Postmenopausal Phase Research Articles

GAMBARAN PENGETAHUAN PREMENOPAUSE TENTANG PERUBAHAN FISIK DALAM MENGHADAPI MASA MENOPAUSE DI DUSUN MANNYOI DESA TAMANNYELENG KECAMATAN BAROMBONG KAB. GOWA

Premenapause Knowledge Overview About Physical Period Facing Menopause Period In Mannyoi Village Tamannyeleng Village Barombong District Gowa Regency 2018. (guided by HJ Sitti Mukarramah and Agustina Ningsih) Changes that occur during menopause, women experience a peak complaint while in the post-menopausal phase of this period lasts 6-7 years after menopause. At this time estrogen levels after the low point in accordance with the state of the art and accompanied by the deterioration of body condition. This study aims to determine the characteristics of respondents and description of premenopausal knowledge about physical changes in the face of menopause In Mannyoi Village Tamannyeleng Village District Barombong Gowa District. Samples were taken from primary data, all mothers aged 40 to 55 years old in Mannyoi Village Tamannyeleng Village Barombong District of Gowa regency that fit the criteria in sampling, during the period of February to May 2018, the type of research is descriptive with the method used is through a questionnaire with cross sectional approach, with a sample size of 50 respondents. Characteristics of respondents based on the level of education is elementary education of 41 respondents (82%), SMP of 8 respondents (16%) and the high school education of 1 respondent (2%) and characteristics of respondents by age, 40-49 years age of 37 74%) and age> 50 years at 13 (26%). Good knowledge as many as 34 people (68%), while knowledgeable enough as much as 9 people (18%) and who have less knowledge as much as 7 people (14%). One of the main concerns of mother's knowledge is the intervention of health workers and information from the surrounding community Keywords: Knowledge, Premenopause

WEIGHT GAIN AND BREAST CANCER IN PREMENOPAUSAL PHASE OF WOMEN

Breast cancer (BC) is one of the leading causes of cancer mortality in female in the world. It is the second most common cancer among Indian women.(1). It is accounted for 25% of female cancer cases at all ages and for a greater percentage among young women. (2,3).Various studies reported that increased adiposity in childhood and before menopause is inversely associated with the risk of breast cancer diagnosed at premenopausal and postmenopausal ages, whereas increased adiposity after menopause is positively associated with risk.( 3-13).Obesity is associated both with a higher risk of developing breast cancer, particularly in postmenopausal women, and with worse disease outcome for women of all ages(14).In this study we considered copious studies concerning with weight gain and breast cancer in premenopausal phase of women. Thereafter in the last section of the study conclusion is made. Discussion: Being a woman is a risk factor for being diagnosed with breast cancer. Studies scrutinized, are reecting that obesity as well as premenopausal and postmenopausal phases impersonate their signicance in accentuated disease occurrence.

Morbidity Patterns among Menopausal Women in Rural Uttar Pradesh, India: A Cross-Sectional Study.

ObjectivesThe quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women.MethodsThis community-based cross-sectional study included menopausal women aged 45–55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews.ResultsA total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase.ConclusionsThis study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage. Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.

Evaluation of histomorphological findings and malignancies in postmenopausal bleeding

Introduction: In this era, as the life expectancy is increasing, women are experiencing a long postmenopausal phase. Postmenopausal bleeding (PMB) is a sinister complaint and accounts for about 10% of postmenopausal complaints. Being a symptom of varied etiologies and its strong association with malignancy, it should be diligently evaluated. Aims and Objectives: 1. To evaluate the histopathological spectrum of lesions presenting as PMB. 2. To estimate the incidence of premalignant, and malignant lesions presenting as PMB. 3. To confirm the benign nature of the lesions to prevent unnecessary radical treatment. Materials and Methods: This prospective study done from January 2016 to September 2017 and included the endometrial biopsies/curettages and cervical biopsies sent for histopathological examination from clinically diagnosed cases of postmenopausal bleeding. Results: Out of all the samples majority were benign lesions (44%), followed by premalignant (25.7%), malignant lesions (18.3%). Conclusion: A variety of histopathological findings are seen in PMB. Benign pathologies were more common in our study but the collective proportion of premalignant and malignant lesions is considerably higher in this study. Accurate diagnosis makes it much easier to counsel the patient about further course of management, prevent unnecessary radical treatment for benign conditions, prompt treatment, and vigilant follow up for malignant lesions. Keywords: Postmenopausal bleeding (PMB), Endometrial carcinoma, Histopathology.

