A direct comparison of women’s perceptions and acceptability of micronised progesterone and medroxyprogesterone acetate in combination with transdermal oestradiol in the management of young postmenopausal women, under 45 years of age

2020 ◽  
Vol 26 (4) ◽  
pp. 210-219
Author(s):  
M Mittal ◽  
N Panay ◽  
PR Supramaniam ◽  
M Savvas ◽  
L Cardozo ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Postmenopausal Women ◽  
Medroxyprogesterone Acetate ◽  
Rating Scales ◽  
Psychological Symptoms ◽  
Hormone Replacement ◽  
Energy Levels ◽  
Symptom Control ◽  
Significant Difference ◽  
Women’S Perceptions

Objective To assess the acceptability and perception of postmenopausal women, to two different hormone replacement therapy regimens, in relation to the control of their symptoms and development of adverse effects. Study design Prospectively recruited postmenopausal women, <45 years, were randomised to one of two treatment arms for 12-months: cyclical micronised progesterone or medroxyprogesterone acetate in combination with transdermal oestradiol. A self-reported questionnaire with matrix rating scales was completed and repeated after 3, 6 and 12-months. Main outcome measures Symptom control and development of adverse effects. Results Seventy-one individuals were screened, with baseline data available for 67 subjects. A total of 190 questionnaires were returned. The most commonly reported symptoms were low energy levels, vasomotor symptoms and sexual dysfunction. The prevalence of adverse effects ranged between 57.89 and 87.50%, with a reduction seen in the transdermal oestradiol + micronised progesterone arm (73.91% at 3-months, decreasing to 57.89% at 12-months; p = 0.33), compared to the transdermal oestradiol + medroxyprogesterone acetate arm (76.92% at 3-months, increasing to 87.50% at 12-months; p = 0.69). The main reported adverse effects were bloating, weight change and psychological symptoms. A significant difference was documented between the groups after set intervals, with a greater proportion reporting breast tenderness after 3-months (p = 0.01), lower numbers reporting mood swings at 6-months (p = 0.01) and irritability at 12-months (p = 0.03) in the transdermal oestradiol + micronised progesterone arm compared to the transdermal oestradiol + medroxyprogesterone acetate arm. Conclusions The acceptability of both regimens was high despite adverse effects, but tolerability of transdermal oestradiol combined with micronised progesterone appeared to be better with fewer women reporting psychological concerns.

scholarly journals Topical estradiol does not interfere with the expression of the metalloproteinase-1 enzyme in photo exposed skin cells

2012 ◽  
Vol 87 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Luciana Neder ◽  
Sebastião Freitas de Medeiros
Keyword(s):  
Postmenopausal Women ◽  
Pap Smear ◽  
Transvaginal Ultrasound ◽  
Hormone Replacement ◽  
Exposed Skin ◽  
Significant Difference ◽  
Before And After ◽  
Dermal Collagen ◽  
Cutaneous Atrophy ◽  
The Right

BACKGROUND: In postmenopausal women there is a rapid destruction of dermal collagen, resulting in accelerated skin ageing, which is manifested by cutaneous atrophy, increased number and depth of wrinkles and sagging. This accelerated catabolism of the collagen is due to estrogen deficiency and increased synthesis of the metalloproteinase-1 enzyme, which degrades the dermal collagen. OBJECTIVES: To assess whether the use of topical estradiol 0.05% cream on photo exposed skin can inhibit the expression of the metalloproteinase-1 enzyme on the dermis and subsequently the rapid loss of collagen in women after menopause. METHODS: We included 40 postmenopausal women without hormone replacement therapy. Information about lifestyle, lipid profile, blood glucose level, thyroid hormones, mammography, Pap smear and transvaginal ultrasound were obtained to rule out associated diseases. Skin biopsy of the right preauricular region was performed before and after treatment with topical estradiol 0.05% for 30 days. The biopsy specimens were subjected to immunohistochemistry to identify the expression of the metalloproteinase-1 enzyme. RESULTS: There was no statistically significant difference on the expression of the metalloproteinase-1 enzyme in keratinocytes, fibroblasts and endothelial cells before and after treatment with topical estradiol for 30 days. CONCLUSION: Treatment with estradiol 0.05% cream, in photo exposed skin for 30 days, does not inhibit the production of metalloproteinase-1.

scholarly journals Hormone Replacement Therapy and Dry Eye in Post Menopausal Women: Study in a Tertiary Centre in Malaysia

