Menopause : the journal of the North American Menopause Society
-
Decision making about menopausal therapies is complex because of the number of clinical factors that must be considered. Menopausal hormone therapy can relieve the vasomotor symptoms of menopause, but the most common preparation, combination estrogen and progesterone, increases the risk of breast cancer. Both tamoxifen and raloxifene can reduce the risk of developing invasive breast cancer, but the adverse effects of these drugs differ substantially. ⋯ Any woman with a family history of breast cancer should be assessed as to whether she is likely to carry a BRCA mutation and referred for genetic counseling and possible genetic testing. Decisions about treatment options should be based on the presence or absence of bothersome vasomotor symptoms, an intact uterus, and risk factors for cardiovascular disease. A simple algorithm is presented to streamline identification and management of menopausal women at high risk for breast cancer.
-
Two competing hypotheses suggest how adiposity may affect menopausal hot flashes. The "thin hypothesis" asserts that aromatization of androgens to estrogens in body fat should be associated with decreased hot flashes. Conversely, thermoregulatory models argue that body fat should be associated with increased hot flashes. The study objective was to examine associations between abdominal adiposity and hot flashes, including the role of reproductive hormones in these associations. ⋯ Increased abdominal adiposity, particularly subcutaneous adiposity, is associated with increased odds of hot flashes, favoring thermoregulatory models of hot flashes. Body fat may not protect women from hot flashes as once thought.
-
Randomized Controlled Trial Multicenter Study
Gabapentin for the treatment of menopausal hot flashes: a randomized controlled trial.
To compare the effectiveness and tolerability of gabapentin with placebo for the treatment of hot flashes in women who enter menopause naturally. ⋯ Gabapentin at 900 mg/day is an effective and well-tolerated treatment for hot flashes.
-
To determine whether reproductive hormone levels are affected by human immunodeficiency virus (HIV) and drug use. ⋯ Age and menopausal status are strongly related to reproductive hormones. Body mass index and use of opiates, cocaine, and highly active antiretroviral therapy as well as educational attainment and perceived health can significantly modify reproductive hormones during the menopausal transition and need to be considered when interpreting hormone levels in middle-aged women.
-
Randomized Controlled Trial
Effect of soy isoflavone protein and soy lecithin on endothelial function in healthy postmenopausal women.
To assess the effects of soy isoflavone protein concentrate and soy lecithin on endothelial function, measured as flow-mediated dilation (FMD) of the brachial artery in healthy postmenopausal women. ⋯ In this sample of healthy postmenopausal women, soy isoflavone protein and soy lecithin significantly improved the lipid profile. A favorable influence on endothelial function could not be confirmed.