WOMEN 'S HEALTH AND MENOPAUSE : - National Heart, Lung ...

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TABLE OF CONTENTS Preface XIII 1 Executive Summary 1 2 The Menopause and Aging 23 3 Symptoms and the Menopause 43 4 Sociocultural Issues in Menopause 65 5 Physiological Role of Estrogen and Estrogen Receptors 77 6 The Pharmacologic Modulation of Estrogen Receptor Activity 103 7 Sexuality 121 8 Cardiovascular and Pulmonary Disease 141 9 Osteoporosis and Oral Bone Loss in Aging Women: Risks and Therapy 181 10 Gynecologic and Urinary Aspects of Menopause 203 11 Hormone Replacement Therapy, Related Therapies, and Cancer 223 12 Menopause and Disorders of Neurologic Function, Mental Health, and the Eye 251 13 Best Clinical Practices: A Comprehensive Approach 271 14 List of Abbreviations 295 XI
Page 1: National Heart, Lung, and Blood Ins
Page 4 and 5: CHAIRS AND EDITORS Chair and Editor
Page 6 and 7: Anne McTiernan, M.D., Ph.D. Associa
Page 8 and 9: Lenore Manderson, Ph.D. Director an
Page 10 and 11: Michael Mendelsohn, M.D. Director,
Page 14 and 15: XII
Page 16 and 17: On behalf of the NHLBI, I would lik
Page 18 and 19: an international panel of experts o
Page 20 and 21: TABLE 1-2 Possible Benefits and Ris
Page 22 and 23: TABLE 1-2 (continued) • Estimates
Page 24 and 25: • Physical activity. Evidence is
Page 26 and 27: tunity to develop ER subtype-select
Page 28 and 29: A lack of benefit may be due to cou
Page 30 and 31: 14 individuals are able to increase
Page 32 and 33: available hormone formulation suits
Page 34 and 35: 18 • Endometrial cancer. Estrogen
Page 36 and 37: TABLE 1-3 Women’s Health and Meno
Page 38 and 39: TABLE 1-3 (continued) 22 Menopausal
Page 40 and 41: 1. INTRODUCTION The third millenniu
Page 42 and 43: FIGURE 2-3 Diabetes Mellitus. Estim
Page 44 and 45: there is considerable individual va
Page 46 and 47: ity of resumption of menstruation a
Page 48 and 49: Subtle reproductive hormonal change
Page 50 and 51: in the early perimenopause, concomi
Page 52 and 53: taken by women are needed so that t
Page 54 and 55: REFERENCES 1 World Health Organizat
Page 56 and 57: 43 Hee J, MacNaughton J, Bangah M,
Page 58 and 59: 84 Crosignani PG, Aimi G, Vercellin
Page 60 and 61: 1. INTRODUCTION A large number of s
Page 62 and 63:
toms in a Scottish postal survey of
Page 64 and 65:
The analysis of longitudinal studie
Page 66 and 67:
flushes. 38 (See figs. 3-1 to 3-5.)
