Premenopausal Research Articles

Adaptations with Intermittent Exercise Training in Post- and Premenopausal Women.

The purposes of the present study was to examine the effect of intermittent exercise training on musculoskeletal and metabolic health in postmenopausal (PM) and premenopausal (PRM) women and, furthermore, to evaluate whether the adaptations can be maintained with a reduced training frequency. Eighteen PM (51 ± 1 yr, mean ± SEM) and 12 PRM (48 ± 1 yr) women participated in floorball training approximately two times per week for 12 wk. In a subgroup (n = 9) of PM women (PM40), exercise training was performed for an additional 40 wk with a reduced training frequency of approximately one training session per week. In PM, the body fat percentage decreased (P < 0.05) and the total lean leg mass increased (P < 0.05) during the 12-wk training period, with no changes in PRM. In both PM and PRM, lean body mass and maximal oxygen uptake (V˙O2max) were higher, and Yo-Yo intermittent endurance test 1 (YYIET-1) performance was better (P < 0.05) after the 12-wk training period. Procollagen type 1 amino-terminal propeptide was higher (P < 0.05) in PM, and total leg bone mineral density (BMD) was higher (P < 0.05) in both PM and PRM after the 12-wk training period. In PM40, total lean leg mass, V˙O2max, YYIET-1 performance, level of procollagen type 1 amino-terminal propeptide, and total leg BMD were maintained, whereas whole-body BMD and glycated hemoglobin (HbA1c) were reduced (P < 0.05) and the expression of muscle glucose transporter type 4 was higher (P < 0.05). Twelve weeks of intermittent exercise training increased BMD, intermittent exercise capacity, and V˙O2max in PM and PRM, with PM also having positive changes in body composition. Additional 40 wk of training with a reduced frequency was sufficient to preserve these physiological adaptations and also improve blood glucose regulation in PM.

Chronic lower abdominal pain is commonly associated with pelvic congestion syndrome

Aims: Pelvic congestion syndrome (PCS) is defined as chronic pelvic pain (CPP) due to incompetence of ovarian veins (OV) and parauterine varicosity (PV). The aim of this study was to investigate the prevalence of symptomatic dilated OV/PV in premenopausal (PreMP) and postmenopausal (PMP) women. Additionally, we wanted to define diagnostic criteria that allow for simplified characterization of patients with PCS.

162P - Menopausal status on tumour biology in early breast cancer

Breast cancer (BC) is primarily a disease of older or post menopausal women. It has been suggested that BC arising in young women is a unique biological subset characterized by less hormone sensitivity and higher HER2 (epidermal growth factor receptor) expression. This study was performed to compare the tumour biology between pre menopausal (PrM) and post menopausal (PoM) women. New diagnosis of early BC from 2011-2015 in the South East Cancer Centre were included. The patients were divided into PrM (<55 years) and PoM (≥55 years) groups. Information on pathology subtype (ductal carcinoma/lobular carcinoma), tumour grade, ki67, Tumour (T) stage, Nodal (N) stage and anatomical stage was obtained. Comparisons between these factors in the two groups were drawn using SPSS version 20.0. Data from 497 patients were obtained. 235 (47.3%) were PrM and 262 (52.7%) were PoM. Age range PrM group vs PoM group (29-54 vs 55-91). The differences between the groups was statistically significant on pathology subtype (p = 0.003), T stage (p = 0.033), and N stage (p = 0.008). Ki67 and grade were not statistically significant. The mean ki67 across biology subtypes (ER/PR/HER2/Ki67) in the PrM group was higher. PrM group had more grade III disease (33.2% vs 30.9%). Table 1: Distribution of tumour biology according to menopausal status.Tabled 1Pre Menopausal n = 235Post Menopausal n = 262P valueAge Range29-5455-91< 0.005Pathology IDC ILC214 21209 530.003Grade I II III4 153 787 174 810.481Size (mm)*25.927.20.396Ki67 (%)*21.819.40.083T stage 1 2 3 497 112 26 0103 131 21 70.033N stage 0 1 2 3129 79 22 5180 60 13 90.008 Open table in a new tab *mean, IDC: invasive ductal carcinoma, ILC: invasive lobular carcinoma. Pre menopausal women in this Irish population had poorer tumour biology compared to their Post menopausal counterpart. Aggressive measures should be taken in the treatment of these women to reduce the incidence of local recurrence and metastases.

Effects of a physical activity program on the urinary collagen crosslinks in pre- and postmenopausal women.

