1.  Title: Female contraception over 40. Author: The ESHRE Capri Workshop Group Source: Human Reproduction Update. 2009 May 20; Abstract: BACKGROUND The majority of women 40-49 years of age need an effective method of contraception because the decline in fertility with age is an insufficient protection against unwanted pregnancy. Although pregnancy is less likely after the age of 40 years, the clinical and social consequences of an unexpected pregnancy are potentially detrimental. No contraceptive method is contraindicated by advanced reproductive age alone; thus there is a need to discuss the effectiveness, risks and non-contraceptive benefits of all family planning methods for women in this age group. METHODS MEDLINE searches were done by topic (epidemiology, age and reproduction, sexual function, delayed childbearing and specific contraceptive methods). The topic summaries were presented to the Workshop Group and omissions or disagreements were resolved by discussion. RESULTS The decline in fecundity in the fifth decade is insufficient for contraceptive purposes. Thus a family planning method is needed. Sterilization is by far the most common method in several countries. Copper intrauterine devices and hormone intrauterine systems have similar effectiveness, with fewer than 1% failures in the first year of typical use. Special considerations in this age group include the frequency of menstrual irregularity, sexual problems and the possibility of menopausal symptoms, all of which may respond to hormonal methods of contraception. CONCLUSIONS Women should be advised to continue with a contraceptive method until they have reached the menopause with its natural state of sterility. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | MENOPAUSE | FAMILY PLANNING | FEMALE STERILIZATION | BIOLOGICAL AGING | AGE FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Reproduction | Sterilization, Sexual | Physiology | Biology | Population Characteristics Document Number: 341250 |
| 2. Title: Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer [letter] Author: Dizdar O; Aksoy S; Altundag K Source: Cancer. 2009 Apr 15;115(8):1802; author reply 1802-3. Abstract: We read with great interest the article by Phipps et al, in which they examined the risk factors for different subtypes of postmenopausal breast cancer. They found that certain reproductive factors have a greater effect on the risk of certain molecular subtypes of disease compared with others. However, the authors did not analyze oral contraceptive use as a risk factor. Oral contraceptive use has been associated with an increased risk of breast cancer in young women. Narod et al demonstrated that among BRCA1 mutation carriers, women who first used oral contraceptives before 1975, who used them before age 30 years, or who used them for > or = 5 years may have an increased risk of developing breast cancer. Sporadic triple-negative breast cancers and tumors that are noted in carriers of the BRCA1 mutation share similar features, including estrogen receptor negativity, high nuclear grade, high Ki-67 staining, cytokeratin 5/6 expression, and epidermal growth factor receptor expression. Furthermore, BRCA1 is rarely mutated in sporadic breast cancers. However, the pathologic similarities suggest that BRCA1 or associated pathways can become inactivated in triple-negative tumors via other mechanisms, such as gene promoter methylation. We previously reported a positive association between oral contraceptive use and triple-negative breast cancer. Although we did not take into consideration the menopausal status of the patients, the frequency of oral contraceptive use in our small cohort was found to be higher in patients with the triple-negative subtype compared with patients with other subtypes of breast cancer (35.3% vs 12.2%; P=.02). Taken together, we propose that oral contraceptive use may be associated with an increased risk of developing triple-negative breast cancer. However, to identify the exact role of oral contraceptive use in the development of breast cancer, more preclinical and clinical studies are warranted. (full-text) Language: English Keywords: TURKEY | UNITED STATES OF AMERICA | CRITIQUE | BREAST CANCER | RISK FACTORS | GENETICS | ORAL CONTRACEPTIVES | MENOPAUSE | AGE FACTORS | Europe, Southeastern | Europe | Developing Countries | Developed Countries | North America | Americas | Cancer | Neoplasms | Diseases | Health | Biology | Contraceptive Methods | Contraception | Family Planning | Reproduction | Population Characteristics | Demographic Factors | Population Document Number: 341636 |
| 3. Title: Breastfeeding and breast cancer risk in India: a multicenter case-control study. Author: Gajalakshmi V; Mathew A; Brennan P; Rajan B; Kanimozhi VC; Mathews A; Mathew BS; Boffetta P Source: International Journal of Cancer. 2009 Aug 1;125(3):662-5. Abstract: Breast cancer incidence is low in India compared with high-income countries, but it has increased in recent decades, particularly among urban women. The reasons for this pattern are not known although they are likely related to reproductive and lifestyle factors. Here, we report the results of a large case-control study on the association between breastfeeding and breast cancer risk. The study was conducted in 2 areas in South India during 2002-2005 and included 1,866 cases and 1,873 controls. Detailed information regarding menstruation, reproduction, breastfeeding and physical activity was collected through in-person interview. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression models. Breastfeeding for long duration was common in the study population. Lifetime duration of breastfeeding was inversely associated with breast cancer risk among premenopausal women (p-value of linear trend, 0.02). No such protective effect was observed in postmenopausal women, among whom a protective effect of parity was suggested. A reduction of breast cancer risk with prolonged breastfeeding was shown among premenopausal women. Health campaign focusing on breastfeeding behavior by appropriately educating women would contribute to reduce breast cancer burden. Language: English Keywords: INDIA | RESEARCH REPORT | CONTROL GROUPS | WOMEN | BREAST CANCER | RISK FACTORS | BREASTFEEDING | TIME FACTORS | MENOPAUSE | PARITY | Asia, Southern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Health | Infant Nutrition | Nutrition | Population Dynamics | Reproduction | Fertility Measurements | Fertility Document Number: 342166 |
| 4. Title: Hormonal contraceptive regimens in the perimenopause. Author: Hardman SM; Gebbie AE Source: Maturitas. 2009 Jun 11; Abstract: Perimenopausal women have low fertility but still need contraception if they are sexually active. They often have co-existing menstrual problems and menopausal symptoms. No method of contraception is contraindicated by age alone. In addition to highly effective contraception, hormonal methods offer non-contraceptive benefits which can improve quality of life for perimenopausal women. Combined hormonal oral contraception has been available for many decades. The combined vaginal ring and transdermal patch are newer methods offering alternative delivery systems but similar risk profiles to oral preparations. New combinations containing naturally occurring estrogens in place of the synthetic hormone ethinylestradiol are now available and, in theory, could be safer. The progestogen-only methods have an excellent safety profile and have a range of delivery systems and dosages to suit all. Concerns regarding loss of bone mineral density with the injectable depot medroxyprogesterone acetate continue but to date there is no evidence that this translates into higher fracture risk. Effective use of any method of contraception is strongly dependent on good counselling and support from healthcare professionals. Risks should be explained in absolute terms for each individual woman, enabling her to make an informed choice on evidence-based medicine and not influenced by ill-informed media publicity. Language: English Keywords: UNITED KINGDOM | CRITIQUE | MENOPAUSE | AGE FACTORS | SIGNS AND SYMPTOMS | HORMONES | CONTRACEPTIVE METHODS | CONTRACEPTIVE SAFETY | RISK FACTORS | MENSTRUATION DISORDERS | Developed Countries | Europe, Western | Europe | Reproduction | Population Characteristics | Demographic Factors | Population | Diseases | Endocrine System | Physiology | Biology | Contraception | Family Planning | Safety | Public Health | Health Document Number: 341711 |
