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

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• Long-term followup until women are at least 10 years postmenopausal, so that longer term effects can be studied, including the natural history of untreated symptoms • Studies of different populations worldwide, representing women from a broader array of racialethnic and socioeconomic backgrounds In the field of treatment interventions, there have been many RCTs of different forms of HRT on symptoms, and larger studies are in progress. On the other hand, there is a need for— • Questionnaires validating phytoestrogen intake against metabolic measures of metabolites in different cultural settings before either RCTs or observational studies of the role of phytoestrogens can proceed • Alarger RCT of phytoestrogen supplementations, including metabolic measures of metabolite levels 58
REFERENCES 1 Stewart AL, Hays RD, Ware JE Jr. The MOS shortform general health survey Reliability and validity in a patient population. Med Care 1988;26(7):724–35. 2 Neugarten BL, Havighurst RJ, Tobin SS. The measurement of life satisfaction. J Gerontol 1961;16:134–43. 3 Folkman S, Lazarus RS. An analysis of coping in a middle-aged community sample. J Health Soc Behav 1980;21(3):219–39. 4 Radloff LS. The Center for Epidemiologic Studies–Depression scale: A self-report depression scale for research in the general population. Appl Psychol Mea 1977;1:385–401. 5 Dennerstein L, Helmes E. The menopausal transition and quality of life: Methodologic issues. Qual Life Res 2000;9(Suppl S):721–31. 6 McKinlay JB, McKinlay SM, Brambilla DJ. Health status and utilization behavior associated with menopause. Am J Epidemiol 1987;125(1):110–21. 7 Morse CA, Smith A, Dennerstein L, Green A, Hopper J, Burger H. The treatment-seeking woman at menopause. Maturitas 1994;18(3):161–73. 8 Avis NE, McKinlay SM. The Massachusetts Women’s Health Study: an epidemiologic investigation of the menopause. J Am Med Womens Assoc 1995;50(2):45–9, 63. 9 Kaufert P, Syrotuik J. Symptom reporting at the menopause. Soc Sci Med – [E] 1981;15(3):173–84. 10 Kupperman H, Blatt M, Wiesbader H, Togashi S. Use of the amenorrhoea and menopausal index in the clinical evaluation of estrogenic compounds. Fed Proc 1952;11:365. 11 Wright AL. On the calculation of climacteric symptoms. Maturitas 1981;3(1):55–63. 12 Holte A. Prevalence of climacteric complaints in a representative sample of middle-aged women in Oslo, Norway. J Psychosom Obst Gyn 1991;12:303–17. 13 Porter M, Penney GC, Russell D, Russell E, Templeton A. A population based survey of women’s experience of the menopause. Br J Obstet Gynaecol 1996;103(10):1025–8. 14 Alder E. The Blatt-Kupperman menopausal index: a critique. Maturitas 1998;29(1):19–24. 15 Blatt M, Wiesbader H, Kuppermann HS. Vitamin E and climacteric syndrome. AMA Arch Intern Med 1953:792–9. 16 Neugarten BL, Kraines RJ. Menopausal symptoms in women of various ages. Pyschosom Med 1965;27:266–73. 17 Greene JG. A factor analytic study of climacteric symptoms. J Psychosom Res 1976;20(5):425–30. 18 Greene JG. Constructing a standard climacteric scale. Maturitas 1998;29(1):25–31. 19 Van Keep Pam, Kellerhals, JM. The ageing woman. About the influence of some social and cultural factors on the changes in attitude and behaviour that occur during and after the menopause. Acta Obstet Gynecol Scand Suppl 1976;51:17–27. 20 McCoy NL, Davidson JM. A longitudinal study of the effects of menopause on sexuality. Maturitas 1985;7(3):203–10. 21 Burger HG, Dudley EC, Hopper JL, Shelly JM, Green A, Smith A, Dennerstein L, Morse C. The endocrinology of the menopausal transition: a cross-sectional study of a population-based sample. J Clin Endocrinol Metab 1995;80(12):3537–45. 22 Wheeler JM. A multivariate look at the menopause. J Clin Epidemiol 1989;42(11):1029-30. 59
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National Heart, Lung, and Blood Ins
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CHAIRS AND EDITORS Chair and Editor
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Anne McTiernan, M.D., Ph.D. Associa
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Lenore Manderson, Ph.D. Director an
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Michael Mendelsohn, M.D. Director,
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TABLE OF CONTENTS Preface XIII 1 Ex
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PREFACE Women’s health and menopa
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CHAPTER 1: EXECUTIVE SUMMARY Nanett
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TABLE 1-1 Evidence Categories Evide
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TABLE 1-2 (continued) Possible Bene
Page 23 and 24: symptom measures, cultural factors,
Page 25 and 26: 5. PHYSIOLOGICAL ROLE OF ESTROGEN A
Page 27 and 28: The atherogenic risk profile of old
Page 29 and 30: • Hormone replacement therapy: Fi
Page 31 and 32: tion of the remaining ridge in area
Page 33 and 34: 9.3.1 Interventions • In many cas
Page 35 and 36: Parkinson’s disease, no overall p
Page 37 and 38: TABLE 1-3 (continued) Sexuality •
Page 39 and 40: CHAPTER 2: THE MENOPAUSE AND AGING
Page 41 and 42: oped and are less prepared to addre
Page 43 and 44: FIGURE 2-4 Diabetes Mellitus. Estim
