Peri Women Research Articles

Bone resorption levels by age and menopausal status in 5,157 women.

The purpose of this study was to describe bone resorption activity using a biochemical marker according to the categories of age, menopausal status, and selected drug/supplement use in middle-aged and elderly community-based women. This was a cross-sectional study that assessed urinary cross-linked N-telopeptide of type I collagen (NTx) and used self-report data to group women as premenopausal (Pre), perimenopausal (Peri), postmenopausal without hormone replacement therapy (Post), and postmenopausal with hormone replacement therapy (HRT). Mean NTx values were found to be significantly different by group and controlling for age (p = 0.001), with post hoc tests showing all pairwise group comparisons as significantly different (p = 0.001), except that the Pre and HRT groups were not significantly different. Both the Peri and the Post NTx levels were significantly higher than the Pre and the HRT groups'. NTx values in the Peri group varied with age-the youngest Peri women were similar to Pre women, and the oldest Peri women were similar to Post women. Significantly lower NTx levels were found only in the Post (p = 0.009) and HRT (p < 0.001) groups using diuretics compared with nonuse and only in the HRT group using calcium supplements compared with nonuse (p = 0.006). No differences by thyroid use were found. With a biochemical marker, the results showed that bone resorption activity differences could be demarcated in women according to age, estimated menopausal stage, and selected drug/supplement use. These results support the usefulness of NTx assessment for indicating bone resorption activity and therefore the potential for osteoporosis or for monitoring the efficacy of antiresorptive therapies.

Non-association of estrogen receptor genotypes with bone mineral density and bone turnover in Korean pre-, peri-, and postmenopausal women.

Estrogen is known to play a critical role in both skeletal maturity and the rate of bone loss. This suggests the possibility that the estrogen receptor (ER) gene is one of the candidate genes that determines peak bone density and/or bone turnover rate. We investigated two established restriction fragment length polymorphisms (RFLPs) in intron 1 at the ER gene, represented as PvuII and XbaI. In 598 healthy Korean women aged 20-74 years, we examined the association of these ER genotypes with bone mineral density (BMD) and bone turnover status. The distribution of the PvuII and XbaI RFLPs was as follows: pp 205 (34.3%), Pp 308 (51.5%), PP 85 (14.2%) and xx 384 (64.2%), Xx 180 (30.1%), XX 34 (5.7%), respectively (where capital letters signify the absence of, and lower-case letters signify the presence of, the restriction site of each RFLP). No significant genotypic differences were found in BMD and bone markers. We grouped the subjects into three categories according to their menstrual status: 104 premenopausal women with regular menstruation, 182 perimenopausal women who had amenorrhea of not less than 3 months and not more than 12 months' duration, and 312 postmenopausal women whose last menstruation was at least 12 months previously. No significant genotypic difference in either BMD or bone markers was found in any of these three groups. Furthermore we categorized women in peri- and postmenopause into a high loser group and a normal loser group according to the level of bone resorption markers. There was no difference in genotypic proportions between the high and normal loser groups. Our data suggest that these ER polymorphisms are not associated with BMD or bone turnover in Korean women.

Reassuring the woman facing menopause: strategies and resources

Reassurance and reliable information are the prime requirements of women in premenopause, perimenopause and postmenopause. Women in premenopause want to know what to expect; women in perimenopause want to know that their experiences fall within the range of `normal'; women in peri- and postmenopause need help in making sensible decisions about the use of hormone therapy. Based on the concerns expressed in over 7000 letters and other messages sent to the international newsletter, A Friend Indeed, this article discusses the concerns of North American women facing menopause in the last decade of the 20th century.

P034 Bone mass density and mechanical properties of forearms of women in peri and postmenopausal period affected by Colles fractures

P034 Bone mass density and mechanical properties of forearms of women in peri and postmenopausal period affected by Colles fractures

Detrusor Instability Score in the Evaluation of Stress Urinary Incontinence

The major cause of failure in the surgical treatment of stress urinary incontinence (SUI) in women is an occult instability. In order to detect instability and its degree, urological histories were standardized by scoring the replies to ten specific questions with O (indicative of SUI), 1 or 2 (slightly and markedly indicative of instability, respectively). The sum of the scores was termed the detrusor instability score (DIS). The DIS was calculated for 134 patients both preoperatively and 2 years after operation, and 112 of these women were also evaluated by bead-chain urethrocystography (UCG) before operation. The 10% failure rate among the 72 patients with a DIS of 0-7 (exclusive or nearly exclusive instability) was significantly less than the 32% rate in the 62 women with a DIS of 8-16 (SUI complicated by marked instability). The 38% failure rate in 47 women of peri- or post-menopausal age and having a DIS of 8-16 was higher than the 10% in the other 87 women. An increased risk of failure was also found in patients who had a DIS of 8-16 together with either a urethral inclination angle of 80 degrees or less (46% failure rate in 28 women) or a posterior urethrovesical angle of 160 degree or less (43% failure rate in 30 women) in lateral bead-chain UCG during straining. The mean DIS decreased after successful surgery, but remained constant in cases of failure. The scored urological data facilitate the detection of patients with instability. This is potentiated by those lateral bead-chain UCG findings which indicate a low motility of the proximal urethra or bladder neck.

Detrusor instability score in the evaluation of stress urinary incontinence.

The major cause of failure in the surgical treatment of stress urinary incontinence (SUI) in women is an occult detrusor instability. In order to detect detrusor instability and its degree, urological histories were standardized by scoring the replies to ten specific questions with O (indicative of SUI), 1 or 2 (slightly and markedly indicative of detrusor instability, respectively). The sum of the scores was termed the "detrusor instability score" (DIS). The DIS was calculated for 134 patients both preoperatively and 2 years after operation, and 112 of these women were also evaluated by bead-chain urethrocystography (UCG) before operation. The 10% failure rate among the 72 patients with a DIS of 0-7 (exclusive or nearly exclusive detrusor instability) was significantly less than the 32% rate in the 62 women with a DIS of 8-16 (SUI complicated by marked detrusor instability). The 38% failure rate in 47 women of peri- or post-menopausal age and having a DIS of 8-16 was higher than the 10% in the other 87 women. An increased risk of failure was also found in patients who had a DIS of 8-16 together with either a urethral inclination angle of 80 degrees or less (46% failure rate in 28 women) or a posterior urethrovesical angle of 160 degree or less (43% failure rate in 30 women) in lateral bead-chain UCG during straining. The mean DIS decreased after successful surgery, but remained constant in cases of failure. The scored urological data facilitate the detection of patients with detrusor instability. This is potentiated by those lateral bead-chain UCG findings which indicate a low motility of the proximal urethra or bladder neck.