This study analyzes the effects of physical exercise on urinary collagen crosslinks, pyridinoline (PYD) and deoxipyridinoline (DPD), in women. Thirty premenopausal (PRE) and 40 postmenopausal (PST) women took part in a six month randomized controlled trial of moderate physical exercise. Moreover, skinfold thickness, muscle strength and flexibility were evaluated. Basal values of urinary PYD and DPD were higher in postmenopausal women versus premenopausal women (P<0.01). Physical exercise increased in both groups urinary PYD levels (P<0.05) and urinary DPD levels in postmenopausal women (P<0.05). After the exercise program, no changes were observed in the levels of urinary DPD in premenopausal women. Significant improvements in flexibility, muscle strength and decrease in skinfolds thickness were observed in the exercise group. No changes were observed in non-exercise group. In conclusion, the physical activity program produced beneficial effects on muscle strength and flexibility and changes in the musculoskeletal system. Also, the physical activity program led to a non-pathological increase in the urinary elimination of bone reabsorption and collagen metabolism biomarkers.

HUBUNGAN TINGKAT PENGETAHUAN OSTEOPOROSIS DENGAN PERILAKU PENCEGAHAN OSTEOPOROSIS PADA WANITA PRE MENOPAUSE DI KELURAHAN TIPES SURAKARTA

The background of this research is Osteoporosis is a disease characterized by reduced bone mass and a change in microarchitecture (the form of micro / subtlest) of bone tissue that result in decreased bone strength and increased bone fragility, leading to brittle bones. From preliminary observations that researchers do in the Village of typhoid in November showed 10 pre-menopausal women who were interviewed 8 of them did not undertake to prevent osteoporosis. Things that cause them not to prevent osteoporosis is ignorance about the dangers of osteoporosis and ignorance about how to prevent. The purpose of the research was to determine Relations Knowledge Level Osteoporosis with Behavioral Prevention of Osteoporosis in Women Pre Menopause in Tipes.The Subject of research were all pre-menopausal women aged 40-50 years with the criteria in the Village Tipes who met the inclusion criteria were already writers set. The sampling technique used is the consecutive sampling technique that is the way the sampling is done by selecting a sample that met the study criteria until a certain time so that the number of samples met. The result of the research are largely pre menopausal women have a high level of knowledge about osteoporosis as many as 32 people (59.3%), the majority of pre menopausal women are 32 women (59.3%) had less active behavior in the prevention of osteoporosis, while women which has the active behavior as much as 22 women (40.7%). From the results of Chi-Square test SPSS version 18.0 with α = 5% (0.05), obtained p equal to 0.002 so that the value of p &lt;0.05, which means that Ho is rejected and Ha accepted. Conclusion of the research was the existence of relationship the level of knowledge about osteoporosis with prevention behaviors pre menopausal osteoporosis in women in Tipes Surakarta.Keywords: Knowledge Level of Osteoporosis, Behavioral Prevention

Abstract B10: Fasting blood glucose and bone mineral density in Latina breast cancer survivors