Page 45 and 46: Sarcopenia, defined as reduced musc
Page 47 and 48: Perimenopause WHO The term “perim
Page 49 and 50: decrease about 2 years before the F
Page 51 and 52: 4.3 Menstrually Defined Menopausal
Page 53 and 54: to be under stress and to hold part
Page 55 and 56: 21 Brincat MP. Hormone replacement
Page 57 and 58: 62 Orentreich N, Brind JL, Rizer RL
Page 59 and 60: CHAPTER 3: SYMPTOMS AND THE MENOPAU
Page 61 and 62: women who may have reached natural
Page 63 and 64: numb-tingling feelings, headaches,
Page 65 and 66: (47 percent), problems sleeping (39
Page 67 and 68: FIGURE 3-2 Proportion of Women Both
Page 69 and 70: tomized hypogonadotropic women expe
Page 71 and 72: 5.1 Exercise It has been suggested
Page 73: to consume 20-150 mg/day of isoflav
Page 77 and 78: 48 Avis NE, Crawford SL, McKinlay S
Page 79: 92 Albertazzi P, Pansini F, Bonacco
Page 82 and 83: Hällström wrote that the psycholo
Page 84 and 85: countries. Perhaps, as the authors
Page 86 and 87: Beyene used a systematic ethnograph
Page 88 and 89: ange of variables, such as genetic
Page 90 and 91: REFERENCES 1 Gannon L, Ekstrom B. A
Page 92 and 93: 47 George T. Women in a south India
Page 94 and 95: 9. Estrogen and inhibins produced b
Page 96 and 97: HRT) display tissue-selective estro
Page 98 and 99: a partial agonist. In contrast, wit
Page 100 and 101: 3. UROGENITAL TRACT ERα and ERβ a
Page 102 and 103: 4. BONE: DEVELOPMENT AND HOMEOSTASI
Page 104 and 105: in response to estrogen. 106,105 In
Page 106 and 107: lation of sleep, motor behavior, an
Page 108 and 109: 7. HORMONE REPLACEMENT THERAPY: TRA
Page 110 and 111: REFERENCES 1 Jensen EV, Jacobsen HI
Page 112 and 113: 40 Power RF, Mani SK, Codina J, Con
Page 114 and 115: 83 Oursler MJ, Pederson L, Fitzpatr
Page 116 and 117: 125 Gabrielsson BG, Carmignac DF, F
Page 118 and 119: 169 Renier MA, Vereecken A, Buytaer
Page 120 and 121: FIGURE 6-1 Structural features of E
Page 122 and 123: ound, the conformation of the recep
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with extremely potent estrogenic ac
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Its potency as an antiestrogen was
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The observation that the degree of
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findings were remarkable because a
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Recently, the use of phage display
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20 Crawley G. Non steroidal estroge
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65 Qu Q, Zheng H, Dahllund J, et al
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in their survey of postmenopausal w
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where over half the world’s popul
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The Danish study of Koster and Gard
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Many studies of sexual interest in
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7. ASSESSING SEXUAL ACTIVITY Clinic
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None of these studies evaluated the
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estrogen-androgen group during the
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REFERENCES 1 Sarrel PM, Whitehead M
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52 Utian WH. The true clinical feat
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140
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outes of administration and differe
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FIGURE 8-2 Change in Age-Adjusted D
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fied as overweight or obese. 32 The
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TABLE 8-1 148 Guide to Risk Reducti
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TABLE 8-1 (continued) 150 Recommend
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TABLE 8-1 (continued) 152 Recommend
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Interesting differences in atherosc
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similar effects in both patients wi
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a lowering of triglycerides, 140 an
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may account for a substantial propo
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associated with an independent prot
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eases preoperatively. Quality of li
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excess risk of 6-18 per 10,000 per
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REFERENCES 1 NHLBI Morbidity and Mo
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36 Samaras K, Hayward CS, Sullivan
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79 Collins P, Rosano GM, Jiang C, L
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121 Mäkelä S, Savolainen H, Aavik
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162 Clarke S, Kelleher H, Lloyd-Jon
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201 Rahimtoola SH, Bennett AJ, Grun
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243 Varas-Lorenzo C, Garcia-Rodriqu
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7. A connection between menopausal