Reproductive aging and executive functions in healthy women

ABSTRACT The aim of this study was to analyze the influence of reproductive aging on executive functions. We assessed executive functions in three groups of healthy women in the premenopausal (n = 45, mean age = 30.89, SD = 10.5), perimenopausal (n = 31, mean age = 50.06, SD = 3.6) and postmenopausal (n = 24, mean age = 63.39, SD = 6.5) phase. No differences between groups were observed in working memory, verbal fluency, inhibitory control, planning, and cognitive flexibility. However, when the analyses were repeated with participants with occupations with lower intellectual demands, perimenopausal and postmenopausal women performed worse than premenopausal women in semantic verbal fluency. This study provides important evidence to understand the effects of reproductive aging on cognitive performance in healthy women. Our findings indicate that cognitive reserve-related factors may be important to understand the differences in executive functions associated with reproductive aging.

Comparison of Some Physiological Parameters in Female Rheumatoid Arthritis Patients in Pre- and Postmenopausal Stages

Rheumatoid arthritis is an autoimmune disorder that is highly prevalent, leading to gradual cartilage distraction, and therefore is important to diagnose in the early stage. This study aimed to estimate the level of rheumatoid factor (RF) and Anti-citrullinated protein (Anti-ccp) in the serum of female patients. We also investigated several female reproductive hormones in the patients and compared their levels in the premenopausal and postmenopausal phases. The study included 88 female subjects, 50 suffering from signs of rheumatoid arthritis who were attending AL-Yarmouk teaching hospital, Baghdad, Iraq, and 38 without clinical signs of RA as a control group. The ELISA technique was used to estimate all the studied parameters. The results showed a significant elevation in the levels of RF (103.6 ± 227.0 vs. 22.1 ± 111.0 U/ml) and Anti-ccp (158.0 ± 170.0 vs. 0.51 ± 1.69 U/ml) in patient’s serum as compared to the control. The percentage of overweight and obese patients was higher than that of those with normal weight. Also, the current results showed significant differences in the serum concentrations of the reproductive hormones between the premenopausal and postmenopausal phases in the patients group. The level of FSH in postmenopausal female patients was higher than that in premenopausal ones (33.5 ± 17.9 vs. 9.01 ± 9.31 U/ml). Also, the level of luteinizing hormone (LH) in the postmenopausal patients was higher than that in the premenopausal patients (26.4 ± 12.3 vs. 12.7 ± 10.2 U/ml). While the level of prolactin (PRL) in RA postmenopausal female patients was lower than that in the premenopausal patients (8.60 ± 7.07 vs. 14.8 ± 10.6 ng/ml). In addition, the level of Anti-mullerian hormone (AMH) in post-menopausal patients was lower than that in the pre-menopausal ones (0.034 ± 0.023 vs. 0.635 ± 0.683 ng/ml). Finally, the concentration of estradiol (E2) in the post-menopausal female patients was lower than that in the pre-menopausal ones (32.9 ± 18.6 vs. 76.5 ± 43.6 ng/ml).

