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Menopause-related symptoms such as hot flushes, night sweats, weight gain, and decreased sexual functioning all have negative impacts on quality of life and affect daily activities such as sleep, work, and leisure activities. During the menopause transition, neurotransmitters, neuropeptides, and neurosteroids undergo important changes as a consequence of the failure of gonadal hormone production, at a time when many central nervous system activities deteriorate. Sex hormones have been implicated in neurite outgrowth, synaptogenesis, dendritic branching, myelination, and other important mechanisms of neural plasticity. Knowledge of interactions between sex steroid hormones and the dominant neurotransmitters, such as serotonin, dopamine, GABA, and glutamate, will give women and health providers an important tool for improving their health and well-being. From the concept of neurosteroids derives another treatment strategy: the use of pharmaceutical agents that increase the synthesis of endogenous neurosteroids within the nervous system. This approach has so far been hampered by lack of knowledge concerning the regulation of the biosynthetic pathways of neurosteroids and their relationship with sex steroids produced by the peripheral gland or with exogenous steroids. The present review summarizes some of the available clinical and experimental findings supporting the critical role of neurosteroids in postmenopausal women and their impact on quality of life. [ABSTRACT FROM AUTHOR]

Objective Hormone therapy is effective for the relief of menopausal symptoms. For women with a uterus, addition of a progestogen is required to protect the endometrium. However, synthetic progestins differ in certain pharmacological characteristics that may have implications for clinical practice. This literature-based review explores differences in the preclinical and clinical profiles of the progestins used in hormone therapy, focusing on their effects on the cardiovascular system and breast. Design Studies included are selected based on criteria of relevance, topicality, and subjective assessment of quality, following comprehensive searches of online databases. Results The biological actions of progestins depend on their receptor binding affinity profiles as well as their specific effects on progesterone receptor signaling, which often differ based on the ligand. Observational studies indicate that hormone therapies which include medroxyprogesterone acetate and certain other progestins may attenuate the cardiovascular benefits of estrogen and add to risk of breast cancer. Appraisal of the evidence suggests these clinical effects correlate with the progestin's pharmacological profile. Among the newer progestins, drospirenone has been investigated extensively in preclinical studies. With a pharmacological profile similar to progesterone, drospirenone is devoid of estrogenic, androgenic and glucocorticoid activity and possesses potent antialdosterone and antiandrogenic activity. This profile of drospirenone contrasts with that of older progestins, conferring specific effects on cardiovascular and breast cells. Conclusions The relative risks associated with hormone therapy vary with the combination of hormones included. Differences in pharmacological profile among progestins may translate to characteristic divergences in clinical profile, with potential implications for long-term health. [ABSTRACT FROM AUTHOR]

The article focuses on a workshop on postmenopausal osteoporosis. Osteoporosis is one of the major health problems of modern society. Current estimates indicate that up to 40% of women aged 50 years or older will suffer an osteoporosis-related fracture within their lifetime. Osteoporosis was described at a 1993 consensus conference as a systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of bone tissue with a resultant increase in fragility and risk of fracture. Today, osteoporosis is under-diagnosed and under-treated notwithstanding the fact that effective prevention and treatment options are available.

This article presents guidelines for hormone treatment of women in the menopausal transition and beyond, recommended by Executive Committee of the International Menopause Society. The Committee recommends the continuation of presently accepted global practice, including the use of estrogen + progestin, or estrogen alone in the case of women who have undergone hysterectomy, for the relief of menopausal and urogenital symptoms, avoidance of bone-wasting and fractures, and atrophy of connective tissue and epithelia. There are no new reasons to place mandatory limitations on the length of treatment, including arbitrary cessation of hormone replacement therapy in women who started replacement during the menopausal transition and remain symptom-free while on hormones.

Suggests state-of-the-art guidelines for research and practice on the controversial issues concerning the effects of menopause and of hormone therapies on the central nervous system. Central nervous system pathology and the effects of steroid hormones; Actions of the immune system on the brain; Menopausal symptoms and treatment; Conclusions and recommendations.