Abstract Background. Elevated fasting blood glucose (FBG) in Latina women has been identified as a risk factor for osteoporosis, independent of history of breast cancer. Elevated FBG, a sign of poor glycemic control among Latina women has been shown to increase bone resorption and subsequent bone loss over time. Treatment for breast cancer can also result in significant decreases in bone mineral density (BMD), which may be further exacerbated by the premature onset of menopause. Decreases in estrogen associated with the onset of menopause and hormonal therapy have been shown to accelerate bone loss in women. Purpose. The purpose of the present investigation was: 1) to examine the association between FBG and lumbar spine and hip (regional) BMD in Latina breast cancer survivors (LBCS); and 2) to examine the influence of menopausal status on FBG and BMD in LBCS. We hypothesized that increased FBG would be correlated with decreased lumbar spine and hip BMD in LBCS. Additionally, it was hypothesized that postmenopausal status would further exaggerate the association between increased FBG and BMD in LBCS. Methods. The present study included baseline data from 24 LBCS, recruited from Los Angeles County Hospital and Norris Comprehensive Cancer Center at USC as a part of a larger ongoing exercise trial. Participants included Stage I-III breast cancer patients who were sedentary and had received chemotherapy and/or radiation within 6 months prior to joining the study. Participants reported to the Women's Health and Exercise Laboratory at the USC for data collection. Participants were required to fast for 12 hours prior to the study visit and plasma FBG was measured using a venous sample from the antecubital vein. Participants completed a dual-energy x-ray absorptiometry (Lunar DEXA®GE Healthcare) scan to measure right (R) and left (L) hip (femur; F) BMD (RFBMD, LFBMD, respectively) and lumbar spine BMD (LSBMD). T scores were obtained via DEXA scan, which is the score of the site-specific BMD when compared to the young (30-year-old woman) normal reference mean. Pearson correlations were used to examine associations between FBG and T-scores of RF/LF/LS BMD in LBCS. Independent t-tests were used to compare mean FBG and BMD values between premenopausal and postmenopausal LBCS. Statistical significance was set at p&amp;lt;0.05. Results. Mean ages were 46.2±7.0 years in premenopausal (PRE) LBCS (n=10) and 56.9±7.5 years in postmenopausal (POST) LBCS (n=14). Mean FBG and T-scores of regional BMD (LSBMD, RFBMD, LFBMD) are listed in Table 1. Mean FBG was significantly greater in postmenopausal LBCS when compared to premenopausal women (p&amp;lt;0.01). T-scores of LSBMD, RFBMD and LFBMD did not significantly differ in premenopausal and postmenopausal LBCS (p=0.58, p=0.97, p=0.54, respectively). Increased FBG was not associated with decreased LSBMD, RFBMD or LFBMD in premenopausal LBCS (p=0.38, r2=-0.31; p=0.99, r2=0.01; p=0.75, r2=0.12, respectively). Increased FBG was not associated with decreased LSBMD, RFBMD or LFBMD in postmenopausal LBCS (p=0.16, r2=0.40; p=0.80, r2=0.08; p=0.55, r2=0.17, respectively). Conclusion. In this limited sample size, FBG was not shown to be a predictive factor for decreased BMD in either premenopausal or postmenopausal LBCS, despite elevated FBG in postmenopausal LBCS. Our results differed from our hypothesis which, may be due to FBG levels that were only slightly elevated in LBCS with relatively healthy BMD. However, future investigations are warranted to further investigate whether elevated FBG is a risk factor for osteoporosis in larger sample of LBCS over a longer follow-up period. Table 1. Outcome Measures PRE LBCS FBG** 95.0±6.72 mg/dL* LSBMD T-score# -0.32±0.73 RFBMD T-score# 0.33±0.34 LFBMD T-score# 0.14±0.35 POST LBCS FBG** 107.8±22.0 mg/dL* LSBMD T-score# -0.14±0.054 RFBMD T-score# 0.25±0.42 LFBMD T-score# 0.27±0.34 **Means are ± SD; #Means are ± SE. *Means are statistically significantly different (p&amp;lt;0.05). Citation Format: Christina Dieli-Conwright, Lindsey Avery, Joanne Mortimer, Debu Tripathy, Darcy Spicer, Leslie Bernstein. Fasting blood glucose and bone mineral density in Latina breast cancer survivors. [abstract]. In: Proceedings of the Thirteenth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2014 Sep 27-Oct 1; New Orleans, LA. Philadelphia (PA): AACR; Can Prev Res 2015;8(10 Suppl): Abstract nr B10.

Androgen receptor expression in the human vagina under different physiological and treatment conditions

Recent data report an important role of testosterone (T) in modulating female sexual responses, but little is known about the expression and distribution of androgen receptor (AR) in the human vagina. Therefore, the aims of our study were to evaluate the expression of AR in the human vagina in premenopausal (PrM) and menopausal (M) women and in T-treated women. Vaginal biopsies were obtained from PrM and postmenopausal women and from women with gender identity disorder (female to male (FtM)) receiving exogenous T. AR gene and protein expression levels in vaginal tissues were determined by real-time PCR and western blot analysis, respectively, whereas the localization of AR in vaginal mucosa and stroma was performed by immunohistochemistry. ARs were detected by immunostaining both in the mucosa and stroma. In vaginal mucosa, AR density score decreases with age but does not change with T administration. In stromal tissue, AR density score does not change with age but significantly increases with T administration (P<0.01). AR protein expression was significantly increased in FtM subjects (P<0.001). The expression of AR messenger RNA (mRNA) evaluated by Real-time PCR showed a significantly higher mRNA expression in FtM versus M patients (P<0.01) and in PrM versus M subjects (P<0.05). In conclusion, we found AR protein and mRNA expression both in the epithelium and stroma of the human vagina in all groups of women. A negative correlation exists between age and AR expression in the vaginal mucosa. T administration increases AR expression in both the mucosa and stroma.

Adipokine concentrations in nonobese women: a study of reproductive aging, body mass index, and menstrual cycle effects.

