Menopause international最新文献

{"title":"Topical oxytocin reverses vaginal atrophy in postmenopausal women: a double-blind randomized pilot study.","authors":"Aino Fianu Jonasson,&nbsp;Lena Edwall,&nbsp;Kerstin Uvnäs-Moberg","doi":"10.1258/mi.2011.011030","DOIUrl":"https://doi.org/10.1258/mi.2011.011030","url":null,"abstract":"<p><strong>Introduction: </strong>Oxytocin is a peptide hormone produced in the hypothalamus and it is best known for its role in labour and lactation. This double-blind, randomized study was performed at Huddinge Hospital of Karolinska Institutet, Stockholm in order to test the effectiveness of topical oxytocin gel in women with postmenopausal vaginal atrophy.</p><p><strong>Methods: </strong>Twenty postmenopausal women (at least two years after menopause) with symptoms of vaginal atrophy such as vaginal dryness, pain, itching, discomfort and bleeding during intercourse were enrolled in the study when visual inspection of the vagina had confirmed that their mucosa was atrophic. The participants were randomized to intravaginal treatment with either oxytocin or placebo gel for seven days. Before and after treatment, a gynaecological examination and a visual and colposcopic inspection of the vagina were performed, biopsies from the vaginal mucosa were taken and blood samples were collected for analysis of circulating levels of estradiol and oxytocin.</p><p><strong>Results: </strong>Prior to treatment, visual and colposcopic inspection showed that all of the 20 participants had an atrophic vaginal mucosa. After treatment with the oxytocin gel, the examination showed that the vaginal epithelium of seven of the 10 participants in the oxytocin group had become healthier and normalized. No change in these parameters was observed among the 10 participants in the placebo group. This difference between the oxytocin and placebo groups was significant (P= 0.003). Seven participants in the active group and four in the placebo group reported relief of symptoms of vaginal atrophy after seven days of applying the gel. The effect of oxytocin to normalize the morphological appearance of the vaginal mucosa was almost significant when compared with the placebo group (P= 0.07). There was no significant difference between the circulating levels of estradiol and oxytocin in both the oxytocin and placebo groups before and after treatment. None of the participants reported any side-effects.</p><p><strong>Conclusion: </strong>Topical treatment with oxytocin appears to improve vaginal atrophy in postmenopausal women. A limitation of this pilot study is that it was based on a small study population hence the results should be regarded with caution. Larger studies are in progress to establish the possibility of using oxytocin as a clinical treatment for vaginal atrophy.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30285055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMS updates its recommendations on HRT.","authors":"Simon Brown","doi":"10.1258/mi.2011.011023","DOIUrl":"https://doi.org/10.1258/mi.2011.011023","url":null,"abstract":"The 13th World Congress on Menopause held in Rome in June saw publication of yet another International Menopause Society (IMS) statement on postmenopausal hormone therapy (HRT), this latest version at a time ‘when the atmosphere around the issue of postmenopausal HRT is much more rational’. The recommendations note that ‘the pendulum has swung back from its peak negative sentiment’ following publication of detailed data from the Women’s Health Initiative (WHI) showing the importance of age at the start of therapy and the ‘good safety profile’ of HRT in women younger than 60 years. Indeed, the recommendations state categorically that the ‘safety of HRT largely depends on age’, adding that healthy women under 60 years ‘should not be unduly concerned about the safety profile of HRT’. New data and re-analyses of older studies according to age show that, for most women, the potential benefits of HRT given for a clear indication are many and the risks are few when treatment is initiated within a few years of menopause. Thus, the benefits of HRT are most likely to be the relief of vasomotor symptoms and urogenital atrophy. Other menopause-related complaints, such as joint and muscle pains, mood swings, sleep disturbances and sexual dysfunction (including reduced libido) ‘may improve’ with HRT. On the contentious question of breast cancer risk, the report emphasizes the contributing role of progestogen; thus, say the recommendations, ‘it seems prudent to minimize progestogen use where safely possible’. And on cardiovascular risk, the recommendation is that in women under 60 years, or in those recently menopausal and without evidence of cardiovascular disease, ‘the initiation of HRT does not cause early harm and may reduce morbidity and mortality’. Continuation of HRT beyond the age of 60 should be decided as part of the overall risk– benefit analysis. The fall-out from the first WHI publication in 2002 was a massive swing away from HRT, as regulatory agencies sought cover under the protection of ‘shortest duration’ and ‘lowest effective dose’. Yet, within the 19-page detail of the IMS recommendations, many of these hyper-precautions are formally rejected, or at least rationally modified. Thus, as a ‘governing principle’, the IMS reports that ‘there are no reasons to place mandatory limitations on the duration of HRT.’ Continuation of therapy should be decided ‘at the discretion of the well-informed woman and her health professional’, dependent upon the specific goals and an objective estimation of ongoing benefits and risks. The IMS thus makes it clear that HRT cannot be prescribed according to an all-embracing formula; necessary for its prescription is a clear indication for use, which remains vasomotor symptoms or ‘the physical effects of estrogen deficiency’. Otherwise, HRT should be ‘individualized and tailored according to symptoms and the need for prevention, as well as personal and family history, results of relevant investigations, the woman’s pr","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29985289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stopping hormone replacement therapy: were women ill advised?","authors":"Grant P Cumming,&nbsp;Heather D Currie,&nbsp;Nick Panay,&nbsp;Rik Moncur,&nbsp;Amanda J Lee","doi":"10.1258/mi.2011.011103","DOIUrl":"https://doi.org/10.1258/mi.2011.011103","url":null,"abstract":"<p><strong>Objective: </strong>To survey women who stopped hormone replacement therapy (HRT) after 2002, including those who later restarted.</p><p><strong>Study design: </strong>A questionnaire on the UK-based menopause website www.menopausematters.co.uk evaluating how women are influenced by HRT advice. Main outcome measures Answers to questions regarding stopping/restarting HRT in response to the advice in the early 2000s and advice given today.</p><p><strong>Results: </strong>A total of 1100 responses were obtained. Of those who made the decision to stop HRT themselves, 56.4% (n = 425/754) said that they were influenced by the media. In those who would potentially most benefit from HRT, 72.8% (n = 220/302) stopped without medical advice. Overall, women aged under 50 years were significantly more likely to stop HRT themselves than women over 50 (P < 0.001). In women in whom symptoms returned, 37.5% (n = 362/966) said these affected their ability to work, 45.1% (n = 436) had problems with decision-making, 53.6% (n = 518) admitted to relationships being negatively affected and 29.2% (n = 286) said that symptoms affected their social relationships. Overall 46.5% of women (n = 485/1044) would not have stopped HRT given the current understanding of risk. Compared with women over 50, significantly more women under the age of 50 said that they would not have previously stopped their HRT based on their current understanding of risk (P < 0.001).</p><p><strong>Conclusions: </strong>The negative impact of published research and its reporting from the early 2000s are being mitigated by current press coverage. Media reports appear to influence the younger woman more than the older woman. Health professionals and media must learn the lessons from the past.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29985291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of menopause information must improve.","authors":"Edward Morris,&nbsp;Heather Currie","doi":"10.1258/mi.2011.011022","DOIUrl":"https://doi.org/10.1258/mi.2011.011022","url":null,"abstract":"The most important aspect of menopause management is providing women with accurate information about the process of ovarian failure (natural or induced) and consequences of estrogen deficiency, or the effects of ovarian removal and consequences of sudden estrogen deficiency, along with treatment options. The menopause affects all women differently and so women need accurate information about estrogen deficiency, diet and lifestyle recommendations and treatment options so that they can make informed choices about managing their menopause. Sadly it appears that this essential information is not being provided. Lyons reported on the low level of documentation of provision of information to women undergoing hysterectomy with or without oophorectomy and Yulia et al. reported similar findings in a poster presented at the 2011 British Menopause Society annual conference. A further poster from the 2011 annual conference from Cumming et al. demonstrated results of a survey asking