Effect of Transdermal Estradiol and Insulin-Like Growth Factor-1 on Bone Endpoints of Young Women with Anorexia Nervosa

2021 ◽  
Author(s):  
Vibha Singhal ◽  
Amita Bose ◽  
Meghan Slattery ◽  
Melanie S Haines ◽  
Mark A Goldstein ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Young Women ◽  
Bone Geometry ◽  
Adolescent And Young Adult ◽  
Bone Resorption Marker ◽  
Adult Women ◽  
Estrogen Replacement ◽  
Weight Changes ◽  
Double Blind ◽  
The Impact

Abstract Context Anorexia nervosa (AN) is prevalent in adolescent girls and is associated with bone impairment driven by hormonal alterations in nutritional deficiency. Objective To assess the impact of estrogen replacement with/ without rhIGF-1 administration on bone outcomes. Design Double-blind, randomized, placebo-controlled 12-month longitudinal study. Participants Seventy-five adolescent and young adult women with AN age 14 - 22 years. Thirty-three participants completed the study. Intervention Transdermal 17-beta estradiol 0.1 mg/day with (i) 30 mcg/kg/dose of rhIGF-1 administered subcutaneously twice daily (AN-IGF-1+) or (ii) placebo (AN-IGF-1-). The dose of rhIGF-1 was adjusted to maintain levels in the upper half of the normal pubertal range. Main Outcome Measures: Bone turnover markers and bone density, geometry, microarchitecture, and strength estimates. Results Over 12 months, lumbar aBMD increased in AN-IGF-1- compared to AN-IGF-1+ (p=0.004). AN-IGF-1+ demonstrated no improvement in areal BMD in the setting of variable compliance to estrogen treatment. Groups did not differ for 12-month changes in bone geometry, microarchitecture, vBMD, or strength (and results did not change after controlling for weight changes over 12 months). Both groups had increases in radial cortical area and vBMD, and tibia cortical vBMD over 12 months. Levels of a bone resorption marker decreased in AN-IGF-1- (p=0.042), while PTH increased in AN-IGF-1+ (p=0.019). AN-IGF-1- experienced irregular menses more frequently than did AN-IGF-1+, but incidence of all other adverse events did not differ between groups. Conclusions We found no additive benefit of rhIGF-1 administration for 12-months over transdermal estrogen replacement alone in this cohort of young women with AN.

scholarly journals Reinventing the Squeal: Young New Zealand Women Negotiating Space in the Current Sexual Culture

2021 ◽  
Author(s):  
◽  
Lesley Wright
Keyword(s):  
New Zealand ◽  
Young Women ◽  
Public Discourse ◽  
Instant Messaging ◽  
Sexual Experience ◽  
Casual Sex ◽  
Adult Women ◽  
Sexual Culture ◽  
Wide Range ◽  
The Impact