To explore the influence of reproductive aging, body mass index (BMI), and the menstrual cycle on adiponectin (AD) and leptin concentrations. Cross-sectional comparison in age- and BMI-matched nonobese volunteers with regular cycles (CO, n = 19) or in early postmenopause (EPM, n = 19), aged 40-52 years, and a young cycling group (CY, n = 21), aged 20-30 years. Sex steroids, fasting AD, leptin, insulin, glucose, AD/leptin (A/L) ratio, and insulin resistance (IR) by homeostasis model assessment (HOMA-IR). In ovulatory women, AD, estradiol (E(2)), and progesterone were assessed weekly across the same menstrual cycle. Insulin, glucose, HOMA-IR, A/L ratio, and leptin values were similar across the three study groups. AD differed, with the highest concentrations in the EPM group (CY: 13.0 +/- 0.9 microg/ml vs. CO: 14.0 +/- 1.1 microg/ml vs. EPM: 17.7 +/- 1.5 microg/ml; p = .05). Values among cycling women were similar. When the cycling groups were combined into a premenopausal (PRE) group and compared to EPM women by BMI (> or <or=25 kg/m(2)), leptin concentrations were higher and A/L ratios lower in PRE and EPM overweight (OW) subgroups versus normal-weight (NW) subgroups. AD was lower in OW, cycling women and higher in the NW EPM subgroup compared to NW PRE women. In cycling women, AD did not vary across the menstrual cycle. Nonobese, midlife women experience minimal adverse effects from reproductive aging on insulin sensitivity and adipokine secretion. The menstrual cycle is not a key mediator of AD. Early menopause has differential, BMI-dependent effects on adipokine secretion.

Relative contributions of different food groups to vitamin D intake in Asian and Caucasian UK women: results from the Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England (D-FINES) Study

There has been a lack of research into the contribution of different food groups to vitamin D intake in varying age and ethnic groups in theUK. The 2006Ð7 D-FINES Study was undertaken in 373 Surrey premenopausal (PRM) and post-menopausal (POM) Caucasian (C) andAsian (A) women. They were assessed in four seasons of the year for vitamin D (25OHD) status, vitamin D dietary intake and UVBexposure. Relative contributions from different food groups for vitamin D intake were calculated for A and C women in each of the fourseasons.As can be seen in the Table, the top three sources of vitamin D in Asians were meat, cereals and eggs. In Caucasians the top sourceswere meat, Þsh and cereals. Analysis by ANOVA indicated that A women obtained a signiÞcantly higher percentage of vitamin D fromeggs and egg products, meat products and from vegetable foods than the C women. However, C women had a signiÞcantly higher absolutevitamin D intake ( P < 0.001). When the women were divided into four groups by ethnicity and menopausal status, signiÞcant differenceswere found in vitamin D intake from cereals, egg products, vegetables and snacks between the groups but no differences were found formilk, Þsh, meat and fats. These differences were found to be to be signiÞcant ( post hoc tests) only between the PRM A and POM Cgroups. For absolute intakes, there was a signiÞcant difference between the four groups ( P < 0.001). POM C had the highest intake ( posthoc tests), followed in order by PRM C, PRM A and POM A, although signiÞcant differences were only found between intakes of POM Aand POM C ( P < 0.001), and between POM A and PRM C ( P = 0.026).

Postmenopausal Expression Changes of Immune System-Related Genes in Human Bone Tissue

The molecular and cellular interactions between the immune system and bone tissue have been established. Sex hormone deficiency after menopause has multifunctional role by influencing growth, differentiation, and metabolism of the skeletal and the immune system. We have used nonparametric and multidimensional expression pattern analyses to determine significantly changed mRNA profile of immune system-associated genes in postmenopausal (POST) and premenopausal (PRE) nonosteoporotic bone. Ten bone tissue samples from POST patients and six bone tissue samples from PRE women were examined in our study. The transcription differences of the selected 50 genes were analyzed in TaqMan probe-based quantitative real-time reverse transcriptase polymerase chain reaction system. Mann-Whitney test indicated significantly downregulated transcription activity of three genes (CD14, HLA-A/MHCI, ITGAM/CD11b) and upregulated expression of six genes (C3, CD86/B7-2, IL-10, IL-6, TGFB3, TNFSF11/RANKL) in postmenopausal bone. According to the canonical variate analysis results, the groups of POST and PRE women are separable by genes coding for cytokines, costimulator molecules, and cell surface receptors involved in antigen presentation and T cell stimulation processes which have high discriminatory power. Based on a complex gene expression pattern analysis of human bone tissue, we could distinguish POST and PRE states from an immunological aspect. Our data might provide further insight into the changes of the intersystem crosstalk between immune and skeletal homeostasis, as well as local immune response in the altered microenvironment of postmenopausal bone.