Exercise intensity to maximal aerobic speed, physical activity level and heart rate variability in postmenopausal women

Physical inactivity is main cause of disease worldwide. Identify the physical exercise preference, resulting in increases adherence and future intention to perform physical activity. The preference of the intensity of exercise questionnaire (PRETIE-Q) is the main tool used to assess preference in physical exercise. Variables as age, body mass index (BMI), usual physical activity level (PAL), maximal oxygen uptake (VO2máx), can influence in PRETIE-Q answers. The purpose of this study was investigate if there is relation between preference for exercise intensity with maximal aerobic speed (MAS), PAL and heart rate variability (HRV) in postmenopausal women phase. Participated of study 30 subjects who answer PRETIE-Q together with analyses of MAS, PAL and HRV. Preference was large correlated with MAS (r = 0.63), PAL (r = 0.57) and HRVRMSSD (r = 0.52). Together, MAS (40.4%), PAL (10.7%) and HRVRMSSD (6.4%) explained 57.5% of the preference score. This results study allow to health professional, that prescribe physical exercise, understand that subjects with high aerobic capacity, cardiovagal modulation and usual PAL will have preference for high intensity exercise. In consequence, can increase the adherence to systematic practice of physical exercise. Conclude that preference of exercise intensity for women in postmenopausal phase is related with aerobic capacity, high HRV and physical activity level.

‘They should come forward with the information': menopause-related health literacy and health care experiences among Vietnamese-born women in Melbourne, Australia

ABSTRACT Objectives: Health literacy refers to an individual’s capacity to access, understand, evaluate and use health information to make well informed health-related decision to maintain and promote optimal health. Low health literacy is linked with worse health outcomes and is more common in people from socio-economically disadvantaged backgrounds and from culturally and linguistically diverse backgrounds and among people with limited education. Peri-menopausal and postmenopausal health behaviour predicts health in later life. This qualitative study was conducted in Melbourne, Australia. The aim of this study was to explore menopause-related health literacy and experiences with menopause-related health care among Vietnamese-born women who had immigrated to Australia as adults. Design: A qualitative study using semi-structured interviews was conducted with women aged between 45 and 60 years and who were either in the peri or postmenopausal phase. Transcripts were analysed thematically. Results: A total of 12 women were interviewed. Participants viewed menopause as a natural event and obtained most of their menopause-related information from family and friends. Limited English language proficiency affected their capacity to access, understand, evaluate and use menopause-related health information. They identified their Vietnamese speaking General Practitioners (GPs) as a reliable source of health information, but ‘shyness’ prevented them from asking questions about menopause and they suggested that GPs need to initiate menopause-related health conversations. Conclusion: Low menopause-related health literacy among Vietnamese-born immigrant women may limit their opportunities to access information about and benefit from menopause-related health-promoting behaviours. Access to menopause-related health information in relevant community languages is essential to support immigrant women to make well informed menopause-related health decisions.

Response to fatigue observed through magnetic resonance imaging on the quadriceps muscle in postmenopausal women

OBJECTIVES:Menopause marks the end of women’s reproductive period and can lead to sarcopenia and osteoporosis (OP), increasing the risk of falls and fractures. The aim of this study is to evaluate the influence of normal and low bone mineral density (BMD) on muscular activity, observed through inflammatory edema when mapping using magnetic resonance imaging (MRI) on the quadriceps muscle of postmenopausal women.METHODS:This was a cross-sectional study involving 16 older women, who were divided into two groups: osteoporosis group (OG), older women with OP, and control group (CG), older women without OP. The groups were evaluated in terms of nuclear MRI exam before and after carrying out fatigue protocol exercises using an isokinetic dynamometer and squatting exercises.RESULTS:The results of the present study showed that in intragroup comparisons, for both groups, there was a significant increase (p<0.05) in the T2 signal of the nuclear MRI in the quadriceps muscle after carrying out exercises using both thighs. In the intergroup comparison, no statistically significant difference was observed between the OG and CG, pre- (p=0.343) and postexercise (p=0.874).CONCLUSION:The acute muscular activation of the quadriceps evaluated by T2 mapping on nuclear MRI equipment is equal in women with and without OP in the postmenopausal phase. BMD did not interfere with muscle response to exercise when muscle fatigue was reached.

Oral manifestation and its management in postmenopausal women: an integrated review.