Page 68 and 69:
FIGURE 3-4 Proportion of Women Both
Page 70 and 71:
6th followup found that variables r
Page 72 and 73:
use of either continuous or sequent
Page 74 and 75:
• Long-term followup until women
Page 76 and 77:
23 Lehert P, Dennerstein L. Statist
Page 78 and 79:
69 Polo-Kantola P, Erkkola R, Irjal
Page 81 and 82:
CHAPTER 4: SOCIOCULTURAL ISSUES IN
Page 83 and 84:
European women and the low prevalen
Page 85 and 86:
majority regarded menopause as a na
Page 87 and 88:
dwellers reported symptoms, whereas
Page 89 and 90:
7. FUTURE NEEDS • As cross-cultur
Page 91 and 92:
22 Chompootweep S, Tankeyoon M, Yam
Page 93 and 94:
CHAPTER 5: PHYSIOLOGICAL ROLE OF ES
Page 95 and 96:
BMD, and tall stature due to unfuse
Page 97 and 98:
such as tamoxifen and raloxifene, o
Page 99 and 100:
damage by radicals and other toxic
Page 101 and 102:
Female mice unable to express eithe
Page 103 and 104:
growth spurt, closure of the epiphy
Page 105 and 106:
female rats has more GH receptors t
Page 107 and 108:
hormones from the anterior pituitar
Page 109 and 110:
8. FUTURE NEEDS Further characteriz
Page 111 and 112:
19 Mangelsdorf DJ, Thummel C, Beato
Page 113 and 114:
63 MacGillivray MH, Morishima A, Co
Page 115 and 116:
104 Register TC, Adams MR. Coronary
Page 117 and 118:
149 Di Paolo T. Modulation of brain
Page 119 and 120:
CHAPTER 6: THE PHARMACOLOGIC MODULA
Page 121 and 122:
factors listed below may contribute
Page 123 and 124:
in the past, to synthesize steroid
Page 125 and 126:
Alkylphenols and Arylphenols: Alkyl
Page 127 and 128:
essential and can be replaced by st
Page 129 and 130:
FIGURE 6-5 Mechanism of action of S
Page 131 and 132:
TABLE 6-1 Selective Estrogen Recept
Page 133 and 134:
REFERENCES 1 Mangelsdorf DJ, Thumme
Page 135 and 136:
42 Couse JF, Lindzey J, Grandien K,
Page 137 and 138:
CHAPTER 7: SEXUALITY Susan Hendrix,
Page 139 and 140:
TABLE 7-1 Prevalence of Female Sexu
Page 141 and 142:
A legitimate question to ask is whe
Page 143 and 144:
It makes sense intuitively that the
Page 145 and 146:
elow. One of the major changes in t
Page 147 and 148:
TABLE 7-2 Medications Associated Wi
Page 149 and 150:
ment in sexual desire in surgically
Page 151 and 152:
treatment efficacy. Sexual well-bei
Page 153 and 154:
23 Floter A, Nathorst-Boos J, Carls
Page 155 and 156:
75 Gartrell N. Increased libido in
Page 157 and 158:
CHAPTER 8: CARDIOVASCULAR AND PULMO
Page 159 and 160:
FIGURE 8-1 Age-Adjusted Death Rates
Page 161 and 162:
2.1 Dyslipidemia There is a strong
Page 163 and 164:
diet alone. 45 The Lifestyle Heart
Page 165 and 166:
TABLE 8-1 (continued) Recommendatio
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
ease. Clinical studies have also sh
Page 173 and 174:
estrogen found a small, but signifi
Page 175 and 176:
Overall, these studies show that or
Page 177 and 178:
were women. It can be concluded tha
Page 179 and 180:
also experienced more unfavorable c
Page 181 and 182:
SHEP have shown that drug treatment
Page 183 and 184:
12.2 Miscellaneous Conditions Pulmo
Page 185 and 186:
18 Pyörälä K, De Backer G, Graha
Page 187 and 188:
57 Mijatovic V, Kenemans P, Netelen
Page 189 and 190:
101 Hulley S, Grady D, Bush T, et a
Page 191 and 192:
142 Su W, Campos H, Judge H, Walsh
Page 193 and 194:
181 Cowley MJ, Mullin SM, Kelsey SF
Page 195 and 196:
221 Kober L, Torp-Pedersen C, Carls
Page 197 and 198:
CHAPTER 9: OSTEOPOROSIS AND ORAL BO
Page 199 and 200:
fracture of the spine, hip, or dist
Page 201 and 202:
caused by an imbalance between the
Page 203 and 204:
5.1.1 Calcium Controlled clinical t
Page 205 and 206:
fracture in postmenopausal women wi
Page 207 and 208:
ing alendronate, administration of
Page 209 and 210:
7.1 Epidemiology Analyses of U.S. d
Page 211 and 212:
8. FUTURE NEEDS • We must improve
Page 213 and 214:
20 Melton LJ III, Atkinson EJ, Coop
Page 215 and 216:
63 Torgerson DJ, Bell-Syer SE. Horm
Page 217 and 218:
107 Humphries S, Devlin H, Worthing
Page 219 and 220:
CHAPTER 10: GYNECOLOGIC AND URINARY
Page 221 and 222:
or hypotrophic, 24 percent were pro
Page 223 and 224:
usually disappears within 1 year. 3
Page 225 and 226:
Estrogen deficiency causes atrophic
Page 227 and 228:
TABLE 10-3 Other Factors Causing In
Page 229 and 230:
egularly to prevent leaking. Timed
Page 231 and 232:
inevitable or shameful but is treat
Page 233 and 234:
REFERENCES 1 Treolar AR, Bounton RE
Page 235 and 236:
43 Tsuda H, Kawabata M, Umesaki N,
Page 237 and 238:
86 Brown JS, Seeley DG, Fong J, Bla
Page 239 and 240:
CHAPTER 11: HORMONE REPLACEMENT THE
Page 241 and 242:
cers, 17 and perhaps with a reduced
Page 243 and 244:
showed that women who had used comb
Page 245 and 246:
TABLE 11-2 Summary Tabulation of Ri
Page 247 and 248:
4. OVARIAN CANCER Descriptive studi
Page 249 and 250:
TABLE 11-3 (continued) Case-Control
Page 251 and 252:
Of 12 case-control studies (see tab
Page 253 and 254:
TABLE 11-4 (continued) Adjustment R
Page 255 and 256:
TABLE 11-5 (continued) Adjustment R
Page 257 and 258:
strual correlates of colorectal can
Page 259 and 260:
In most studies, HRT has been relat
Page 261 and 262:
22 La Vecchia C. Sex hormones and c
Page 263 and 264:
70 Shapiro S, Kaufman DW, Slone D,
Page 265 and 266:
116 Calle EE, Miracle-McMahill HL,
Page 267 and 268:
CHAPTER 12: MENOPAUSE AND DISORDERS
Page 269 and 270:
TABLE 12-1 Estrogen Actions Potenti
Page 271 and 272:
cause of dementia; 45 whether its o
Page 273 and 274:
Alzheimer’s disease from, for exa
Page 275 and 276:
is alleviated by estrogen treatment
Page 277 and 278:
4.2 Cataract Cataract refers to a l
Page 279 and 280:
REFERENCES 1 Trévoux R, De Brux J,
Page 281 and 282:
42 Polo-Kantola P, Portin R, Polo O
Page 283 and 284:
86 O’Leary DH, Polak JF, Kronmal
Page 285 and 286:
138 Gregoire AJ, Kumar R, Everitt B
Page 287 and 288:
CHAPTER 13: BEST CLINICAL PRACTICES
Page 289 and 290:
Perception: Estrogen prevents memor
Page 291 and 292:
• Oral tibolone is as effective a
Page 293 and 294:
3.2.2 Diet • Correct calcium defi
Page 295 and 296:
4.1.1 Risk Factors The main risk fa
Page 297 and 298:
4.2.1 Lifestyle • At each visit,
Page 299 and 300:
see no reason to discontinue HRT in
Page 301 and 302:
• Pelvic exam • Colorectal scre
Page 303 and 304:
absence of HRT. The evidence for th
Page 305 and 306:
SUGGESTED READING (SYSTEMATIC REVIE
Page 307 and 308:
LaCroix AZ, Ott SM, Ichikawa L, Sch
Page 309 and 310:
Virtamo J, Rapola JM, Ripatti S, et
Page 311 and 312:
14. LIST OF ABBREVIATIONS ACC Ameri
Page 313 and 314:
ICI Imperial Chemical Industries PL
Page 315 and 316:
Discrimination Prohibited: Under pr
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