<p>The sexual behaviour of young emergent adult women in New Zealand has become a target of media attention and commentary. Moralising language is prevalent in the public discourse, describing young women negatively with respect to character and psychology. Research investigating the increase of cultural artefacts such as hooking up or casual sex is often risk-focused, concentrating predominantly on detrimental impacts such as STIs, rape-risks, and depression. Some feminist analyses describe behaviour as postfeminist or as examples of false consciousness. Despite these positions, young New Zealand women are engaging in these and other non-relationship sexual activities in growing numbers, suggesting that current approaches are failing to capture salient explanatory information. Due to the negative impacts of social constraints such as the sexual double standard, traditional femininity and moralising social commentary on young women it is important to present a more holistic image of their behaviour so as to provide a deeper explanatory view which better accounts for young women’s experiences and motivations. In this study I utilise a mixed method research design to access a wide range of participants on a sensitive research topic. A self-selecting sample of 163 young women aged between 18 and 30, recruited from various university campuses around New Zealand, completed an online survey. From this group 18 heterosexually-identifying young women were selected to participate in instant messaging, email and face to face interviews, and an online discussion group. To analyse the material they provided I use a Third Wave feminist theoretical lens in order to give primacy not only to their voices but also their claims to agency and the importance of subjective positionality. I use Sexual Script Theory as a framework to illuminate the impact of cultural dialogues on individuals, and space was conceptualised as a way to illustrate performances and agency. Results suggest that young New Zealand women are strongly affected by risk-focused and moralising dialogues to the effect that they have internalised a risk-focused cultural script that guides their sexual interactions and behaviours within socio-sexual culture in constrained and avoidant ways. Other performed scripts such as ‘good girl’ femininity, traditional masculinity, and the normative performance of heterosex also presented as barriers to subjective sexual experience/development. However, many young women in this study were resistant to some of these scripts, as evidenced in their attempts to occupy traditionally masculine and/or social spaces where non-normative behaviours are (partially) permitted. Their behaviour suggests critical engagement with their socio-sexual environment and some awareness of script elements that dictate acceptable feminine behaviour, and how these constraints can be (at least temporarily) resisted as a means to not only developing sexual subjectivity but also to refashioning modern femininity.</p>

scholarly journals Discharge Body Mass Index, Not Illness Chronicity, Predicts 6-Month Weight Outcome in Patients Hospitalized With Anorexia Nervosa

2021 ◽  
Vol 12 ◽  
Author(s):  
Graham W. Redgrave ◽  
Colleen C. Schreyer ◽  
Janelle W. Coughlin ◽  
Laura K. Fischer ◽  
Allisyn Pletch ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Body Mass ◽  
Adult Women ◽  
Short Term ◽  
Illness Duration ◽  
Weight Restoration ◽  
The Impact

Proposed treatments for severe and enduring anorexia nervosa (SE-AN) focus on quality of life, and psychological and social functioning. By de-emphasizing weight restoration as a priority, however, premature diagnosis of SE-AN may reduce potential for recovery. The present study assessed the effect of weight restoration, illness duration, and severity on treatment outcome 6 months after discharge from an intensive, meal-based behavioral treatment program. Participants included hospitalized adult women (N = 191) with AN or underweight other specified feeding and eating disorder (OSFED). Participants were characterized as short-term (ill &lt;7 years; n = 74) or long-term ill (ill ≥ 7 years; n = 117). Compared with short-term ill, long-term ill patients were older, had lower lifetime body mass index (BMI), more prior admissions, and exhibited greater depression and neuroticism. Long-term vs. short-term ill patients gained weight at the same rate (~2 kg/wk) and were equally likely to be weight restored by discharge (&gt;75% reached BMI ≥ 19 kg/m2 in both groups). At 6-month follow-up (n = 99), both groups had equivalent self-reported BMI, and depression, drive for thinness, body dissatisfaction, and bulimia scores. The only predictor of BMI ≥ 19 kg/m2 at follow-up was discharge BMI. The likelihood of a BMI ≥ 19 kg/m2 at follow-up was 5-fold higher for those with discharge BMI ≥ 19 kg/m2. Few studies of long-term ill inpatients with AN have examined the impact of full weight restoration on short-term outcomes. This study supports the therapeutically optimistic stance that, regardless of illness duration, hospitalized patients with AN benefit from gaining weight to a BMI ≥ 19 kg/m2.

scholarly journals Reinventing the Squeal: Young New Zealand Women Negotiating Space in the Current Sexual Culture

2021 ◽  
Author(s):  
◽  
Lesley Wright
Keyword(s):  
New Zealand ◽  
Young Women ◽  
Public Discourse ◽  
Instant Messaging ◽  
Sexual Experience ◽  
Casual Sex ◽  
Adult Women ◽  
Sexual Culture ◽  
Wide Range ◽  
The Impact