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3. PATHOGENESIS OF FRACTURE Fractur
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Diagnosis of osteoporosis according
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density and has a favorable effect
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How should this information be inco
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emergence of proved treatment alter
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Data on the relation between skelet
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REFERENCES 1 Osteoporosis Preventio
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42 Gluer CC. Quantitative ultrasoun
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85 Ettinger B, Pressman A, Silver P
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130 Jeffcoat MK, Lewis CE, Reddy M,
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1. INTRODUCTION Perimenopausal wome
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for breast cancer are at increased
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findings on biopsy in women with an
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thra. Patients typically describe l
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Biofeedback: Used in conjunction wi
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There has been one systematic revie
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ence in pelvic organ prolapse. The
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21 Ferenczy A. Endometrial carcinom
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65 Wyman JF, Fantl JA, McClish DK,
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222
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1. INTRODUCTION Worldwide, breast c
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difficult to compare because of com
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Although HRT has been related to an
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cyclic use and 2.9 (95 percent CI 2
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TABLE 11-3 Selected Studies on Horm
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TABLE 11-3 (continued) Thus, a stro
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TABLE 11-4 236 Cohort Studies on Ho
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TABLE 11-5 238 Case-Control Studies
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TABLE 11-5 (continued) 240 Adjustme
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When the same women in NSABP were r
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REFERENCES 1 Pisani P, Parkin DM, B
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47 Day NE. Epidemiology: the role o
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93 Rodriguez C, Patel AV, Calle EE,
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139 Parazzini F, La Vecchia C, Negr
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1. INTRODUCTION Menopause is associ
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inverse relation with nonverbal mem
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ease decreased significantly with i
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of households selected to be repres
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standard antipsychotic drugs increa
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5. FUTURE NEEDS • Explore the pos
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19 Berman KF, Schmidt PJ, Rubinow D
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64 Lerner A, Koss E, Debanne S, Row
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114 Smith R, Studd JW. A pilot stud
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162 Klein BE. Lens opacities in wom
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patients with strong personal convi
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Therefore, convincing evidence of t
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3.1.1 Risk Factors Many factors are
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278 lower dosages of estrogen will
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• Diabetes: Women with diabetes b
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Lipids and lipoproteins • LDL cho
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284 persists but is less steep in w
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5.2.3 Pharmacotherapy Breast Cancer
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• There is no clinical trial evid
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Sirtori CR, Pazzucconi F, Colombo L
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Hansson L, Zanchetti A, Carruthers
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Dementia and Mental Health Forette
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CRP C-reactive protein CT computed
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PTCA percutaneous transluminal coro
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U.S. DEPARTMENT OF HEALTH AND HUMAN
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