| 5. Title: Breast cancer in young women and its impact on reproductive function. Author: Hickey M; Peate M; Saunders CM; Friedlander M Source: Human Reproduction Update. 2009 May-Jun;15(3):323-39. Abstract: BACKGROUND: Breast cancer is the most common cancer in women in developed countries, and 12% of breast cancer occurs in women 20-34 years. Survival from breast cancer has significantly improved, and the potential late effects of treatment and the impact on quality of life have become increasingly important. Young women constitute a minority of breast cancer patients, but commonly have distinct concerns and issues compared with older women, including queries regarding fertility, contraception and pregnancy. Further, they are more likely than older women to have questions regarding potential side effects of therapy and risk of relapse or a new primary. In addition, many will have symptoms associated with treatment and they present a management challenge. Reproductive medicine specialists and gynaecologists commonly see these women either shortly after initial diagnosis or following adjuvant therapy and should be aware of current management of breast cancer, the options for women at increased genetic risk, the prognosis of patients with early stage breast cancer and how adjuvant systemic treatments may impact reproductive function. METHODS: No systematic literature search was done. The review focuses on the current management of breast cancer in young women and the impact of treatment on reproductive function and subsequent management. With reference to key studies and meta-analyses, we highlight controversies and current unanswered questions regarding patient management. RESULTS: Chemotherapy for breast cancer is likely to negatively impact on reproductive function. A number of interventions are available which may increase the likelihood of future successful pregnancy, but the relative safety of these interventions is not well established. For those who do conceive following breast cancer, there is no good evidence that pregnancy is detrimental to survival. We review current treatment; effects on reproductive function; preservation of fertility; contraception; pregnancy; breastfeeding and management of menopausal symptoms following breast cancer. CONCLUSION: This paper provides an update on the management of breast cancer in young women and is targeted at reproductive medicine specialists and gynaecologists. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | BREAST CANCER | SURGERY | DRUGS | GENETICS | FERTILITY | CONTRACEPTION | PREGNANCY | BREASTFEEDING | MENOPAUSE | AGE FACTORS | TAMOXIFEN | Oceania | Developed Countries | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Population Dynamics | Demographic Factors | Population | Family Planning | Reproduction | Infant Nutrition | Nutrition | Population Characteristics | Fertility Agents | Reproductive Control Agents Document Number: 341960 |
| 6. Title: Long-term oral contraceptive treatment, metabolic syndrome and measures of cardiovascular risk in pre-menopausal women: National Health and Nutrition Examination Survey 1999-2004. Author: Hurwitz BE; Henry N; Goldberg RB Source: Gynecological Endocrinology. 2009 Jun 2;:1-9. Abstract: Aim. Differences in subclinical cardiometabolic measures were examined as a function of oral contraceptive pills (OCP) treatment duration to compare never-treated women with four OCP-treatment groups (<1, 1-5, 5-10 and >10 years). Methods. The NHANES (1999-2004) database was used to evaluate 2089 healthy, pre-menopausal women, aged 18-55 years, with or without OCP history, no other hormonal treatment or history of systemic conditions. Outcome measures included body mass, central obesity, blood pressure, glycemia, insulinemia, lipid profile and inflammation. Analyses evaluated differences in prevalence of Metabolic Syndrome (MetS), constituent MetS and other clinical risk criteria, as well as outcome magnitudes. Analyses controlled for demographic and health-related variables, and study-eligible conditions. Results. Relative to other groups, women with >10 years OCP-use, and to some extent those with 5-10 years treatment, displayed no differences in prevalence of MetS and most risk criteria. Further analysis showed that, relative to women treated for <5 years, those with more prolonged OCP treatment displayed lower body mass and fasting glycemia with higher HDL-c levels, but more elevated LDL-c and total cholesterol. Conclusions. The findings of both beneficial and detrimental subclinical cardiometabolic differences with more long-term OCP-treatment reinforces the need to monitor changes in these factors within the context of the treated patient's risk-benefit profile. However, because the magnitude of these differences was small, relative to normative ranges, it may be concluded that OCPs, as used in recent decades, are unlikely to markedly affect cardiometabolic risk. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | MENOPAUSE | CARDIOVASCULAR EFFECTS | ORAL CONTRACEPTIVES | RISK FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Reproduction | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning | Health Document Number: 341563 |
| 7. Title: Impact of hormone therapy for women aged 35 to 65 years, from contraception to hormone replacement. Author: Kase NG Source: Gender Medicine. 2009;6 Suppl 1:37-59. Abstract: BACKGROUND: Midlife women (aged 35-65 years) present a complex combination of clinical challenges and health care opportunities. To meet these issues effectively, recognition of the various phases of the entire menopausal transition is necessary, because each possesses unique biological properties underlying phase-specific clinical presentations. OBJECTIVE: The aim of this article is to inform health care decisions by defining the endocrine, metabolic, and clinical consequences of therapeutic inaction or intervention at each stage of the midlife experience. METHODS: Using PubMed, MEDLINE was searched for age- and phase-specific publications about ovarian function and corresponding clinical manifestations in women aged 35 to 65 years. Large, long-term longitudinal prospective, case-control, and observational studies were selected for inclusion. Results of the Framingham Heart Study, Study of Women's Health Across the Nation, Nurses' Health Study (NHS), and Women's Health Initiative (WHI), as well as materials from the World Health Organization and American College of Obstetricians and Gynecologists, were obtained from the relevant groups' Web sites in 2008. RESULTS: Synthesis of the data acquired, particularly the confirmatory and contrasting elements displayed in the WHI and NHS publications, leads to a set of guiding principles whereby individualized phase-specific management strategies may be safely employed. These include the value of weight control and exercise; use of specific nonhormonal therapies for defined indications; definition of strict inclusion/exclusion criteria; and individualization of timing, regimen, dosage, and portal of entry for possible hormone therapy. CONCLUSION: An evidence-based, restrictive inclusion/exclusion strategy can be used to maximize benefits and minimize risks for this large, growing, and health-conscious but increasingly vulnerable population. Language: English Keywords: GLOBAL | LITERATURE REVIEW | DATA COLLECTION | WOMEN | MENOPAUSE | ESTROGENS | LOW-DOSE PROGESTINS | HORMONE REPLACEMENT THERAPY | AGE FACTORS | Research Methodology | Demographic Factors | Population | Reproduction | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics Document Number: 341576 |