<p>The sexual behaviour of young emergent adult women in New Zealand has become a target of media attention and commentary. Moralising language is prevalent in the public discourse, describing young women negatively with respect to character and psychology. Research investigating the increase of cultural artefacts such as hooking up or casual sex is often risk-focused, concentrating predominantly on detrimental impacts such as STIs, rape-risks, and depression. Some feminist analyses describe behaviour as postfeminist or as examples of false consciousness. Despite these positions, young New Zealand women are engaging in these and other non-relationship sexual activities in growing numbers, suggesting that current approaches are failing to capture salient explanatory information. Due to the negative impacts of social constraints such as the sexual double standard, traditional femininity and moralising social commentary on young women it is important to present a more holistic image of their behaviour so as to provide a deeper explanatory view which better accounts for young women’s experiences and motivations. In this study I utilise a mixed method research design to access a wide range of participants on a sensitive research topic. A self-selecting sample of 163 young women aged between 18 and 30, recruited from various university campuses around New Zealand, completed an online survey. From this group 18 heterosexually-identifying young women were selected to participate in instant messaging, email and face to face interviews, and an online discussion group. To analyse the material they provided I use a Third Wave feminist theoretical lens in order to give primacy not only to their voices but also their claims to agency and the importance of subjective positionality. I use Sexual Script Theory as a framework to illuminate the impact of cultural dialogues on individuals, and space was conceptualised as a way to illustrate performances and agency. Results suggest that young New Zealand women are strongly affected by risk-focused and moralising dialogues to the effect that they have internalised a risk-focused cultural script that guides their sexual interactions and behaviours within socio-sexual culture in constrained and avoidant ways. Other performed scripts such as ‘good girl’ femininity, traditional masculinity, and the normative performance of heterosex also presented as barriers to subjective sexual experience/development. However, many young women in this study were resistant to some of these scripts, as evidenced in their attempts to occupy traditionally masculine and/or social spaces where non-normative behaviours are (partially) permitted. Their behaviour suggests critical engagement with their socio-sexual environment and some awareness of script elements that dictate acceptable feminine behaviour, and how these constraints can be (at least temporarily) resisted as a means to not only developing sexual subjectivity but also to refashioning modern femininity.</p>

scholarly journals Breast Cancer in Adolescent and Young Adult Women Under the Age of 40 Years

2021 ◽  
pp. OP.20.00793
Author(s):  
Elizabeth J. Cathcart-Rake ◽  
Kathryn J. Ruddy ◽  
Archie Bleyer ◽  
Rebecca H. Johnson
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Young Women ◽  
Locally Advanced ◽  
Significant Proportion ◽  
Local Therapy ◽  
The United States ◽  
Adolescent And Young Adult ◽  
Multidisciplinary Teams ◽  
Adult Women

In the United States, one in 196 women is diagnosed with breast cancer under the age of 40 years. Adolescents and young adults (AYAs), of age 15-39 years at diagnosis, experience a number of unique challenges when confronting breast cancer. The incidence of invasive breast cancer has increased among AYA women in the United States since 2004, and most of this change is due to an increase in young women diagnosed with distant disease. AYAs are more likely than older women to present with aggressive subtypes and advanced disease, and they often require systemic staging at diagnosis. Clinical trials should be considered whenever possible, particularly in AYAs with locally advanced or metastatic disease at diagnosis and those with disease progression or recurrence. A significant proportion of AYAs carry germline cancer predisposition mutations, which necessitates prompt genetic testing for all AYAs at diagnosis and may influence choice of local therapy. Suppression of ovarian function, as an adjunct to chemotherapy, may improve breast cancer survival in AYAs. To provide optimal care for AYAs with breast cancer, clinicians should engage multidisciplinary teams that offer fertility preservation, genetic counseling, physical and occupational therapy, nutrition, and psychosocial support, along with medical expertise in tailoring cancer-directed therapy and symptom management toward young women.