what information women feel that they would like to be given and whether or not this information was received, showing failure in terms of advising about diet, lifestyle and alternative therapies. If women choose to take hormone therapy to manage their menopause, they then need ongoing review and advice about risks and benefits, which is the most appropriate type, and how long this should be taken. A survey looking at women’s reasons to stop taking hormone replacement therapy (HRT) and the effects of stopping shows that in fact many women decide to stop therapy without discussion with their health-care professional, and that often their decision is influenced by the media. For many women, this may indeed be the correct decision, but it appears that many young women, who are most likely to benefit from continuing HRT, stopped therapy without discussion, and that many have recurrence of troublesome symptoms on stopping. If women rely on information from the media, then this too needs to be accurate, yet a presentation at the International Menopause Society annual conference suggested that in respect of HRT, osteoporosis and menopause in general, the knowledge of media personnel, at least in Sri Lanka, was unsatisfactory. A similar survey in other countries would be of great interest. A previous issue included the British Menopause Society recommendation that all women should be invited for a health check around the time of their 50th birthday. This would be an ideal opportunity to provide up-to-date, essential information and advice that could transform her future health risk. Until this process is in place, we must all keep in mind the consequences of estrogen deficiency in the intermediate and long term, not just short term, when seeing women in the postmenopausal years, for whatever reason, so that we can provide required information opportunistically. We suggest therefore, that education about menopause, the consequences of estrogen deficiency and treatment options should exten","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29985288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global study of women's experiences of premenstrual symptoms and their effects on daily life.","authors":"Lorraine Dennerstein,&nbsp;Philippe Lehert,&nbsp;Klaas Heinemann","doi":"10.1258/mi.2011.011027","DOIUrl":"https://doi.org/10.1258/mi.2011.011027","url":null,"abstract":"<p><strong>Objectives: </strong>To determine cross-cultural and other effects on women's experiences of premenstrual symptoms and their impact on activities of daily life (ADL).</p><p><strong>Study design: </strong>Cross-sectional survey. Sample A total of 7226 women aged 15-49 recruited by random sampling with approximately 400 each from France, Germany, Hungary, Italy, Spain, UK, Brazil, Mexico, Hong Kong, Pakistan and Thailand. Approximately 1000 women in Japan and Korea and 500 Australian women were found using Internet panels.</p><p><strong>Main outcome measures: </strong>Questionnaire of 23 premenstrual symptoms, sociodemographic and lifestyle variables, ADL and women's knowledge of premenstrual terms.</p><p><strong>Results: </strong>The most prevalent symptoms were abdominal bloating, cramps or abdominal pain, irritability, mastalgia and joint/muscle/back pains. Severity of symptoms was directly proportional to duration (number of affected cycles) (R = 0.78). A linear model found that symptom prevalence (duration × severity) was associated with age (linear and quadratic effects), parity, current smoking and country. Premenstrual physical and mental symptom domains had similar negative effects on ADL. Impact on ADL was affected by education and exercise participation. Women's knowledge of the terms premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) varied by symptom intensity, age, education and country.</p><p><strong>Conclusions: </strong>Four of the five most prevalent premenstrual symptoms were physical. There was a great deal of similarities of women's experiences of these symptoms across countries and regions. Women's knowledge of PMS terms is highly dependent on the country in which they live.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30130681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of yoga on menopausal symptoms.","authors":"Sulabha Joshi,&nbsp;Rambhau Khandwe,&nbsp;Dinesh Bapat,&nbsp;Ujwala Deshmukh","doi":"10.1258/mi.2011.011020","DOIUrl":"https://doi.org/10.1258/mi.2011.011020","url":null,"abstract":"<p><strong>Objectives: </strong>To observe the effect of yoga on menopausal symptoms using a prospective, randomized, controlled and interventional study. Main outcome measures Total Menopause Rating Scale (MRS) score and three subscale scores (somatovegetative, psychological and urogenital) were measured on day 1 and day 90 in the study group which performed yoga (asana, pranayam and meditation) under supervision for three months, and were compared with the control group that did not perform yoga. MRS has been designed to measure health-related quality of life of ageing women. It consists of 11 symptoms and three subscales.