| 8. Title: Metabolic profile and sex hormone binding globulin (SHBG) in different reproductive phases of Czech women and their relations to weight, body composition and fat distribution. Author: KOSKOVA I; PETRASEK R; VONDRA K; DUSKOVA M; STARKA L Source: Physiological Research / Academia Scientiarum Bohemoslovaca. 2009;58(3):393-402. Abstract: In our study, 213 healthy Czech women aged 20 to 65 years were examined and divided into fully reproductive, premenopausal, menopausal and postmenopausal groups. In all subjects body composition was determined by classical anthropometry and metabolic profile was assessed. A total of 146 subjects completed 3-year longitudinal study. Total and LDL cholesterol increased and ratio HDL/total cholesterol decreased with age (p<0.001), most significantly in menopause. Triacylglycerols increased only up to menopause. HDL had a very slight trend to decrease in menopause and postmenopause. Fasting blood glucose level increased progressively (p<0.001), in postmenopause frequently exceeded normal range. Higher BMI, total fat mass and central fat indices were associated with higher total and LDL cholesterol, triacylglycerols, C-peptide, insulin and fasting blood glucose level (p<0.001; fasting blood glucose level to waist-to-hip ratio: p<0.01) and lower HDL cholesterol (p<0.001). Higher C-peptide and insulin were associated with lower HDL cholesterol and higher triacylglycerols (p<0.001). Fasting glucose correlated with LDL cholesterol (p<0.01). Higher SHBG was associated with higher HDL and lower LDL cholesterol (p<0.001). Hormone replacement treatment was related to lower fasting blood glucose level in postmenopausal women (p<0.01). Oral contraception is suggestive of a positive influence on lipid spectrum by increasing the ratio HDL/total cholesterol. Markers of lipid and carbohydrate metabolism are not only age-related, but they are also related to BMI, total fat mass and central fat indices. Therefore, preventive programs should be focused above all on menopausal women. Language: English Keywords: CZECHOSLOVAKIA | RESEARCH REPORT | LONGITUDINAL STUDIES | WOMEN | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | CHOLESTEROL | BODY WEIGHT | ANTHROPOMETRY | AGE FACTORS | MENOPAUSE | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | Europe, Central | Europe | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Metabolic Effects | Physiology | Biology | Lipids | Measurement | Population Characteristics | Reproduction | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342621 |
| 9. Title: Female issues in epilepsy: a critical review. Author: Luef G Source: Epilepsy and Behavior. 2009 May;15(1):78-82. Abstract: The focus on gender-related issues for women with epilepsy has heightened in recent years. The emphasis, however, has been on the childbearing years. Epilepsy and antiepileptic drug treatment affect sexual development, the menstrual cycle, and aspects of contraception, fertility, and reproduction. Female patients with epilepsy at a reproductive age face a unique set of reproductive issues, ranging from descriptions of disorders of reproduction in epilepsy and its causes, to contraception, pregnancy, sexuality, menopause, and osteoporosis. Conditions and diseases that specifically affect women are discussed. The role of hormones across the life cycle--endogenous and exogenous hormones and their effects on drug interactions, drug metabolism, and therapeutic outcomes--is described. Contraception and pregnancy issues for women with epilepsy have received the appropriate attention. Language: English Keywords: GLOBAL | CRITIQUE | WOMEN | CHRONIC DISEASES | NEUROLOGIC EFFECTS | DRUGS | ENDOCRINE EFFECTS | DRUG INTERACTIONS | HORMONES | ORAL CONTRACEPTIVES, COMBINED | BIRTH DEFECTS | DECREASED LIBIDO | MENOPAUSE | Demographic Factors | Population | Diseases | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endocrine System | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Neonatal Diseases and Abnormalities | Sex Behavior | Behavior | Reproduction Document Number: 342324 |
| 10. Title: Counselling women about hormonal therapy. Author: Martinelli I Source: Thrombosis Research. 2009;123 Suppl 2:S74-8. Abstract: Effective communication and counselling are critical for the successful use of oral contraceptives (OCs) and hormone replacement therapy (HRT). Effective communication requires listening and responding to patient concerns and then educating patients through personal interaction and materials that explain the risks and benefits of OC and HRT use. Where possible, actual data should be provided in terms that are easily understood by patients. The discussion of whether or not a woman should be tested for thrombophilia before using hormonal therapy should include the implications of thrombophilia testing for symptomatic and asymptomatic individuals. Pre-test counselling should include the potential advantages and disadvantages of hormone therapies and of thrombophilia testing, including the psychosocial aspects and implications for medical management. Clinicians should also clarify that thrombophilia testing is a matter of testing for a susceptibility gene rather than a disease state. Post-test counselling is equally as important for women who test both positive and negative. The goal of post-test counselling should be to help make decisions about hormone therapies. (excerpt) Language: English Keywords: ITALY | CRITIQUE | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN | COUNSELING | HORMONE REPLACEMENT THERAPY | THROMBOEMBOLISM | MENOPAUSE | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES, SIDE EFFECTS | SIDE EFFECTS | PREVALENCE | AGE FACTORS | RISK FACTORS | Developed Countries | Europe, Southern | Europe | Research Methodology | Demographic Factors | Population | Clinic Activities | Program Activities | Programs | Organization and Administration | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Embolism | Vascular Diseases | Diseases | Reproduction | Safety | Public Health | Measurement | Population Characteristics Document Number: 341122 |
| 11. Title: Reproductive factors, exogenous hormone use and risk of lymphoid neoplasms among women in the National Institutes of Health-AARP Diet and Health Study Cohort. Author: Morton LM; Wang SS; Richesson DA; Schatzkin A; Hollenbeck AR; Lacey JV Jr Source: International Journal of Cancer. 2009 Jun 1;124(11):2737-43. Abstract: Reasons for higher incidence of lymphoid neoplasms among men than women are unknown. Because female sex hormones have immunomodulatory effects, reproductive factors and exogenous hormone use may affect risk for lymphoid malignancies. Previous epidemiologic studies on this topic have yielded conflicting results. Within the National Institutes of Health-AARP Diet and Health Study cohort, we prospectively analyzed detailed, questionnaire-derived information on menstrual and reproductive factors and use of oral contraceptives and menopausal hormone therapy among 134,074 US women. Using multivariable proportional hazards regression models, we estimated relative risks (RRs) for 85 plasma cell neoplasms and 417 non-Hodgkin lymphomas (NHLs) identified during follow-up from 1996 to 2002. We observed no statistically significant associations between plasma cell neoplasms, NHL, or the 3 most common NHL subtypes and age at menarche, parity, age at first birth, oral contraceptive use or menopausal status at baseline. For menopausal hormone therapy use, overall associations between NHL and unopposed estrogen and estrogen plus progestin were null, with the potential exception of an inverse association (RR = 0.49, 95% CI, 0.25-0.96) between use of unopposed estrogen and diffuse large B-cell lymphoma (DLBCL), the most common NHL subtype, among women with a hysterectomy. These data do not support an important role for reproductive factors or exogenous hormones in modulating lymphomagenesis. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | MULTIVARIATE ANALYSIS | WOMEN | PREVALENCE | CANCER | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | MENOPAUSE | MENSTRUATION | REPRODUCTIVE HEALTH | RISK ASSESSMENT | RISK FACTORS | Developed Countries | North America | Americas | Research Methodology | Data Analysis | Demographic Factors | Population | Measurement | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Evaluation Document Number: 330982 |