Postmenopause is a phase of life which leads physical and emotional instability from multiple health related issues. Oral health in this stage of life is also compromised. Oral health has an impact on general wellbeing of the individual as oral cavity is commonly act as a mirror to general health. Menopause is phase in a woman’s life when menstrual cycles cease by reduced secretion of the ovarian hormones, such as estrogen and progesterone. This review article has emphasized on the diverse oral presentations of peri- and postmenopausal phase of women’s life. Practicing dental surgeons and general physician should be aware of the possible association of postmenopause and its various oral signs and symptoms in this midlife phase of women. It also focuses on its symptomatic management of various oral health issues. This article explains diverse oral conditions in detailed and their management. Stress causing anxiety and depression among this midlife phase of women can lead to alteration in immunity which can again lead to various oral conditions, like lichen planus, apthous ulcer that can cause burning sensation in oral mucosa and alter the food habit. By dealing with all this diverse condition, practicing oral physician can help to reduce and manage oral manifestation of postmenopausal phase of life.

Do Older Adults With Reduced Bone Mineral Density Benefit From Strength Training? A Critically Appraised Topic.

Clinical Scenario: Reduced bone mineral density (BMD) is a serious condition in older adults. The mild form, osteopenia, is often a precursor of osteoporosis. Osteoporosis is a pathological condition and a global health problem as it is one of the most common diseases in developed countries. Finding solutions for prevention and therapy should be prioritized. Therefore, the critically appraised topic focuses on strength training as a treatment to counteract a further decline in BMD in older adults. Clinical Question: Is strength training beneficial in increasing BMD in older people with osteopenia or osteoporosis? Summary of Key Findings: Four of the 5 reviewed studies with the highest evidence showed a significant increase in lumbar spine BMD after strength training interventions in comparison with control groups. The fifth study confirmed the maintenance of lumbar spine density due to conducted exercises. Moreover, 3 reviewed studies revealed increasing BMD at the femoral neck after strength training when compared with controls, which appeared significant in 2 of them. Clinical Bottom Line: The findings indicate that strength training has a significant positive influence on BMD in older women (ie,postmenopausal) with osteoporosis or osteopenia. However, it is not recommended to only rely on strength training as the increase of BMD may not appear fast enough to reach the minimal desired values. A combination of strength training and supplements/medication seems most adequate. Generalization of the findings to older men with reduced BMD should be done with caution due to the lack of studies. Strength of Recommendation: There is grade B of recommendation to support the validity of strength training for older women in postmenopausal phase with reduced BMD.

Herbal prescription for managing menopausal disorders: A practice survey in Korean medicine doctors

BackgroundThe aim of this study was to investigate the clinical practice of Korean medicine doctors (KMDs) for managing menopausal disorders. MethodsWe conducted a web-based questionnaire for KMDs to respond to recommendations across the three main KM domains: major symptoms of menopausal disorders, herbal prescriptions, and pattern identification. ResultsWe received responses from 227 doctors who have treated menopausal disorders. The major pattern identifications recommended by the doctors for the pre-, peri-, and postmenopausal phases, respectively, were depression of liver energy (59.5%), kidney yin deficiency (49.8%), and kidney yin deficiency (50.7%). The most frequent herbal remedies prescribed for the pre-, peri-, and postmenopausal phases were Jiawei shaoyao-san (58.1%), Jiawei shaoyao-san (48.5%), and Jiawei guipi-decoction (37.9%), respectively. ConclusionThe results of our clinical practice survey provide information on KMDs’ clinical experiences of using herbal medicines and their use of pattern identification to manage menopausal disorders.

Joint recommendations for the diagnosis and treatment of vulvo-vaginal atrophy in women in the peri- and post-menopausal phases from the Società Italiana per la Menopausa (SIM) and the Società Italiana della Terza Età (SIGiTE).

Herein, joint recommendations for diagnosis and treatment of vulvo-vaginal atrophy (VVA) in women in the peri- and post-menopausal phases from the Società Italiana per la Menopausa (SIM) and the Società Italiana della Terza Età (SIGiTE) are presented. The recommendations are aimed at all healthcare personnel caring for women in the menopausal transition or postmenopausal phase, and are also intended to raise awareness of VVA. Recent data clearly indicate VVA is a highly prevalent condition among postmenopausal women, and that the vast majority of women with VVA are not adequately treated. In reality, diagnosis of VVA is simple and largely clinical. Many types of treatments are available for VVA, ranging from preventive education measures to local non-hormonal therapies, local agents that modulate hormonal receptors and systemic as well as laser therapy and radiofrequency. Regardless of the therapeutic approach adopted, greater communication between the physician and the woman with VVA should be actively encouraged. This is also in light of the difficulty of talking about the VVA and related disorders. Greater communication also encourages adequate therapy and thus minimizes the impact of VVA on the quality of life of the woman and her partner.

Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production.

Although it is now recognized that women suffer from myofascial pain to a greater extent than men, and that the muscular fasciae can respond to hormonal stimuli, thanks to the expression of sex hormone receptors, how the fasciae can modify their structure under hormonal stimulation is not clear. In this work, an immunocytochemical analysis of collagen-I, collagen-III and fibrillin were carried out on fibroblasts isolated from human fascia lata after in vitro treatment with various levels of sex hormones β-estradiol and/or relaxin-1, according to the phases of a woman’s period (follicular, periovulatory, luteal, post-menopausal phases and pregnancy). This study demonstrates for the first time that fascial cells can modulate the production of some components of the extracellular matrix according to hormone levels, when treated with β-estradiol: collagen-I falls from 6% of positivity in the follicular phase to 1.9 in the periovulatory phase. However, after the addition of relaxin-1 to the cell culture, the production of extracellular matrix decreased and remained at the same level (1.7% of collagen-I, at both follicular and periovulatory levels of hormones). These results confirm the antifibrotic function of relaxin-1, thanks to its ability to reduce matrix synthesis. They are also a first step in our understanding of how some hormonal dysfunctions in women can cause a dysregulation of extracellular matrix production in fasciae.

Influence of thyroid hormones on bone density.

Aim To investigate the relations between hormonal status of the thyroid gland and mineral bone density in women in menopause with or without osteoporosis. Methods The study included 120 postmenopausal women, who were divided into two groups. Group I included postmenopausal patients with osteoporosis, of whom 30 were in the early stages of postmenopause, and 30 of them where in the late postmenopausal phase. The second group included patients with preserved bone mass, of which 30 were in the early stage of postmenopause, and 30 were in the late postmenopausal phase. Bone densitometry (DEXA) was performed for all patients, along with analysis of the level of follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Results A statistically significant correlation between TSH level and mineral bone density in the lumbar spine level (r=0.27) was found in early postmenopausal women (r<0.05), TSH and T-score at the level of the lumbar spine (r=0.31) (p<0.05), as well as between TSH and mineral content of the femur bone (r=0.29; <0.05). There was statistically significant independent association between thyroxine and mineral bone density at the lumbar spine level in the late postmenopausal women (ß=0.29; p=0.025). Conclusion In the early postmenopausal phase, TSH was associated with mineral bone density in the lumbar spine and in the area of the femur.

Inhibitory role of Metformin for tamoxifen induced ‎uterine cell proliferation in diabetic ‎patients with ER-‎positive Breast cancer

The objective of the current work to evaluate the role of metformin in inhibiting the tamoxifen induced ‎endometrial ‎changes in diabetic patients with ER-positive breast cancer, a case-control study, carried out between December 2018 to May 2019, forty ‎diabetic women in postmenopausal phase with ER+ breast cancer on tamoxifen (20mg/day), ‎metformin ‎‎(1700 mg/day) GROUP A, and 40 diabetic patients with ER+ breast cancer on the ‎same dose of tamoxifen, but other hypoglycemic agent GROUP B, were selected as controls. ‎Uterine thickness was assessed by ultrasonography imaging at the beginning of treatment with ‎tamoxifen and after 2 years of treatment. Hysteroscopy ‎was done, and pathological findings also ‎recorded.‎ Mean uterine thickness of diabetic patients on other hypoglycemic was ‎significantly higher than diabetic patients on metformin (14.79±3.6 vs 4.37±1.8). Uterine ‎thickness &gt;5mm were 2 (5%) vs ‎36 (85%) reported with the diabetic patient on metformin and the ‎diabetic patient on ‎other oral hypoglycemic group. Three cases (7.5%) of the diabetic patients ‎on other hypoglycemic agent were developed uterine polyps, and one case (2.5%) of diabetic ‎patients on metformin were developed uterine polyps. One case (2.5%) of uterine carcinoma ‎was reported with diabetic patients on other hypoglycemic group.‎ In conclusions metformin significantly inhibit tamoxifen-induced endometrial changes and ‎offers favorable endometrium protection.