</p><p><strong>Results: </strong>It was observed that on day 1 the scores in both the groups were comparable. On day 90, the scores in the yoga group showed a reduction in score on all the subscales, which was statistically significant. No significant difference was noted in the control group.</p><p><strong>Conclusion: </strong>Yoga is effective in reducing menopausal symptoms and should be considered as alternative therapy for the management of menopausal symptoms.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29985290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global epidemiological study of variation of premenstrual symptoms with age and sociodemographic factors.","authors":"Lorraine Dennerstein,&nbsp;Philippe Lehert,&nbsp;Klaas Heinemann","doi":"10.1258/mi.2011.011028","DOIUrl":"https://doi.org/10.1258/mi.2011.011028","url":null,"abstract":"<p><strong>Objectives: </strong>To determine patterns of premenstrual symptom experiences across the reproductive age range, and the effects of other factors on premenstrual symptoms.</p><p><strong>Study design: </strong>Global cross-sectional survey. Sample A total of 7226 women aged 15-49 recruited by random sampling with approximately 400 each from France, Germany, Hungary, Italy, Spain, UK, Brazil, Mexico, Hong Kong, Pakistan and Thailand. Approximately 1000 women in Japan and Korea and 500 Australian women were found using Internet panels.</p><p><strong>Main outcome measures: </strong>Questionnaire of 23 premenstrual symptoms, sociodemographic and lifestyle variables.</p><p><strong>Results: </strong>Four different patterns of premenstrual symptoms were found with ageing: symptoms showing no change with age, symptoms decreasing with age, symptoms reaching a maximum just before or around age 35, and symptoms reaching a maximum around age 40-44. Smoking was associated with an increase in most of the premenstrual symptoms. Increasing parity was associated with a decrease in some of the symptoms.</p><p><strong>Conclusions: </strong>These results suggest that the premenstrual symptoms most associated with the years of regular ovulatory cycles are skin disorders, lack of energy, appetite problems, joint/muscle/back pain, anger, abdominal bloating, depressed mood and irritability. Other symptoms which peaked later (swelling of extremities, breast tenderness/pain, weight gain) may reflect exacerbation by hormonal changes of the late reproductive/early menopausal transition. Smokers report more problematic premenstrual symptoms.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30130682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D and the postmenopausal population.","authors":"Christopher R Holroyd,&nbsp;Cyrus Cooper,&nbsp;Nicholas C Harvey","doi":"10.1258/mi.2011.011025","DOIUrl":"https://doi.org/10.1258/mi.2011.011025","url":null,"abstract":"<p><p>Vitamin D, a hormone critical to the body's maintenance of serum calcium and phosphorus concentrations, is currently the subject of much scientific interest. Low levels of vitamin D have been observed in many populations and epidemiological studies have suggested a link between this biochemical state and a range of diseases, such as cancer, diabetes and multiple sclerosis. While the consequence of vitamin D deficiency is well documented for bone (rickets and osteomalacia), with mixed findings relating to falls and fractures, a causal link between vitamin D deficiency and these wider health outcomes has not been established. If these relationships were found to be causal, the morbidity and mortality resulting from low levels of vitamin D could be substantial; the current evidence base, however, most robustly supports the assessment of serum 25(OH)-vitamin D in the context of specific symptoms, low bone mineral density or biochemical abnormalities, rather than as an entity to treat in its own right or as the basis for a population-wide screening programme.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30130683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Row brewing over the relevance of survival or mortality rates in breast cancer.","authors":"Simon Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30070927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis? Just check the facial wrinkles.","authors":"Simon Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30216561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}