| 12. Peer Reviewed Title: Daily variation of brain-derived neurotrophic factor and cortisol in women with normal menstrual cycles, undergoing oral contraception and in postmenopause. Author: Pluchino N; Cubeddu A; Begliuomini S; Merlini S; Giannini A; Bucci F; Casarosa E; Luisi M; Cela V; Genazzani AR Source: Human Reproduction. 2009 Jun 2; Abstract: BACKGROUND Plasma brain-derived neurotrophic factor (BDNF) levels are associated with the hormonal status of women. Moreover, the suprachiasmatic nucleus appears to be implicated in the modulation of BDNF central levels. We aimed to investigate whether BDNF circadian rhythms exist in women and if there is a relationship with cortisol circadian rhythmicity. Moreover, we aimed to establish whether the hormonal status influences BDNF diurnal variations. METHODS A total of 30 women were studied: 10 fertile ovulatory women, 10 women undergoing oral contraceptive (OC) therapy and 10 post-menopausal women. Basal BDNF and estradiol levels were assayed in blood samples collected after overnight fasting at regular intervals (08:00, 12:00, 16:00, 20:00, 24:00). BDNF and cortisol levels were measured in samples collected during the follicular and luteal phases in ovulatory women and once a month in OC and post-menopausal women. RESULTS Luteal BDNF levels were significantly higher than follicular levels in fertile women (P < 0.001). In OC women, BDNF levels were similar to the follicular BDNF levels, whereas in post-menopausal women, they were significantly lower (P < 0.001). BDNF showed a diurnal rhythm in the follicular phase and in women undergoing OC, although the diurnal rhythm was blunted in the luteal phase. In post-menopausal women, BDNF and cortisol levels significantly decreased during the day. CONCLUSIONS BDNF has a diurnal variation in women that is somewhat analogous to cortisol variation; however, the amplitude of the variation in BDNF levels appears to be influenced by ovarian function. Interactions between BDNF, the hypothalamus-pituitary-adrenal axis and sex steroids might play a critical role in the human homeostasis and adaptation. Language: English Keywords: ITALY | RESEARCH REPORT | WOMEN | MENOPAUSE | ORAL CONTRACEPTIVES | MENSTRUATION | TRANSCORTIN BOUND CORTISOL ALTERATIONS | Developed Countries | Europe, Southern | Europe | Demographic Factors | Population | Reproduction | Contraceptive Methods | Contraception | Family Planning | Hematological Effects | Hemic System | Physiology | Biology Document Number: 341570 |
| 13. Title: [Options of hormonal contraceptives and substitution in female diabetic patients] Moznosti hormonalni antikoncepce a substituce u diabeticek. Author: Sadlonova J Source: Vnitrni Lekarstvi. 2009 Apr;55(4):375-83. Abstract: The pregnancy planning is extremely important for women with diabetes mellitus and therefore, reliable contraceptives are indispensable for such women. Generally, female diabetic patients can use the same forms of contraceptives as healthy women, however, in their case many specific circumstances must be considered, which are addressed in the first part of the overview. In particular, the selection of hormonal contraceptives for type I female diabetic patients with late complications and type II female diabetic patients is problematic as in this area very few studies are available. The other part of the overview is dedicated to hormonal substitution therapy. The author discusses its metabolic effects and possible administration to female diabetic patients. Menopause and diabetes mellitus are associated with a high risk of cardiovascular complications. Both pharmacologic and non-pharmacologic control of risk factors may reduce the risk of the disease. However, a definite recommendation of hormonal substitution therapy is not possible; both the benefits and risks for a particular female patient need to be considered. Language: Czech Keywords: RESEARCH REPORT | CLIENTS | WOMEN | DIABETES | PREGNANCY | FAMILY PLANNING | CONTRACEPTIVE USAGE | CARDIOVASCULAR EFFECTS | RISK FACTORS | MENOPAUSE | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Diseases | Reproduction | Contraception | Physiology | Biology | Health Document Number: 341198 |
| 14. Title: The cutest little baby face: a hormonal link to sensitivity to cuteness in infant faces. Author: Sprengelmeyer R; Perrett DI; Fagan EC; Cornwell RE; Lobmaier JS; Sprengelmeyer A; Aasheim HB; Black IM; Cameron LM; Crow S; Milne N; Rhodes EC; Young AW Source: Psychological Science. 2009 Feb;20(2):149-54. Abstract: We used computer image manipulation to develop a test of perception of subtle gradations in cuteness between infant faces. We found that young women (19-26 years old) were more sensitive to differences in infant cuteness than were men (19-26 and 53-60 years old). Women aged 45 to 51 years performed at the level of the young women, whereas cuteness sensitivity in women aged 53 to 60 years was not different from that of men (19-26 and 53-60 years old). Because average age at menopause is 51 years in Britain, these findings suggest the possible involvement of reproductive hormones in cuteness sensitivity. Therefore, we compared cuteness discrimination in pre- and postmenopausal women matched for age and in women taking and not taking oral contraceptives (progestogen and estrogen). Premenopausal women and young women taking oral contraceptives (which raise hormone levels artificially) were more sensitive to variations of cuteness than their respective comparison groups. We suggest that cuteness sensitivity is modulated by female reproductive hormones. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | INFANT | AGE FACTORS | MENOPAUSE | HORMONES | ESTROGENS | PERCEPTION | IMPACT | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Youth | Population Characteristics | Reproduction | Endocrine System | Physiology | Biology | Psychological Factors | Behavior | Communication Document Number: 342100 |
| 15. Title: Reproductive factors and risk of pancreatic cancer in women: a review of the literature. Author: Wahi MM; Shah N; Schrock CE; Rosemurgy AS 2nd; Goldin SB Source: Annals of Epidemiology. 2009 Feb;19(2):103-11. Abstract: PURPOSE: Pancreatic cancer (PCA) is the fourth leading cause of cancer death in the United States. The male-to-female incidence and mortality ratio of PCA is 1.1-2.0. One possible explanation for this difference is that female hormone exposure is protective for the development of PCA. Several hypotheses were investigated in this systematic review: (1) increased exposure to estrogen through early menarche and later menopause is associated with a decreased risk of PCA; (2) increased exposure to pregnancy is associated with decreased risk of PCA; and (3) increased exposure to oral contraceptives and/or hormone replacement therapy is associated with decreased risk of PCA. METHODS: Of 371 articles identified, 10 case-control and 5 cohort studies met the criteria for our review. Odds ratios for case-control studies and hazard ratios for cohort studies and their accompanying 95% confidence intervals for analyses relevant to our hypotheses were considered in the review. RESULTS: For all 3 hypotheses, studies displayed inconsistent results, and this may have been due to the diversity of study populations, exposure quantification, analysis approach, confounding and other limitations, and biases across studies. CONCLUSIONS: As there was no strong support for any of the 3 hypotheses, it appears that reproductive factors are not associated with the development of PCA in women. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | METHODOLOGICAL STUDIES | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | COHORT ANALYSIS | WOMEN | CANCER | RISK FACTORS | SEX FACTORS | MENARCHE | AGE FACTORS | ESTROGENS | MENOPAUSE | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Neoplasms | Diseases | Health | Population Characteristics | Menstruation | Reproduction | Hormones | Endocrine System | Physiology | Biology Document Number: 331229 |