2013 ◽  
Vol 1 (1) ◽  
pp. 12-15
Author(s):  
Norshamsiah M Din ◽  
Siti H. B. Sa’aid ◽  
Lam C. Shen ◽  
Yap S. Shu ◽  
Marina B. A. Rahman ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Dry Eye ◽  
Hormone Replacement ◽  
Test Strip ◽  
The Body ◽  
Cross Sectional ◽  
Tear Production ◽  
Significant Difference

Background: Menopause involves decrease in the body estrogen level. There are many disorders associated with estrogen deficiency state. Postmenopausal women frequently report dry eye symptoms due to the decrease in the level of circulating estrogen hormone. Hormone replacement therapy (HRT) is given to alleviate some of the menopausal effects. This study aimed to compare the tear production between postmenopausal women treated with or without HRT.Methods: This cross-sectional study was performed on 140 participants attending various clinics in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) namely the obstetric and gynecology, Surgery, Orthopedic and Otorhinolaryngology clinics over a period of 3 months. The subjects were either with or without HRT. Schirmer’s Test strip was used to measure the tear quantity. Dry eye was defined when the length of the moistened area on the strip is less than 5 mm.Results: The results showed significant difference in tear quantity in postmenopausal women treated with or without HRT (p=0.003). No correlation was observed between tear quantity and duration of HRT consumption (p=0.217). No significant correlation was also found between the tear quantity and duration of menopause (p=0.150).Conclusions: Our results suggested that HRT helps in improving tear production in postmenopausal women regardless of the duration of HRT consumption or menopause. However, duration of HRT consumption or menopause exert no significant effect on the tear quantity.

scholarly journals Longitudinal associations between sex hormone-binding globulin and insulin resistance

2020 ◽  
Vol 9 (5) ◽  
pp. 418-425
Author(s):  
Kristin Ottarsdottir ◽  
Margareta Hellgren ◽  
David Bock ◽  
Anna G Nilsson ◽  
Bledar Daka
Keyword(s):  
Insulin Resistance ◽  
Postmenopausal Women ◽  
Hormone Replacement ◽  
Premenopausal Women ◽  
Sex Hormone Binding Globulin ◽  
Model Assessment ◽  
Cross Sectional ◽  
Men And Women ◽  
Significant Difference ◽  
Homeostatic Model Assessment

Purpose We aimed to investigate the association between SHBG and the homeostatic model assessment of insulin resistance (HOMA-Ir) in men and women in a prospective observational study. Methods The Vara-Skövde cohort is a random population of 2816 participants living in southwestern Sweden, aged 30–74. It was recruited between 2002 and 2005, and followed up in 2012–2014. After excluding participants on insulin therapy or hormone replacement therapy, 1193 individuals (649 men, 544 women) were included in the present study. Fasting blood samples were collected at both visits and stored in biobank. All participants were physically examined by a trained nurse. SHBG was measured with immunoassay technique. Linear regressions were computed to investigate the association between SHBG and HOMA-Ir both in cross-sectional and longitudinal analyses, adjusting for confounding factors. Results The mean follow-up time was 9.7 ± 1.4 years. Concentrations of SHBG were significantly inversely associated with log transformed HOMA-Ir in all groups with estimated standardized slopes (95% CI): men: −0.20 (−0.3;−0.1), premenopausal women: −0.26 (−0.4;−0.2), postmenopausal women: −0.13 (−0.3;−0.0) at visit 1. At visit 2 the results were similar. When comparing the groups, a statistically significant difference was found between men and post-menopausal women (0.12 (0.0;0.2) P value = 0.04). In the fully adjusted model, SHBG at visit 1 was also associated with HOMA-Ir at visit 2, and the estimated slopes were −0.16 (−0.2;−0.1), −0.16 (−0.3;−0.1) and −0.07 (−0.2;0.0) for men, premenopausal and postmenopausal women, respectively. Main conclusion Levels of SHBG predicted the development of insulin resistance in both men and women, regardless of menopausal state.

scholarly journals Hormone Replacement Therapy with Estrogen or Estrogen plus Medroxyprogesterone Acetate Is Associated with Increased Epithelial Proliferation in the Normal Postmenopausal Breast1

1999 ◽  
Vol 84 (12) ◽  
pp. 4559-4565 ◽  
Author(s):  
Lorne J. Hofseth ◽  
Ahmed M. Raafat ◽  
Janet R. Osuch ◽  
Dorothy R. Pathak ◽  
Carol A. Slomski ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cell Proliferation ◽  
Hormone Replacement Therapy ◽  
Epithelial Cell ◽  
Breast Cancer Risk ◽  
Postmenopausal Women ◽  
Medroxyprogesterone Acetate ◽  
Hormone Replacement ◽  
Breast Epithelial Cell ◽  
Breast Epithelial