Nonhormonal drug use and its relation to androgens in perimenopausal women

To outline the prevalence of nonhormonal drug use in middle-aged women and to assess plausible associations between serum androgen levels and variables associated to health such as drug use and planned visits to healthcare units. This was a population-based study of women aged 50 to 59 years (n = 6,893). Women were divided into three groups according to their menopause status: premenopausal (PM), postmenopausal without hormone therapy (PM0), and postmenopausal with hormone therapy (PMT). Data regarding current drug use and healthcare visits were collected from a questionnaire. The overall prevalence of nonhormonal drug use was 36.4% in all women. In the PM, PM0, and PMT groups, these percentages were 28.3%, 35.3%, and 39.3%, respectively, and the differences between them were statistically significant (P < 0.01). In all women, the most common medication used was for cardiovascular conditions (12.0%), followed by those for asthma (4.0%) and pain (3.7%). The number of drugs used by all women and women in the PM0 and the PMT groups were negatively associated with the serum levels of androstenedione (P < 0.05). In the postmenopausal groups, the number of visits to healthcare units was negatively associated to the levels of serum testosterone and androstenedione (P < 0.05). Hormone therapy in postmenopausal women seems to be associated with increased use of nonhormonal pharmacotherapy, rendering higher prevalence of such drugs in middle-aged women. Postmenopausal women with lower serum testosterone and a higher number of office visits used medications for cardiovascular problems and depression more than other medications. Whether this is an effect related to the hormone therapy itself or to experiencing more perimenopausal symptoms in this group of women is still unclear.

Oral supplementation with NaFeEDTA reduces blood lead in postmenopausal but not premenopausal Korean women with anemia

Objective The objective was to evaluate the effect of iron supplementation for 6 mo on blood lead (PbB) concentration in populations of premenopausal (PRE-M) and postmenopausal (POST-M) Korean women. Methods We conducted a community intervention trial in Asan, Republic of Korea. Of the 137 enrolled women with hemoglobin (Hb) levels lower than 12 g/dL, 37 were PRE-M and 100 were POST-M. Each woman received the equivalent of 9 mg of supplemental iron per day in the form of sodium-iron ethylene-diaminetetra-acetic acid (NaFeEDTA) syrup for a period of 6 mo. Results The initial PbB concentrations were 2.56 ± 0.99 μg/dL (mean ± SD) for the PRE-M women and 3.27 ± 1.24 μg/dL for the POST-M women. The differences were statistically significant ( P < 0.01). After 6 mo of NaFeEDTA supplementation, the PbB concentration decreased in the POST-M group but no change was observed in the PRE-M group. When age and baseline Hb levels were adjusted for, PbB concentrations decreased by 0.10 and 0.31 μg/dL in the PRE-M and POST-M groups, respectively, and the results were significant using a multivariate model ( P = 0.016). Iron status determined by zinc protoporphyrin, transferrin saturation, and Hb improved significantly in both groups, but serum ferritin decreased significantly in the POST-M women ( P < 0.001), with no change in the PRE-M group. Conclusion After 6 mo of supplementation with the equivalent of 9 mg of iron/d in the form of NaFeEDTA, the PbB concentrations in Korean women with anemia appeared to depend on their menopausal status.

Serotonin dilemma in postmenopausal women: Is it low or high?

Objective In this study, we have studied with premenopausal (PM), naturally menopausal (NM) and surgically induced menopausal (SM) women in order to investigate the differences in serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), follicle stimulating hormone (FSH) and estradiol (E2) levels on serum serotonin levels. Methods Forty premenopausal (36.7 ± 3.5 years), 40 naturally menopausal (54.2 ± 8.4 years) and 38 surgically induced menopausal (55.4 ± 11.2 years) women were included in the study. None of the subjects were using antidepressants or hormone replacement therapy. In NM and SM, years since menopause (YSM) were 3.16 ± 1.58 and 3.36 ± 1.89, respectively. Cortisol, DHEA-S, FSH and E2 levels were determined by immunochemiluminisence while serotonin levels were determined by HPLC. Results Serum serotonin levels in NM women were higher than the other two groups [144.23 ± 45.29 μg/L vs 61.35 ± 37.72 μg/L in SM women and 98.74 ± 50.29 μg/L in PM women]. E2 and DHEA-S were positively correlated, while FSH and cortisol were negatively correlated with serotonin in NM and SM. There was no significant correlation between serotonin and age or YSM. In the PM group, there was no significant correlation between serotonin and the hormones. Conclusion In conclusion, increased serotonin levels in naturally menopausal women may be a compensatory mechanism to decreased E2 levels as it is postulated that there is strong interaction between E2 and the serotoninergic system.