| 16. Title: Levonorgestrel-releasing intrauterine system: uses and controversies. Author: Bahamondes L; Bahamondes MV; Monteiro I Source: Expert Review of Medical Devices. 2008 Jul;5(4):437-45. Abstract: This article provides a perspective on the use of the levonorgestrel-releasing intrauterine system as a contraceptive method and as therapy in different situations, as well as presenting the corresponding controversies and unresolved issues. All studies have reported high contraceptive efficacy, an improvement in menstrual blood loss in women with idiopathic menorrhagia, menorrhagia due to thrombophilic diseases and fibroids, and excellent endometrial protection during postmenopausal estrogen therapy. Moreover, the device is able to reduce pelvic pain and dysmenorrhea as well as improve the staging of endometriosis and adenomyosis, and to control, albeit partially, endometrial hyperplasia. The expectation is that in years to come the number of hysterectomies and female sterilizations will fall due to increased use of the device, including use by patients with endometriosis and HIV-positive women. It would also be desirable to develop a smaller device for postmenopausal women and nulligravidas. Language: English Keywords: BRAZIL | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PERSONS LIVING WITH HIV/AIDS | IUD, HORMONE RELEASING | LEVONORGESTREL | CONTRACEPTIVE EFFECTIVENESS | MENORRHAGIA | THROMBOSIS | CONTRACEPTIVE SAFETY | IUD SIDE EFFECTS | MENOPAUSE | HORMONE REPLACEMENT THERAPY | ENDOMETRIOSIS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Economic Development | Economic Factors | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Thromboembolism | Embolism | Vascular Diseases | Safety | Public Health | Health | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 329259 |
| 17. Title: Risk factors for the incidence of breast cancer: do they affect survival from the disease? Author: Barnett GC; Shah M; Redman K; Easton DF; Ponder BA Source: Journal of Clinical Oncology. 2008 Jul 10;26(20):3310-6. Abstract: PURPOSE: Risk factors that influence the incidence of breast cancer may also affect survival after diagnosis. METHODS: Data from 4,560 women with invasive breast cancer who had taken part in the population-based Studies of Epidemiology and Risk Factors in Cancer Heredity (SEARCH) breast cancer study were used to investigate the influence on survival of variables related to pregnancy, menarche and menopause, prior use of exogenous hormones, height, weight, body mass index (BMI), smoking history, and alcohol intake. RESULTS: In univariate analyses, there was no association between prognosis and age at menarche and menopause, menopausal status at diagnosis, smoking history, or prior use of the oral contraceptive pill. Women whose most recent pregnancy was more than 30 years ago had a 35% reduced risk of dying (95% CI, 8% to 54%) compared with women who had a full-term pregnancy in the past 15 years, and the use of hormone replacement therapy for more than 4 years was associated with a similar risk reduction. BMI was associated with a 3% (95% CI, 1% to 4%) increase in mortality per unit increase. Improved prognosis was seen with increasing current alcohol consumption, with a 2% (95% CI, 1% to 3%) reduction in the risk of death per unit of alcohol consumed per week. CONCLUSION: The apparent benefit of alcohol intake has not been described before, and our data need to be interpreted with some caution. However, our finding that an increase in BMI is associated with a poorer prognosis supports previously published data and suggests that advice on weight loss should be given to all obese patients with breast cancer. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | INCIDENCE | WOMEN | BREAST CANCER | RISK FACTORS | PREGNANCY | MENARCHE | MENOPAUSE | BODY HEIGHT | BODY WEIGHT | ALCOHOL USE AND ABUSE | TOBACCO USE | Developed Countries | Europe, Western | Europe | Measurement | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Biology | Reproduction | Menstruation | Physiology | Behavior Document Number: 328315 |
18.  Peer Reviewed Title: Menstrual and reproductive factors in the risk of differentiated thyroid carcinoma in native women in French Polynesia: A population-based case-control study. Author: Brindel P; Doyon F; Rachedi F; Boissin JL; Sebbag J Source: American Journal of Epidemiology. 2008 Jan 15;167(2):219-229. Abstract: French Polynesia has one of the world's highest incidence rates of thyroid cancer. A case-control study among native residents of French Polynesia included 201 women diagnosed with differentiated thyroid cancer before the age of 56 years, between 1981 and 2004, matched to 324 population controls on date of birth. Face-to-face interviews were conducted from 2002 to 2004. Odds ratios were calculated by using conditional logistic regression and were reported in the total group and by ethnic group ("Polynesian" vs. "mixed"). The risk of thyroid cancer increased with natural (odds ratio = 1.9) or artificial (odds ratio = 4.5) menopause compared with that associated with a premenopausal status and with number of births (p for trend = 0.03): odds ratios for one, two, three, four or five, six or seven, and eight or more births were, respectively, 0.90, 1.6, 2.3, 2.2, 2.7, and 1.7 compared with a nulliparous status. Similar results were observed for Polynesian women. No association was observed with irregular menstrual cycles, age at menopause, history of miscarriage or induced abortion, time since last birth, age at and outcome of first pregnancy, or breastfeeding. This study confirms the role of menstrual and reproductive factors in the risk of differentiated thyroid cancer in Pacific island populations. (author's) Language: English Keywords: FRENCH POLYNESIA | RESEARCH REPORT | CASE CONTROL STUDIES | MULTIVARIATE ANALYSIS | INTERVIEWS | WOMEN | INDIGENOUS POPULATION | NEOPLASMS | THYROID EFFECTS | MENSTRUATION DISORDERS | MENOPAUSE | REPRODUCTIVE BEHAVIOR | BIRTH HISTORY | BREASTFEEDING | Developed Countries | Oceania | Studies | Research Methodology | Data Analysis | Data Collection | Demographic Factors | Population | Population Characteristics | Diseases | Endocrine Effects | Endocrine System | Physiology | Biology | Reproduction | Fertility | Population Dynamics | Pregnancy History | Fertility Measurements | Infant Nutrition | Nutrition | Health Document Number: 323776 |
