on the pathogenesis of schizophrenia and suggest that the pineal gland may exert a protective effect against its onset.
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1308538
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Symptomatology and hormonal levels among Thai women with natural menopause.
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The hormonal levels and symptoms after natural menopause have been studied in 100 patients. The mean age was 56.8 years while menopausal age was 50.3 years. Postmenopausal symptoms presented 55.0 per cent with the three most common complaints of hot flushes, emotional lability and vaginal dryness, respectively. The levels of plasma FSH, estradiol and testosterone were also reported corresponding to the years after menopause. Both gonadotropins reach a maximum concentration at two to three years after the menopause and then gradually declined. The LH/FSH ratio was 0.6. The mean concentration of estradiol was 10.07 pg/ml, the level remained consistently low during the menopausal period. Testosterone concentration declined little in postmenopausal women.
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1333183
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Menopause related changes of adrenocortical steroid production.
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To elucidate changes of adrenocortical steroid production with age, reproductive age (n = 14), peri-menopausal (n = 12) and post-menopausal (n = 13) women were studied using basal hormone levels and the results of a rapid ACTH stimulation test. Peripheral serum levels of pregnenolone, 17 alpha-hydroxypregnenolone, 17 alpha-hydroxyprogesterone, dehydroepiandrosterone and androstenedione were measured by RIA. The basal levels of all steroids except pregnenolone decreased with age. A significant increase in the levels of all steroids after ACTH stimulation was observed in all subjects. Although, there was an age related decrease in the response of C19-steroids to ACTH, the response of pregnenolone and 17 alpha-hydroxyprogesterone to ACTH did not alter with age. The preserved response of 17 alpha-hydroxyprogesterone to ACTH in post-menopausal women suggests that 17 alpha-hydroxyprogesterone production plays a role in the age independency of cortisol. In the present paper, the changes in the capacity of the post-menopausal adrenal cortex to produce androgens and C21-steroids were demonstrated.
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1345259
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Menopause and hyperlipidemia: pravastatin lowers lipid levels without decreasing endogenous estrogens.
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In study 1, serum lipid and estrogen levels were determined in 30 women (aged 40 to > 60 years). Total cholesterol (TC) levels increased significantly with age, but no significant association was found between TC levels and menopausal status. Hypercholesterolemia (TC > 220 mg/dl) was identified in 10 women and hypertriglyceridemia (> 150 mg/dl) in 5 women. Among women not receiving estrogen replacement therapy, a significant negative correlation was found between TC levels and estradiol-17 beta levels. In study 2, serum lipid and estrogen levels were determined in 74 women; 12 of the 74 were receiving conjugated estrogen for the treatment of the menopausal syndrome and 21 hyperlipidemic women were receiving pravastatin (2.5 to 30 mg daily). Among postmenopausal women, high-density lipoprotein cholesterol levels were significantly higher and low-density lipoprotein (LDL) cholesterol levels significantly lower in the estrogen-treated than untreated women. Serum TC and LDL cholesterol levels were significantly reduced during pravastatin treatment. Levels of endogenous estrogens (estradiol-17 beta, estrone, and estrone sulfate) were not significantly affected by pravastatin treatment. The results indicate that pravastatin can be used to reduce hyperlipidemia in menopausal women without affecting endogenous estrogen levels.
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1357959
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Menopause and serum cholesterol: differences between blacks and whites. The Minnesota Heart Survey.
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The relation between menopause and serum total and high-density-lipoprotein cholesterol was examined by the Minnesota Heart Survey in a cross-sectional, population-based study of 344 black women and 474 white women aged 35-54 years from the Twin Cities metropolitan area in 1985-1986. Analysis of covariance was used to examine differences in serum total and high-density-lipoprotein cholesterol in black women and white women by menopausal status, adjusting for the effects of age, educational level, cigarette smoking, body mass index, exercise, alcohol consumption, diabetes mellitus, sex hormone, beta blocker, and diuretic use. Among whites, adjusted serum total cholesterol was 13 mg/dl higher in postmenopausal than in premenopausal women (p less than 0.002). Black postmenopausal women had slightly higher serum total cholesterol than did their premenopausal counterparts (5.4 mg/dl). However, this was not statistically significant. An interaction term in a linear regression model confirmed a racial difference in the total cholesterol association with menopause (p less than 0.02). The higher total cholesterol levels observed in white postmenopausal women were mainly among those with natural menopause (20.7 mg/dl higher than premenopausal, p less than 0.0003) and those with a hysterectomy and at least one intact ovary (11.0 mg/dl higher, p = 0.05). Among black women, only the subgroup with a hysterectomy and a bilateral oophorectomy had a significantly higher serum total cholesterol (19.9 mg/dl higher than premenopausal, p less than 0.05). There was no significant association between high-density-lipoprotein cholesterol and any type of menopause in either black women or white women. Our findings may reflect a true physiologic difference in the relation between menopause and serum total cholesterol between American blacks and whites. The lack of a significant association between menopause and high-density-lipoprotein cholesterol in either race raises the possibility that menopause may not affect atherosclerosis risk via reduced high-density-lipoprotein cholesterol.
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1380360
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Stereological analysis of the female breast alveolar ductulus epithelial cells in premenopause and postmenopause.