Abstract 588: Relationship of serum progesterone and progesterone metabolites with mammographic density

Abstract Background: Mammographic breast density (MBD) is a strong breast cancer (BC) risk factor, but its biologic underpinnings are poorly understood. Use of estrogen plus progestin menopausal hormone therapy is linked to increased MBD and BC risk. Experimental data suggest that ratios of tumor promoting (5α-dihydroprogesterone [5αP]) and anti-tumorigenic (3α-dihydroprogesterone [3αP]) progesterone metabolite levels may be related to BC risk. However, relationships of endogenous progesterone and its metabolites with MBD and BC risk have not been established. Accordingly, we assessed levels of circulating progesterone and its metabolites with MBD. Methods: In this cross-sectional study, serum progesterone and its metabolites were quantified using a novel liquid chromatography-tandem mass spectrometry assay in 103 postmenopausal and 52 premenopausal (luteal menstrual cycle phase) women, ages 40-65, undergoing diagnostic image-guided ipsilateral breast biopsy. MBD was measured as percent fibroglandular volume (MBD-V) on pre-biopsy digital mammograms using single X-ray absorptiometry. Square-root transformed MBD-V was examined across tertile categories of progesterone/progesterone metabolites using age and body mass index (BMI)-adjusted linear regression models. Results: Concentrations of the hormones were as follows among postmenopausal women: progesterone [mean: 12.6 pmol/L (range: 5.2-45.8)], 3αP [5.6 pmol/L (1.4-18.8)], 5αP [100 pmol/L (16.7-388)], and 5αP/3αP ratio [26.1 (2.1-150)]; and among luteal phase premenopausal women: progesterone [2063 pmol/L (13.6-7098), 3αP [12.7 pmol/L (2.4-64.4)], 5αP [243 pmol/L (25.3-774)], 5αP/3αP ratio [25.9 (2.3-73.7)]. Among postmenopausal women, progesterone was positively associated with MBD-V (Tertile 3 vs. 1: β=0.68, p-trend=0.02). A similar borderline positive association was observed among premenopausal women (β=0.74, p-trend=0.10). Additional adjustment for circulating estradiol did not substantively alter observed associations. Levels of 3αP, 5αP and the 5αP/3αP ratio were not associated with MBD-V among pre- or postmenopausal women. Conclusions: Concentrations of progesterone and it metabolites show substantial inter-woman variation. We observed a positive association between endogenous progesterone and MBD-V among both postmenopausal and premenopausal luteal phase women. We did not observe an association with the ratio of 5αP to 3αP levels and MBD-V. These findings suggest the need for additional studies to understand the biological basis of the role of progesterone and its metabolites in MBD and BC risk. Citation Format: Manila Hada, Hannah Oh, Sharon Fan, Roni T. Falk, Berta Geller, Pamela Vacek, Donald Weaver, John Shepherd, Jeff Wang, Bo Fan, Amir P. Mahmoudzadeh, Serghei Malkov, Sally Herschorn, Louise A. Brinton, Xia Xu, Mark E. Sherman, Britton Trabert, Gretchen L. Gierach. Relationship of serum progesterone and progesterone metabolites with mammographic density [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 588.