| 19. Title: Comparison of the effects of hormone therapy regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women. Author: Cayan F; Dilek U; Pata O; Dilek S Source: Journal of Sexual Medicine. 2008 Jan;5(1):132-138. Abstract: Sexual dysfunction is more prevalent in postmenopausal women. The aims were to prospectively evaluate and compare the effects of hormone therapy (HT) regimens, oral and vaginal estradiol, estradiol + drospirenone and tibolone, on sexual function in healthy postmenopausal women. The study included 169 consecutive healthy postmenopausal women, and the women were divided into two groups: 111 women received HT, and 58 women received no treatment and served as a control group. As an HT, 23 women with surgically induced menopause received oral 17-b estradiol. The rest of the women with natural menopause were prospectively randomized: 22 received oral 17-b estradiol + drospirenone daily, 42 received oral tibolone, and 24 received vaginal 17-b estradiol. Sexual function was evaluated with a detailed 19-item questionnaire, the female sexual function index, including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. The differences in sexual function were compared before and 6 months after the treatment in all women. Total sexual function score increased from 19.81 +or- 7.15 to 22.9 +or- 6.44 in the HT group and decreased from 21.6 +or- 8.69 to 17.6 +or- 5.7 in the control group, revealing a significant difference from baseline to post-treatment between the two groups (P = 0.000). The highest improvement in total score and arousal was achieved with the oral 17-Beta estradiol (P = 0.000 and P = 0.000, respectively). The highest improvement in lubrication was achieved with the oral and vaginal 17-Beta estradiol groups (P = 0.000). The highest improvement in orgasm was achieved with the tibolone group (P = 0.000). The highest improvement in pain was achieved with the oral and vaginal 17-Beta estradiol groups (P = 0.000). HT provided significant improvement in sexual function compared to women receiving no treatment, and therefore, HT regimens should be suggested for improvement in sexual functioning of postmenopausal women. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | CASE CONTROL STUDIES | CLINICAL RESEARCH | COMPARATIVE STUDIES | KAP SURVEYS | WOMEN | HORMONE REPLACEMENT THERAPY | MENOPAUSE | ESTRADIOL | SEX BEHAVIOR | LUBRICANTS | SATISFACTION | PAIN | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Surveys | Sampling Studies | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Estrogens | Hormones | Endocrine System | Physiology | Biology | Behavior | Ingredients and Chemicals | Psychological Factors | Signs and Symptoms | Diseases Document Number: 323235 |
| 20. Title: Maternal tobacco use its preimplantation effects on fertility: More reasons to stop smoking. Author: Cooper AR; Moley KH Source: Seminars in Reproductive Medicine. 2008 Mar;26:204-212. Abstract: There are numerous health concerns regarding tobacco smoke. Yet, only recently have researchers extensively explored the association between tobacco smoke and a woman's inability to conceive. Whether exposure occurs in utero, during pregnancy, or throughout the reproductive years, it can affect all facets of fertility and lead to diminished ovarian function and earlier menopause. This review analyzes the literature concerning the delay or absence of conception in some women exposed to cigarette smoke and provides a detailed examination of the potential reproductive targets of the mutagenic and toxic components of tobacco. A negative influence on ovarian steroidogenesis and gametogenesis, oocyte maturity, ovulation, oocyte cumulus complex pick-up, gamete and embryo transport by the oviduct, fertilization, and implantation could all play a role. Assisted reproductive technology, or more specifically, in vitro fertilization, has allowed us to more thoroughly analyze successful pregnancy cycles and the negative consequences of smoking. Objective measurements of tobacco compounds and their metabolites in follicular fluid correlate with subjective measures of ovarian, gamete, and embryo quality in smokers and in those exposed to passive smoke. Regardless, there is an abundance of literature accumulating and more than enough reasons to tell patients to stop smoking. (author's) Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN | EMBRYO | TOBACCO USE | INFERTILITY | MENOPAUSE | OVULATION SUPPRESSION | GENETICS | TOXICITY | CHROMOSOME ABNORMALITIES | IN VITRO | FERTILITY | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Pregnancy | Reproduction | Behavior | Contraceptive Mode of Action | Contraception | Family Planning | Biology | Physiology | Neonatal Diseases and Abnormalities | Diseases | Population Dynamics Document Number: 324981 |
| 21. Title: Oral contraceptives, postmenopausal hormones, and risk of asynchronous bilateral breast cancer: The WECARE study group. Author: Figueiredo JC; Bernstein L; Capanu M; Malone KE; Lynch CF Source: Journal of Clinical Oncology. 2008 Mar 20;26(9):[8] p. Abstract: The purpose was to investigate whether oral contraceptive (OC) use and postmenopausal hormones (PMH) are associated with an increased risk of developing asynchronous bilateral breast cancer among women diagnosed with breast cancer younger than 55 years. The WECARE (Women's Environment, Cancer, and Radiation Epidemiology) study is a population-based, multicenter, case-control study of 708 women with asynchronous bilateral breast cancer and 1,395 women with unilateral breast cancer. Risk factor information collected during a telephone interview focused on exposures before and after the first breast cancer diagnosis. Treatment and tumor characteristics were abstracted from medical records. Multivariable conditional logistic regression was used to estimate rate ratios (RR) and 95% CIs. OC use before the first breast cancer diagnosis was not associated with risk of asynchronous bilateral breast cancer (RR = 0.88; 95% CI, 0.67 to 1.16). OC use after breast cancer diagnosis was also not significantly associated with risk (RR = 1.56; 95% CI, 0.71 to 3.45). Risk did not increase with longer duration of use or among women who had begun using OCs at a younger age. No evidence of an increased risk of asynchronous bilateral breast cancer was observed with PMH use before (RR = 1.21; 95% CI, 0.90 to 1.61) or after breast cancer diagnosis (RR = 1.10; 95% CI, 0.67 to 1.77). Neither duration nor type of PMH were associated with risk. Age at and time since first breast cancer diagnosis did not substantially affect these results. This study provides no strong evidence that OC or PMH use increases the risk of a second cancer in the contralateral breast. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CASE CONTROL STUDIES | INTERVIEWS | BREAST CANCER | ORAL CONTRACEPTIVES | MENOPAUSE | HORMONE REPLACEMENT THERAPY | RISK FACTORS | AGE FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Data Collection | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Population Characteristics | Demographic Factors | Population Document Number: 324213 |
| 22. Title: By the way, doctor. Do birth control pills disguise menopause? Author: Gharib S Source: Harvard Health Letter. 2008 May;33(7):3. Abstract: Question: How do I know whether I'm approaching menopause if I'm taking birth control pills? Answer: Oral contraceptives-which typically are a combination of estrogen and progestin- prevent pregnancy by suppressing ovulation. The hormones work by "fooling" the body into thinking it's pregnant. Women in their late 40s often take birth control pills for an additional reason: they help control the irregular bleeding that's the result of declining ovarian function during perimenopause, the years that precede menopause. You won't be able to tell if you're menopausal (which means menstruation has ceased) if you keep on taking birth control pills. The hormones contained in oral contraceptives stop ovulation, but they also act on the lining of the uterus and in doing so, promote monthly bleeding, even if you're no longer naturally menstruating. The hormones supersede the underlying physiology. Most doctors recommend that women go off the pill by age 50 because the risk of blood clots becomes too high. Even without oral contraceptives, the risk of clots increases for women as they get older because of inactivity and the higher likelihood of diseases-cancer, for example-that can cause a clot. You don't want to add to that risk with birth control pills. (full-text) Language: English Keywords: UNITED STATES OF AMERICA | WOMEN | MENOPAUSE | ORAL CONTRACEPTIVES | ESTROGENS | CONTRACEPTIVE AGENTS, PROGESTIN | SIGNS AND SYMPTOMS | Developed Countries | North America | Americas | Demographic Factors | Population | Reproduction | Contraceptive Methods | Contraception | Family Planning | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents | Diseases Document Number: 328712 |