The relative effects of postmenopausal hormone replacement therapy (HRT) with estrogen alone vs. estrogen+progestin on breast cell proliferation and on breast cancer risk are controversial. A cross-sectional observational study was carried out to examine the proliferative effects of HRT with estrogen or estrogen plus the progestin, medroxyprogesterone acetate, in breast tissue of postmenopausal women. Benign breast biopsies from 86 postmenopausal women were analyzed with antiproliferating cell nuclear antigen (anti-PCNA) and Ki67 antibodies to measure relative levels of cell proliferation. Epithelial density and estrogen and progesterone receptor status were also determined. The women were categorized either as users of: 1) estrogen (E) alone; 2) estrogen+medroxyprogesterone acetate (E+P); or 3) no HRT. Compared with no HRT, the breast epithelium of women who had received either E+P or E alone had significantly higher PCNA proliferation indices, and treatment with E+P had a significantly higher index (PCNA and Ki67) than treatment with E alone. Breast epithelial density was significantly greater in postmenopausal women treated with E and E+P, compared with no HRT. Thus, the present study shows that postmenopausal HRT with E+P was associated with greater breast epithelial cell proliferation and breast epithelial cell density than E alone or no HRT. Furthermore, with E+P, breast proliferation was localized to the terminal duct-lobular unit of the breast, which is the site of development of most breast cancers. Further studies are needed to assess the possible association between the mitogenic activity of progestins and breast cancer risk.

scholarly journals Correlation of the Severity of Physical and Psychological Symptoms and Severity of Insomnia in Postmenopausal Women

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Maryam Masoudi ◽  
Hamzeh Ahmadian ◽  
Maryam Akbari ◽  
Nasrin Jalilian
Keyword(s):  
Postmenopausal Women ◽  
Rating Scale ◽  
Sleep Problems ◽  
Psychological Symptoms ◽  
Pearson Correlation ◽  
Social Characteristics ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean ◽  
Insomnia Severity

Background: Menopause is associated with physical and psychological as well as sleep problems that cause disruption in quality of life in women. Objectives: The question of whether the severity of physical and psychological symptoms correlated with the severity of insomnia in postmenopausal women is investigated in this study. Methods: This cross-sectional study was performed on 214 postmenopausal women referred to health centers in Kermanshah city between May 2019 and May 2020. Data collection tools included demographic and social characteristics questionnaires, Menopausal Rating Scale (MRS) and Insomnia Severity Index (ISI). Data were analyzed using ANOVA and Pearson correlation test using SPSS software. Results: The mean total score of insomnia severity was 14.3 ± 5. Also, according to the severity of insomnia, 22 women had no insomnia, but 88 and 87 women had mild and moderate insomnia and 17 women had severe insomnia, respectively. Comparing the mean scores of 11 MRS items in different insomnia severities showed a significant difference in the rate of symptoms, so that in the physical domain, hot flashes and sleep problems, and in the psychological domain, depression items, irritability, anxiety, poor memory and lack of concentration were higher in the sever insomnia, but none of the items of the genitourinary domain were associated with the severity of insomnia. Conclusions: Our study showed that in postmenopausal women, the rate of physical and psychological symptoms increases with higher severity of insomnia. Insomnia should be considered as a disorder that requires special attention and treatment in postmenopausal women.

No increased risk of endometrial hyperplasia with fixed long-cycle hormone replacement therapy after two years

2002 ◽  
Vol 8 (4) ◽  
pp. 155-156
Author(s):  
Risto Erkkola ◽  
Ulpu Kumento ◽  
Sirpa Lehmuskoski ◽  
Leena Mattila ◽  
Mika Mustonen
Keyword(s):  
Clinical Trial ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Medroxyprogesterone Acetate ◽  
Endometrial Hyperplasia ◽  
Hormone Replacement ◽  
Long Cycle ◽  
Increased Risk

The appropriate dose of progestogen during long-cycle hormone replacement is still under debate. We present preliminary two-year results from an open five-year clinical trial of 132 postmenopausal women. All subjects had long-cycle HRT consisting of 70 days 2 mg oestradiol valerate (E2V), followed by 14 days 2 mg E2V plus 20 mg medroxyprogesterone acetate, and a seven-day hormone-free period. No endometrial samples with hyperplasia or indicative of malignancy were found at 24 months.

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