PCN155 ESTIMATIVE OF THE TOTAL NUMBER OF PATIENTS WITH ADVANCED OR METASTATIC BREAST CANCER HR+ / HER2-, STRATIFIED BY TREATMENT LINES IN BRAZIL

To estimate the total number of patients with advanced or metastatic breast cancer hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-) in Brazil and also the number of patients in each treatment lines (first and second lines). A retrospective analysis was performed based on epidemiological and published data from Instituto Nacional do Câncer (INCA). Were considered the Brazilian female population in 2018 and the prevalence of advanced or metastatic breast cancer to estimate the number of patients with advanced or metastatic breast cancer HR+ / HER2-, followed by the prevalence of postmenopausal patients in each treatment lines. An average rate of 0.7% of female population growth in Brazil was considered based on the last five years data from Instituto Brasileiro de Geografia e Estatística (IBGE) to estimate the population for the next four years (2019 to 2022). According to available data, it was possible to estimate that there were a total of 7,724 women with advanced or metastatic breast cancer HR+ /HER2- in 2018, of which 2,248 are pre-menopausal and 5,476 are in postmenopausal phase. For those in postmenopausal, considering the profile of Brazilian patients, it is estimated that, 3,177 women will receive the first line of treatment. Furthermore it was estimated a total of 3,192 that will receive second line treatment. Breast cancer presents several histological subtypes that can be directly related to prognosis, therefore, it is relevant to estimate these populations in order to customize the treatment for the patients. In this context, it is possible to conclude that this is a significant result considering the studied population, and it is necessary to increase the efficacy and the access to treatment for these patients in Brazil.

Evaluation of Thyroid Hormone Status and Bone Density Ratio in Euthyroid Postmenopausal Women in Early and Late Stage of Bone Loss.

Introduction:Osteoporosis is a consequence of reduction in bone mass and disorders of bone structure, which makes the bones prone to fractures. Physiological variations of thyroid-stimulating hormone (TSH) may be an early indicator of the predisposing basis of the emergence of osteoporosis.Aim:To evaluate the thyroid hormone status and bone density ratio in euthyroid postmenopausal women in early and late stage of bone loss.Methods:The research is an observational, intersected, controlled study involving postmenopausal women admitted to the Clinic for Nuclear medicine and endocrinology of the Clinical Center University of Sarajevo (CCUS). The study included a total of 120 postmenopausal subjects divided into two groups. First group included 60 postmenopausal patients with osteoporosis, 30 of them were at the early stage of postmenopause, and 30 were in the late postmenopausal phase. The second group consisted of 60 postmenopausal patients with preserved bone mass, 30 of which were in the early stage of postmenopause and 30 in the late postmenopausal phase. For all patients included in the study follicle-stimulating hormone (FSH), TSH, free thyroxine (FT4), free triiodothyronine (FT3) were analyzed.Results:The mean duration of the postmenopausal period was statistically significantly higher in the group of women with osteoporosis (11.4 ± 1.1 years). The mean values of FSH were statistically significantly higher in the group of women with osteoporosis (54.0 ± 2.6 IU / L). The mean level of TSH and FT3 did not statistically significantly differ in the group of women with osteoporosis compared to the control group of women. The mean FT4 level in women with osteoporosis was statistically significantly lower (14.7 ± 0.29 pmol / L) compared to the control group of women (15.95 ± 0.3 pmol / L) (p = 0.004).Conclusion:In our examined group, the FT4 patient (mean) was significantly lower in the serum of women with osteoporosis compared to subjects with preserved bone mass. It would be most effective to recognize risk factors in order to influence them on time, and to alleviate and slow down the consequences of osteoporosis. One of these possible factors is the hormonal status of the thyroid gland, that is, TSH whose physiological variations may be an early indicator of the predisposing basis for the emergence of osteoporosis. The frequency and prevalence of these medical problems require additional research, and it is also a great challenge to understand the effects of thyroid hormone on bone tissue.

Vasomotor and Related Menopause Symptoms.

Vasomotor symptoms are the most common manifestation of the menopause transition and postmenopausal phases of reproductive life. They interfere not only in quality of life, but also contribute to sleep and mood disturbances that potentially compromise home and work effectiveness. Treatment options include hormone therapy (HT), nonhormonal prescription drugs, mind body and behavior therapies, and over-the-counter preparations. Evidence confirms that HT is the most effective option. The initial reticence to prescribe HT immediately following publication of the Women's Health Initiative has been replaced by clear guidelines for confidently identifying women for whom this therapy will be safe.