| 23. Title: Treatment of endometrial hyperplasia without atypia in peri- and postmenopausal women with a levonorgestrel intrauterine device. Author: Haimovich S; Checa MA; Mancebo G; Fuste P; Carreras R Source: Menopause. 2008 Sep-Oct;15(5):1002-4. Abstract: OBJECTIVE: To assess the effectiveness of the Mirena levonorgestrel-releasing intrauterine system (LNG-IUS) in peri- and postmenopausal women with endometrial hyperplasia without atypia. DESIGN: All consecutive women with histologically documented endometrial hyperplasia without atypia recruited during a 1-year period participated in an open, prospective, single-center study. They were followed for at least 2 years after levonorgestrel-releasing intrauterine system insertion. The pattern of uterine bleeding was evaluated on a 4-point qualitative scale (1 = amenorrhea, 2 = scarce, 3 = normal, 4 = abundant). RESULTS: The study population consisted of 15 women with a mean (SD) age of 49 (2.7) years. Compared with baseline, bleeding decreased quantitatively from a mean score of 3 at baseline (normal bleeding) to 2 (scarce) at 3and 6 months, and 1 (amenorrhea) at 24 months. Endometrial biopsies performed at 12 months revealed atrophicendometrium in 14 women (93.3%) and secretory endometrium in 1 (6.7%)(P < 0.001). At 24 months, endometrial atrophy was documented in 100% of women. CONCLUSIONS: The levonorgestrel-releasing intrauterine system seems to be an effective and safe alternative in the treatment of peri- and postmenopausal women with (simple) endometrial hyperplasia without atypia. Language: English Keywords: SPAIN | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | MENOPAUSE | LEVONORGESTREL | IUD, HORMONE RELEASING | HORMONE REPLACEMENT THERAPY | BLEEDING | AMENORRHEA | ENDOMETRIAL CANCER | Europe, Southwestern | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Reproduction | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | IUD | Contraceptive Methods | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Menstruation Disorders | Cancer | Neoplasms Document Number: 329631 |
| 24. Title: Effects of pre- and postmenopausal use of exogenous hormones on receptor content in normal human breast tissue: a randomized study. Author: Hallberg G; Persson I; Naessen T; Magnusson C Source: Gynecological Endocrinology. 2008 Aug;24(8):475-80. Abstract: OBJECTIVE: To examine the effects of exposure to endogenous and exogenous hormones on estrogen receptor-alpha (ERalpha) and progesterone receptor (PR) levels in normal human breast tissue. METHODS: In a randomized study of women scheduled for mammary reduction plasty (n = 81), ERalpha and PR content in breast parenchyma was analyzed in premenopausal (n = 49) and postmenopausal (n = 16) women. Premenopausal women were randomized to surgery in the follicular or luteal phase of the menstrual cycle or after oral contraceptive treatment for 2 months. Postmenopausal women were randomized to sequential or estrogen-only therapy for 2 months prior to surgery. RESULTS: ERalpha content was higher in parous than in nulliparous (p = 0.009) premenopausal women and displayed a positive association with age (r(s) = 0.51, p = 0.0002). Compared with premenopausal women in the follicular phase, postmenopausal women had higher ERalpha content (p = 0.040) whereas premenopausal women on oral contraception had lower ERalpha (p = 0.048) and PR (p = 0.007) content. Smokers had lower PR content than non-smokers (p = 0.02). CONCLUSION: In the present study ERalpha content was higher in parous than in non-parous women and associated with premenopausal age. Short-term oral contraceptives yielded lower ERalpha and PR contents. Postmenopausal estrogen/progestogen combined therapy yielded lower PR content than estrogen-only therapy. Language: English Keywords: SWEDEN | RESEARCH REPORT | WOMEN | MENOPAUSE | SURGERY | BREAST EXAM | ORAL CONTRACEPTIVES | PROGESTERONE | ESTROGENS | EXPOSURE | CANCER | Europe, Northern | Europe | Developed Countries | Demographic Factors | Population | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physical Examinations and Diagnoses | Examinations and Diagnoses | Contraceptive Methods | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Risk Factors | Neoplasms | Diseases Document Number: 329582 |
| 25. Title: Underlying pathology of women with "atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion" smears, in a region with a high incidence of cervical cancer. Author: Kietpeerakool C; Srisomboon J; Tantipalakorn C; Suprasert P; Khunamornpong S Source: Journal of Obstetrics and Gynaecology Research. 2008 Apr;34(2):204-209. Abstract: The aim was to evaluate the histopathology of women who had "atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions" (ASC-H) on cervical cytology in a region with high incidence of cervical cancer. This study was conducted at Chiang Mai University Hospital, Chiang Mai, Thailand. All women with ASC-H, who had undergone colposcopic and histolopathologic evaluation between October 2004 and January 2007, were recruited. Similar cohorts with other squamous cell abnormalities on a Pap-smear, who had undergone colposcopy during the same period, were included as comparative groups. During the study period, 85 women who had ASC-H smears underwent colposcopic and histopathologic evaluation. The mean age was 45.3 years (range, 20-64 years). The histopathologic results of these 85 women were as follows: cervical intraepithelial neoplasia (CIN) II-III, 52 (61.2%); invasive cancer, 7 (8.2%); CIN I, 6 (7.1%); and no lesions, 20 (23.5%). The incidence of underlying CIN II or higher inan ASC-H smear (69.4%) was intermediate between atypical squamous cell of undetermined significance (22.7%), low-grade squamous intraepithelial lesion (44.7%) and high-grade squamous intraepithelial lesion (90.5%) smears. There was no statistically significant difference in the incidence of CIN II or higher between women who were 40 years old or more and those who were younger (68.7% and 71.4%, respectively, P = 0.81), or between pre-menopausal and post-menopausal women (71.4% and 63.6%, respectively, P = 0.49). Reporting ASC-H cytology in our population is strongly associated with significant cervical pathology, particularly invasive cancer that is possibly at a rate higher than previously reported. Women who have ASC-H smears should therefore be referred for immediate colposcopy regardless of age and menopausal status. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | WOMEN | PAP SMEAR | CERVICAL CANCER | CYTOLOGY | HISTOLOGY | AGE FACTORS | MENOPAUSE | Asia, Southeastern | Asia | Developing Countries | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Cancer | Neoplasms | Diseases | Biology | Population Characteristics | Reproduction Document Number: 326140 |
| 26. Title: Spontaneous perforated pyometra with an intrauterine device in menopause: a case report. Author: Li CH; Chang WC Source: Japanese Journal of Infectious Diseases. 2008 Nov;61(6):477-8. Abstract: Spontaneous perforation of the uterus is rare and only several cases have been reported in the English medical literature. Most of the patients had gynecological malignancy and almost all were associated with cervical occlusion. We report a case of diffuse peritonitis resulting from spontaneously perforated pyometra with an intrauterine device (IUD) inserted for more than two decades. This case differs from others in that the cervical canal was not occluded. In the absence of other possible causes of uterine perforation, the etiology in this case is mostly likely hemorrhagic necrosis related to the long-term IUD. Language: English Keywords: TAIWAN | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | MENOPAUSE | UTERINE PERFORATION | IUD COMPLICATIONS | PERITONEAL DISEASES | CERVICAL EFFECTS | LONGTERM EFFECTS | Asia, Eastern | Asia | Developed Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Perforations | Diseases | IUD | Contraceptive Methods | Contraception | Family Planning | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Time Factors | Population Dynamics | Demographic Factors | Population Document Number: 329813 |