Abstract P092: Adolescent and Young Adult Women Have Low Cardiovascular Disease Awareness

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Holly C Gooding ◽  
Courtney Brown ◽  
Caterina Stamoulis ◽  
Anna C Revette ◽  
Sarah D DeFerranti
Keyword(s):  
Heart Disease ◽  
Young Adult ◽  
Young Women ◽  
Adolescent And Young Adult ◽  
Health Study ◽  
Regular Exercise ◽  
Adult Women ◽  
Young Adult Women ◽  
Sugar Intake ◽  
Disease Awareness

Introduction: The American Heart Association (AHA) Go Red for Women campaign has substantially improved awareness of heart disease among adult women over the past fifteen years, as demonstrated by triennial surveys of women ages 25 years and older. Little is known about awareness among younger women, who represent a key time in the life course for primordial prevention. We hypothesized that adolescent and young adult women 15 to 24 years of age would have lower rates of heart disease awareness than women 25 years of age and older. Methods: We assessed awareness of heart disease and prevention efforts among young women ages 15-24 years using the AHA National Women’s Health Study survey. Participants were a random convenience sample of 103 women recruited from the waiting rooms of two clinical practices (one community health center and one academic medical center). We performed statistical comparisons of this cohort to responses from the 2012 AHA National Women’s Health Study survey of 168 women ages 25-34 years using the chi-square test (binary responses). Results: Only 13 (13%) adolescent and young adult women correctly identified heart disease as the leading cause of death in women. This was significantly lower than the rate of awareness of adult women overall in 2012 (56% of 2432) and of women ages 25-34 years (44% of 168) (p<0.001 for both comparisons). Almost half of the young women surveyed in the current study [(n= 44 (43%)] said they were not at all informed about heart disease. While physicians emerged as the preferred source of information about heart disease among participants, the majority [n=64 (62%)] had never spoken to a health care professional about their risk of heart disease. Most young women surveyed worried little [n = 44 (43%)] or not at all [n = 40 (39%)] about heart disease; mood disorders were the most common concern in this age group, followed by sexual health issues. Despite a lack of general awareness about heart disease, many young women did report engaging in activities known to reduce the risk of heart disease, including getting regular exercise [n = 81 (79%)], maintaining healthy blood pressure [n = 76 (74%)], reducing sugar intake [n = 48 (47%)], and losing weight [n = 48 (47%)]. A significantly higher proportion of women ages 15-24 years aimed to maintain a healthy blood pressure and get regular exercise compared to those ages 24-34 (p<0.02), whereas a similar proportion aimed to lose weight and reduce sugar intake (p>0.7). Conclusions: Adolescent and young adult women are largely unaware of heart disease as the leading cause of death in women. As the antecedents of heart disease begin in childhood and adolescence, these findings demonstrate a major unmet need. Given most young women are not worried about heart disease at this life stage, campaigns to promote heart healthy behaviors should underscore the benefits of these prevention behaviors to mood and emotional health.

scholarly journals Effects of Estrogen Replacement on Bone Geometry and Microarchitecture in Adolescent and Young Adult Oligoamenorrheic Athletes: A Randomized Trial

2019 ◽  
Vol 35 (2) ◽  
pp. 248-260 ◽  
Author(s):  
Kathryn E Ackerman ◽  
Vibha Singhal ◽  
Meghan Slattery ◽  
Kamryn T Eddy ◽  
Mary L Bouxsein ◽  
...  
Keyword(s):  
Young Adult ◽  
Randomized Trial ◽  
Bone Geometry ◽  
Adolescent And Young Adult ◽  
Estrogen Replacement

Determinants of Bone Mass and Bone Geometry in Adolescent and Young Adult Women

2000 ◽  
Vol 66 (2) ◽  
pp. 81-89 ◽  
Author(s):  
A. F. M. Kardinaal ◽  
G. Hoorneman ◽  
K. Väänänen ◽  
P. Charles ◽  
S. Ando ◽  
...  
Keyword(s):  
Young Adult ◽  
Bone Mass ◽  
Bone Geometry ◽  
Adolescent And Young Adult ◽  
Adult Women ◽  
Young Adult Women