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Stereological characteristics of the ductular parenchyma epithelial cells were analysed ultrastructurally in 18 cases of normal breast tissue. Different physiological states were compared in the premenopause and postmenopause. The volume density (VV), surface density (SV) and specific surface density (SV/VV) of nuclei and the epithelial cell cytoplasm were stereologically examined and compared. After a menopause a slight decrease of the volume density (VVj), surface density (SVj) and specific surface density (SVj/VVj) of epithelial cell nuclei was noted, while the volume density (VVc), surface density (SVc) and the specific surface density (SVc/VVc) of the epithelial cell cytoplasm were slightly increased.
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1393775
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Risk for developing osteoporosis in untreated premature menopause.
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The bone mineral density (BMD) of the lumbar spine and proximal femur was determined by dual photon absorptiometry in 32 women with untreated premature menopause (cessation of menses before 45 years of age). The BMD of the spine and proximal femur in four obese patients was not different from the BMD of the age-matched controls. On the contrary, the BMD of the nonobese females with premature menopause was significantly lower with respect to the average values found in healthy young women, in age-matched and menopause-matched controls. The BMD deficit was greater over the lumbar spine than in the proximal femur. Forty three percent of nonobese patients were already under the vertebral fracture threshold and 25% of nonobese patients were below the hip fracture threshold. The BMD deficit in the lumbar spine was correlated to the loss observed in the femoral neck (r = 0.59, P less than 0.001), in the trochanter (r = 0.65, P less than 0.001) and in the Ward's triangle (r = 0.73, P less than 0.001). A negative correlation was observed between years of menopause and the BMD of the lumbar spine (r = -0.39, P less than 0.05). The results indicate the high individual risk for osteoporotic fractures in nonobese females with untreated premature menopause. The BMD loss was greater over the skeletal areas that are predominantly composed of trabecular bone compared with cortical bone.
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1398514
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Bone mineral density (BMD) in patients with lymphoma: the effects of chemotherapy, intermittent corticosteroids and premature menopause.
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Young women with a chemotherapy-induced early menopause are theoretically at considerable risk of developing post-menopausal osteoporosis with problems developing earlier and more severely. In this study bone mineral density (BMD) measurements were made, using a dual-energy X-ray absorptiometer (DXA), at the spine and hip of 50 young women who had been treated for lymphoma, 24 of whom were post-menopausal and 78, healthy age-matched controls. On analysis of the results, there was no significant difference between the control group and the 26 post-treatment, pre-menopausal patients, but the BMD levels were significantly lower than the controls in the post-menopausal group particularly in 16 patients who had been menopausal greater than 18 months. The results confirm that these young women with treatment-induced premature menopause are at considerable risk of developing osteoporotic problems. Early recognition of this is important so that preventative measures with hormone replacement therapy can be initiated where this is safely possible. The results also indicate that chemotherapy for lymphoma (cytotoxics and high dose intermittent steroids), are unlikely to contribute directly to the lowering of the BMD of these patients.
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1399867
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Attitudes of low-income clinic patients toward menopause.
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The bulk of menopause research has been conducted on samples of middle-class White women. In this study, attitudes toward menopause in a sample of 66 low-income women at a women's clinic were studied using Bowles's (1986) Menopause Attitude Scale (MAS) and the attitude segment of Millette's (1981) survey of attitudes and knowledge about menopause. The typical participant was a single, 34-year-old Black woman with a yearly income below $10,000. Research questions examined general attitudes toward menopause, and MAS scores of Bowles's middle-income, White sample were compared with those of the present low-income, predominantly Black sample. Results indicated a somewhat positive attitude toward menopause in the low-income sample. Although the trend was toward higher scores in the low-income group, only the 18- to 25-year-olds in the low-income group had significantly higher MAS scores than the corresponding age group in Bowles's sample. Nursing implications pertain to teaching and support group leadership.
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1410947
|
General practitioners' attitudes to oestrogen prescription in the menopause: a national survey in Norway.
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A questionnaire was mailed to a random sample of approximately 10% of Norwegian general practitioners (GPs) in order to investigate attitudes to the prescription of hormone replacement therapy (HRT) in menopausal women. Nine short case histories were presented, and the GPs indicated their attitude to oestrogen prescription in each case on a five-step scale. Each case history contained four items that were systematically varied so that the effect of each could be investigated by comparing the answers from case to case. 251 GPs (74%) responded to the questionnaire. The answers indicated restrained attitudes towards prescription of HRT. Smoking and a family history of cardiovascular disease were regarded as contraindications. Angina pectoris was considered a contraindication for local oestrogen application in elderly women with urogenital complaints.
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1424192
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Effect of menopause and hormone replacement therapy on urinary excretion of pyridinium cross-links: a longitudinal and cross-sectional study.
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To study longitudinally the effect of the menopause and hormone replacement therapy on the new markers of bone resorption: urinary excretion of pyridinoline and deoxypyridinoline.
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1429782
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Relations between fertility, body shape and menopause in Austrian women.
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The influence of number and date of pregnancies, births, and spontaneous and induced abortions on body shape, age at menopause and menopausal symptoms have been studied for 110 postmenopausal Viennese women. A significant correlation between fertility and age at menopause was not found, but several menopausal symptoms showed statistically significant correlations with fertility. With a higher number of pregnancies the individual symptoms became more severe.
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