Androgen activity on the peripheral female genital target: ultrastructural study

There are still many areas in the field of female sexual physiopathologies that remain to be fully studied, among which are disturbances of the excitation phase, particularly the hemodynamics of the clitoral corpora cavernosa. Low levels of estrogens and vascular risks lie at the base of female sexual arousal disorders. The aim of our study was to investigate the ultrastructure of the clitoral cavernosal tissue in healthy women and those affected by metabolic and hormonal pathologies. Recent data show the presence of nitric oxide synthase in the clitoral tissue, suggesting that nitric oxide could be involved in the mechanisms of clitoral tumescence. Moreover, the presence of type 5 phosphodiesterase activity in clitoral tissue has been hypothesized. Informed consent was obtained from the 24 women enrolled in the study. Five were diabetic premenopausal women, and 8 were naturally post menopausal and 6 surgically post menopausal women affected by HSDD. They all underwent a micro-biopsy of the clitoral body by means of fine needle aspiration under total anesthesia during gynaecological operation for stress urinary incontinence. Five health women undergoing surgically procedures for benign gynaecological pathology were considered as control group. The tissue removed was fixed in Karnowski's liquid and underwent ultrastructural analysis with standard procedures. Histomorphometric studies have shown that there is a correlation between age and smooth muscle fibers of the clitoral corpora cavernosa due to an increase of connective tissue. In the clitoris there is also a correlation between large diameter thin-walled vessels and smooth muscle fibrocells(SMF), which make up the majority of the cellular elements of the concavity. In health premenopausal women there are extensive bundles of smooth muscle fibrocells SMF, seen both transversely and longitudinally; the SMF have regular borders, regular nuclei with dense chromatin and evident nucleoli. The cytoplasm includes contractile microfilaments and dense bodies. The cell borders do not have continuous basal membranes(BM) and electro-ionic junctions of the “tight” type. The SMF, in all pre menopause subjects, are isometric with regular borders, having a homogeneous distribution of the microfilaments and dense bodies. The basal membranes are regular with a constant thickness, rarely reduplicate. The blood vessels are thin-walled, made up of a flattened endothelial layer and by an incomplete layer of pericytes, a close association with the interstitial SMF is observed, which, with the pericytes, form tight junctions. The vascular lacunae are particularly interesting, having a single line of flattened epithelial cells with a cytoplasm relatively poor in organules, resting on continuous BM. The SMF have a direct relationship with the vascular lacunae, giving rise to an anatomical-functional complex comparable to that of the corpora cavernosa of the penis. In diabetic women, the SMF of the BM and the vascular lacunae are notably thickened. In natural post menopausal subjects the general arrangement is maintained, and only rarely is there a discrete thinning of the SMF, which can, in places, have an irregular border. The concavity, made up of isometric collagen fibers that can be poorly cohesive and moderately thickened in post menopausal subjects. In surgically postmenopausal women, clitoral tissue is reduced; the SMF have irregular distribution of the microfilaments and borders. The blood vessels are riduced, and the vascular lacunae have not relationship the SMF. Transdermic testosterone therapy of surgically postmenopausal women affected by HSDD seems to also act at the level of the clitoral tissue. In fact, the ultrastructure of the clitoral corpora cavernosa has features almost identical to those found in pre menopausal women. We hope the electronic microscopic study of the clitoral cavernosal tissue can give similar information to that recorded above, and can be used as an additional tool for the diagnosis, prognosis and therapeutic orientation of female sexual dysfunctions.

Could androgens protect middle-aged women from cardiovascular events? A population-based study of Swedish women: The Women's Health in the Lund Area (WHILA) Study

Objective The aim of this analysis was to delineate perceived associations between androgens and cardiovascular events in perimenopausal women.Design A cross-sectional, population-based study of 6440 perimenopausal women aged 50–59 years, living in Southern Sweden. In all, 461 (7.1%) women were premenopausal (PM), 3328 (51.7%) postmenopausal without hormone therapy (HT) (PM0) and 2651 (41.2%) postmenopausal with HT (PMT). For further comparisons, 104 women (1.6%) who reported cardiovascular disease (CVD) were studied in detail; 49 had had a myocardial infarction, 49 a stroke and six women both events. For each woman with CVD, two matched controls were selected (n = 208).Results In the matched controlled series, androstenedione levels were lower (p < 0.005) in cases. Cases with hormone therapy had also lower testosterone levels than matched controls (p = 0.05). In the total cohort, by using multiple logistic regression analyses, testosterone was positively associated with low density lipoprotein cholesterol (p < 0.001) and high density lipoprotein cholesterol (HDL-C) (p < 0.001) in all women, but negatively associated with levels of triglycerides in both the PM0 (p < 0.001) and PMT (p < 0.001) groups. Androstenedione levels were positively associated with HDL-C (p < 0.05) and negatively with triglycerides (p < 0.05) in the PM group.Conclusion Women with cardiovascular disease had lower serum androgen levels, particularly women using hormone replacement therapy, even when controlled for lipids and other potential risk factors.