Combined Oral Contraceptive in Adolescent and Young Adult Women: Current Evidence and Future Perspectives

2019 ◽  
Vol 15 (2) ◽  
pp. 109-118 ◽  
Author(s):  
Agnese Maria Chiara Rapisarda ◽  
Roberta Brescia ◽  
Fabrizio Sapia ◽  
Gaetano Valenti ◽  
Giuseppe Sarpietro ◽  
...  
Keyword(s):  
Oral Contraceptive ◽  
Young Adult ◽  
Young Women ◽  
Adolescent And Young Adult ◽  
Current Evidence ◽  
Hormonal Contraceptives ◽  
Adult Women ◽  
Care Providers ◽  
Young Adult Women ◽  
Irregular Bleeding

Background:The use of effective contraceptive methods must be encouraged among adolescents, not only to prevent unintended pregnancies but also to promote the sexual health and well-being of these young people. In effect, hormonal contraceptives offer several benefits beyond prevention of pregnancy to every woman, in particular to adolescents (e.g., dysmenorrhea, irregular bleeding, hirsutism, acne); moreover, they can be a targeted therapy for some gynecological diseases (e.g., endometriosis, polycystic ovary syndrome), to ensure a better quality of life.Objective:The purpose of this article is to review the different formulations of COCs for adolescent and young adult women, and analyze their efficacy, safety, and benefits of specific pathological conditions.Methods:We screened published literature on PubMed/MEDLINE and Scopus, using as keywords “oral contraceptive” in adolescent and young adult women. We included only articles in English about the COCs, different regimens and formulations.Results:Our literature analysis allows us to underline the important role of COC not only as birth control method, but also as valid treatments for gynecological disorders related to hormonal fluctuations (e.g., dysmenorrhea, irregular bleeding, hirsutism, acne) and pathological diseases, such as polycystic ovarian syndrome (PCOS), endometriosis, with a preventive role for fertility preservation and pelvic inflammatory disease.Conclusion:Adequate, care and competent counseling is the key to achieve good compliance of young women with contraception. Through the “GATHER” method suggested by WHO, health care providers should first evaluate the balance between benefits and risks of hormonal treatment, create an appropriate safety profile and then recommend COC prescription in adolescent and young women.

Caregiving History and Prenatal Depressive Symptoms in Low-Income Adolescent and Young Adult Women: Moderating and Mediating Effects

2007 ◽  
Vol 31 (3) ◽  
pp. 241-251 ◽  
Author(s):  
Stephanie Milan ◽  
Trace S. Kershaw ◽  
Jessica Lewis ◽  
Claire Westdahl ◽  
Sharon Schindler Rising ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Young Women ◽  
Low Income ◽  
Women Of Color ◽  
Developmental Differences ◽  
Adolescent And Young Adult ◽  
Adult Women ◽  
Interpersonal Context ◽  
Mental Health Interventions ◽  
Independent Association

Prenatal depressive symptoms have been linked to negative outcomes for mothers and children. Using attachment theory as a framework, this study examined developmental differences in the interpersonal context of prenatal depressive symptoms among adolescents (age 14 to 19 years; n = 352) and young adults (age 20 to 24 years; n = 348). Participants included low-income, single, predominantly African American and Latina women. Moderating and mediating factors were found in the relation between caregiving history (perceived unavailability and inconsistency of maternal and paternal figures during childhood) and depressive symptoms. For pregnant adolescents, maternal unavailability predicted depressive symptoms whereas maternal inconsistency did not. In contrast, for pregnant young women, only maternal inconsistency predicted depressive symptoms; and this association was mediated by perceptions of prenatal support. For both groups, paternal caregiving history had a small yet independent association with depressive symptoms. Results highlight the need to consider developmental differences in the interpersonal context of prenatal depressive symptoms in delivering mental health interventions to young women of color.

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