| 27. Title: Self-reported data on reproductive variables were reliable among postmenopausal women. Author: Lucas R; Azevedo A; Barros H Source: Journal of Clinical Epidemiology. 2008 Sep;61(9):945-50. Abstract: OBJECTIVE: We aimed to assess the reliability of self-reported reproductive variables in postmenopausal women. STUDY DESIGN AND SETTING: We evaluated 535 women in two interviews, as part of the recruitment and first follow-up of a cohort of Portuguese adults. Median time between evaluations was 5 years. Women were inquired about sociodemographic characteristics, cognitive status, and reproductive history: gravidity, parity, lifetime use of oral contraceptives, menopausal status, age at menopause, hysterectomy, oophorectomy, and lifetime use of hormone replacement therapy (HRT). RESULTS: Age at menopause was consistent within 1 year for 66% of women and agreement was higher in women reporting surgical menopause. Reliability regarding age at menopause decreased with time since menopause. Gravidity was consistent for 81% of women, whereas parity was consistent for 94%. The proportion of different answers regarding number of pregnancies and number of live births was higher in women with high gravidityand parity, respectively. Agreement was 96% for hysterectomy and 92% for oophorectomy. The proportion of consistent reports was 90% for oral contraceptives and 93% for HRT. Women with higher education reported parity and HRT more reliably. CONCLUSION: Agreement was over 90% for self-reported parity, hysterectomy, oophorectomy, and HRT, which supports their use in analytical studies. (author's) Language: English Keywords: PORTUGAL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | MENOPAUSE | EDUCATIONAL STATUS | REPRODUCTIVE BEHAVIOR | HORMONE REPLACEMENT THERAPY | ORAL CONTRACEPTIVES | CONTRACEPTIVE USAGE | PREGNANCY HISTORY | DATA COLLECTION | STUDY DESIGN | RELIABILITY | Europe, Southwestern | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Reproduction | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility | Population Dynamics | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Fertility Measurements | Measurement Document Number: 328370 |
| 28. Peer Reviewed Title: Non-contraceptive health benefits of oral contraceptives. Author: Maia H Jr; Casoy J Source: European Journal of Contraception and Reproductive Health Care. 2008 Mar;13(1):17-24. Abstract: The use of combined oral contraceptives (COCs) is associated with a reduced risk of developing endometriosis, myomas, and endometrial and ovarian carcinoma. The mechanisms involved are multiple; next to ovulation suppression, a reduction in inflammation in the genital tract is involved. This is accomplished through inhibition of the endometrial expression of enzymes related to the biosynthesis of prostaglandin and oestrogen, particularly cyclooxygenase type II (Cox-2) and aromatase. The blockade of these enzymatic systems by COCs explains the beneficial effects of these compounds in treating the symptoms, and halting the progression of myomas, endometriosis and adenomyosis, all of which are characterized by increased inflammation. Inhibition of aromatase and Cox-2 expression in the endometrium by COCs may explain their efficacy in controlling the pain and excessive uterine bleeding caused by these pathologies. The reduction of inflammation in the endometrium may also be the mechanism behind the lower incidence of endometrial carcinoma in COC users. The blockade of ovulation and ovarian steroidogenesis, on the other hand, may explain the lesser incidence of ovarian cancer and the improvement of acne in users. In conclusion, inflammation appears to play a pivotal role in the development of various benign and malignant gynecological diseases. COCs reduce inflammation in the female genital tract by blocking enzymes such as Cox-2 and aromatase. (author's) Language: English Keywords: BRAZIL | LITERATURE REVIEW | WOMEN | ORAL CONTRACEPTIVES | ENDOMETRIOSIS | MENORRHAGIA | ENDOMETRIAL CANCER | OVARIAN CANCER | ACNE | MENOPAUSE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Diseases | Menstruation Disorders | Cancer | Neoplasms | Dermatitis | Reproduction Document Number: 324655 |
| 29. Title: Stereotypes of women in different stages of their reproductive life: data from Mexico and the United States. Author: Marvan ML; Islas M; Vela L; Chrisler JC; Warren EA Source: Health Care for Women International. 2008 Aug;29(7):673-687. Abstract: College students from Mexico and the United States (n = 349) were surveyed to explore stereotypes regarding women in different menstrual cycle phases and other stages of reproductive life. Participants from both countries defined a premenstrual or menstrual woman as irritable and moody and a menopausal woman as old and irritable. A woman with a hysterectomy was defined as sad, and only Americans used other words that did not have any negative connotation. Participants used some positive adjectives to describe other stages. For example, a pregnant woman was defined as happy, but only by Mexicans. Finally, a woman with a young baby was defined in both countries as happy; however, Americans implied that having a baby is complicated. The findings are discussed in light of sociocultural differences and similarities. Language: English Keywords: MEXICO | UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | STUDENTS | UNIVERSITIES | MENSTRUATION | REPRODUCTIVE AGE | MENOPAUSE | SOCIOCULTURAL FACTORS | PSYCHOLOGICAL FACTORS | North America | Americas | Developing Countries | Developed Countries | Sampling Studies | Studies | Research Methodology | Education | Schools | Reproduction | Behavior Document Number: 308018 |
| 30. Peer Reviewed Title: Relation between vaginal and endocervical pH in patients undergoing cold-knife conization and hysterectomy. Author: Murta EF; Perfeito PB; Oliveira TM; Michelin MA; Maluf PJ Source: Archives of Gynecology and Obstetrics. 2008 Jan;277(1):43-46. Abstract: This study aimed to investigate the influence of endocervical pH on vaginal pH, and also the changes in these pH values following hysterectomy and cold-knife conization. Vaginal pH is important for maintaining the equilibrium of the vaginal microflora. Two groups of women were studied: the first (n = 20, median age 45, range 33-50 years-old), before and after hysterectomy (without ovariectomy) for myomatosis; the second group (n = 18, median age 38.5, range 37-65 years-old), before and after cold-knife conization for cervical intraepithelial neoplasia (CIN) grade II or III. Four samples (before and 90 days after surgery) were collected from the women by means of swabs: (1) anterior vaginal fornix, (2) posterior vaginal fornix, (3) posterior wall of lower vagina, and (4) endocervix (except in cases after hysterectomy). The pH was measured using a digital pH-meter (Sentron). We observed that endocervical pH was less acidic than were all the vaginal locations measured, before both surgeries. After both surgeries, all vaginal pH measurements were higher, but without reaching statistical significance. Endocervical pH correlated with vaginal pH. We concluded that recent hysterectomy does not alter vaginal pH and that vaginal and endocervical pH values are related. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | CERVICAL EFFECTS | VAGINA | HYSTERECTOMY | SURGERY | MENOPAUSE | MENSTRUAL CYCLE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Gynecologic Surgery | Urogenital Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Menstruation Document Number: 322614 |
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