The Enhancement of Female Sexual Function with ArginMax, a Nutritional Supplement, Among Women Differing in Menopausal Status

We conducted a double-blind, placebo-controlled study to determine the role of dietary supplementation on sexual function in women of differing menopausal status. One hundred eight (108) women, age 22–73 years, who reported a lack of sexual desire, enrolled as participants. Of these, 55 received ArginMax for women and 53 received placebo. ArginMax for women contains L-arginine, ginseng, ginkgo, damiana, multivitamins, and minerals. The 108 women, given definitions, self-reported as 59 premenopausal (PRE); 20 perimenopausal (PERI), and 29 postmenopausal (POST). After 4 weeks, PRE women on ArginMax primarily reported significant improvement in level of sexual desire (72%; p = 0.03) and satisfaction with overall sex life (68%; p = 0.007), compared with placebo group, according to the Female Sexual Function Index (FSFI; Kaplan et al., 1999) scales. Frequency of sexual desire (60%; p = 0.05) and frequency of intercourse (56% p = 0.01) also increased among the PRE women. In contrast, among PERI women, primary improvements were reported for frequency of intercourse (86%; p = 0.002), satisfaction with sexual relationship (79%; p = 0.03), and vaginal dryness (64%; p = 0.03) compared with placebo group. POST women primarily showed an increased in level of sexual desire, with 51% showing improvement, compared with only 8% in the placebo group (p = 0.008). Nutritional intervention plays an important role in women's sexual health, but issues and areas of greatest improvement differ among women of different menopausal states. The largest number of attribute improvements were seen in PRE and PERI women, although attribute types vary among these groups. Level of desire was shown to increase significantly in POST women. Since ArginMax for women has been shown to exhibit no estrogen activity, it may be desirable alternative to hormone therapy for sexual concerns.

Does the hormonal situation modify lipid effects by lifestyle factors in middle-aged women? Results from a population-based study of Swedish women: the Women's Health in the Lund Area study

The aim of the study was to outline whether the influence by lifestyle factors on serum lipids was modified by the hormonal situation in middle-aged women. Six thousand nine hundred eight women, aged 50 to 59 years, participated in a health assessment program, including a serum lipid profile evaluation. The women were grouped according to their hormonal status into premenopausal (PM) (n = 492), postmenopausal without hormone therapy (HT) (PM0) (n = 3600), and postmenopausal with HT (PMT) (n = 2816). From the PMT group, we analyzed oral (n = 901) and transdermal HT (n = 351) regimens, containing norethisterone acetate and 17 β-estradiol. Serum lipids and lipoproteins were determined by conventional methods. Lifestyle factors included smoking and physical activity at leisure time and at work. Multivariate linear regression analysis controlling for age, education, and dietary habits showed that current smoking was positively associated with triglycerides in the PM, PM0, PMT, and oral HT groups. In the PM0, PMT, and oral HT groups, current smoking was positively associated with total cholesterol and low-density lipoprotein and negatively associated with high-density lipoprotein (HDL). Low physical activity at leisure time was positively associated with triglycerides in the PM and PMT groups and negatively associated with HDL in the PM0 and PMT groups. High physical activity at work was positively associated with triglycerides in the PMT group and with total cholesterol in the PM0 group, but negatively associated with HDL in the PMT and transdermal groups. Body mass index was positively associated with triglycerides and negatively with HDL in all the groups regardless of the hormonal situation. The serum lipid profile as influenced by lifestyle factors was modified by the hormonal situation. Compared with the postmenopausal women without HT use, the use of HT contributes to fewer “negative” effects by lifestyle factors on serum lipids.

Colorectal cancer in middle-aged women in relation to hormonal status: A report from the Women's Health in the Lund Area (WHILA) study

Objective. To delineate a perceived association of estradiol versus estradiol plus norethisterone hormone therapy on the prevalence of colorectal cancer in postmenopausal women.Methods. The Women's Health in the Lund Area (WHILA) project covers 10 766 women aged 50–60 years, living in the Lund area, Sweden. Out of this population, 6908 (64%) women completed questionnaires, underwent physical and laboratory assessments and had self-reported information regarding colorectal cancer. Four hundred and twenty-two (6%) were premenopausal (PM), 3600 (52%) were postmenopausal without hormone therapy (PM0), 2452 (36%) were postmenopausal with combined hormone therapy (PMT-HT) and 364 (5%) were postmenopausal with estrogen monotherapy (PMT-E).Results. There were 21 cases of colorectal cancer (0.3%), one in the PM group, 16 in the PM0 group, two in the PMT-HT group and another two in the PMT-E group. Colorectal cancer prevalence was lower in the PMT-HT than in the PM0 group (odds ratio (OR) = 0.18, 95% confidence interval (CI) = 0.04–0.80). However, for the PMT-E group, the OR (95% CI) was 1.02 (0.86–1.20). There was a positive association between low physical activity (p = 0.04), low parity (p = 0.02) and risk of colorectal cancer.Conclusion. Combined hormone therapy seemed to be associated with a lower risk of colorectal cancer in postmenopausal women in contrast to estrogen monotherapy. Hence the progestin might have a protective role.

Hormone Receptors, HER2/neu and p53 in 1027 Mexican patients with breast cancer

903 Background: In Mexico there are no significant epidemiologic studies concerning the hormonal receptors (HR), HER2/neu and p53 in breast cancer (BC). The purpose of this work was to study the frequency of each of these markers, the relationship between them and according to age groups. Methods: Data was obtained from the immunohistochemical (IH) area of the Pathology Department register of BC patients at the ABC Hospital for a 3 year period (2000–2002). Determination of HR, HER2/neu and p53 was performed by IH (positive estrogen receptor ER+ > 5%, positive progesterone receptor PrR+ >10%); HER2/neu overexpression was defined as positive immunomarking of 3+, (Herceptest). The frequency of each in the general population, and in the premenopausal (PrM) and postmenopausal (PoM) groups (defined as =< 50 years old and >50 years old, respectively) was analyzed. Results: IH reports of 1027 patients with BC were studied. The median age was 52.9. ER+ were found in 627 patients (61%) and PrR in 59% (n=610). The frequency HR+ (either ER+ and/or PrR +) was 68.9%. HER2/neu was measured in 966 of 1027 patients, being 3+ in 246 patients (25.5%). p53 gene mutation was determined in 915 patients, being positive in 670 (73.2%). We obtained 494 PrM patients, with a 66.6% HR+, and 71% in the PoM (n= 533), which was not statistically significant (p=0.119). HER2/neu was determined in 468 PrM patients, being 3+ in 114 (24.4%) versus 132/498 cases (26.5%) in the PoM group. p53 mutation was studied in 915/1027 patients, being positive in 670 (73.2%), 73.3% in PrM and 73.2% in PoM (p=0.95). Regarding the association among molecular markers, HER2/neu 3+ was found in 21.8% (n=150) of HR+ patients, while in HR- patients it was found in 30% (n=96), (p=0.44). Analyzed by age groups, the frequency of HER2/neu 3+ in PrM patients HR- was 22.3% versus 28.5% in the PoM group (p=0.005). Conclusions: According to these results, it can be noted that the number of patients that should be treated with hormone therapy is high. If the determination of HR is performed only in PoM patients, then, a great deal of PrM patients are being undertreated. It was also seen, that at least two thirds of the patients with BC can benefit with a monoclonal treatment along with chemotherapy and/or hormone therapy if indicated. No significant financial relationships to disclose.

Cardiovascular risk factors in middle-aged women and the association with use of hormone therapy: results from a population-based study of Swedish women. The Women's Health in the Lund Area (WHILA) Study

Objective Cardiovascular diseases in women are multifactorial. Women carry different risk factors compared to men and these specific risk factors need to be delineated, particularly in relation to the hormonal situation, and effects of diet and lifestyle.Methods Out of the total cohort of 10 766 women born 1935–1945 living in the Lund area of southern Sweden, 6917 women completed a generic questionnaire and underwent a physical and laboratory assessment. According to hormonal status, 492 women were premenopausal (PM), 3600 were postmenopausal without hormone therapy (HT) (PM0) and 2816 were postmenopausal with ever-use of HT (PMT). Major cardiovascular risk factors as well as level of education, diet, and degree of physical activity were assessed in relation to hormonal status.Results Compared to the PM0 group, the women in the PMT group had a higher level of education, more often worked full time, more often had sedentary work and lived a more regular life. They also had a lower rate of cigarette consumption, lower waist-to-hip ratio and lower body mass index than women in the PM0 group. The PMT group had lower levels of serum total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglycerides than the PM0 group and also had lower systolic and diastolic blood pressures, a lower prevalence of type II diabetes mellitus, of deep venous thrombosis and of coronary artery disease. Low-risk factors for cardiovascular disease and high level of education were still associated with HT, after adjustment by multiple logistic regression. Major risk factors for coronary heart disease were similar between the PM and the PMT groups.Conclusion Use of HT is accompanied by a lower risk profile for cardiovascular disease and also by several factors indicating a healthier lifestyle.