12 results on '"Estrogen Replacement Therapy/adverse effects"'
Search Results
2. Systemic or Vaginal Hormone Therapy After Early Breast Cancer:A Danish Observational Cohort Study
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Søren Cold, Frederik Cold, Maj-Britt Jensen, Deirdre Cronin-Fenton, Peer Christiansen, and Bent Ejlertsen
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Cancer Research ,Aromatase Inhibitors ,Hormone Replacement Therapy ,Denmark ,Estrogen Replacement Therapy ,Estrogen Replacement Therapy/adverse effects ,Hormone Replacement Therapy/adverse effects ,Breast Neoplasms ,Estrogens ,Denmark/epidemiology ,Cohort Studies ,Oncology ,Receptors, Estrogen ,Humans ,Female ,Breast Neoplasms/chemically induced ,Menopause ,Aromatase Inhibitors/therapeutic use - Abstract
Background Women treated for breast cancer (BC) often suffer genitourinary syndrome of menopause. These symptoms may be alleviated by vaginal estrogen therapy (VET) or menopausal hormone therapy (MHT). However, there are concerns of risks of recurrence of BC and death following treatment. Methods Our study included longitudinal data from a national cohort of postmenopausal women, diagnosed 1997-2004 with early-stage invasive estrogen receptor–positive nonmetastatic BC, who received no treatment or 5 years of adjuvant endocrine therapy. We ascertained prescription data on hormone therapy, VET or MHT, from a national prescription registry. We evaluated mortality and risk of recurrence associated with use of VET and MHT vs non-use using multivariable models adjusted for potential confounders. Results Among 8461 women who had not received VET or MHT before BC diagnosis, 1957 and 133 used VET and MHT, respectively, after diagnosis. Median follow-up was 9.8 years for recurrence and 15.2 years for mortality. The adjusted relative risk of recurrence was 1.08 (95% confidence interval [CI] = 0.89 to 1.32) for VET (1.39 [95% CI = 1.04 to 1.85 in the subgroup receiving adjuvant aromatase inhibitors]) and 1.05 (95% CI = 0.62 to 1.78) for MHT. The adjusted hazard ratios for overall mortality were 0.78 (95% CI = 0.71 to 0.87) and 0.94 (95% CI = 0.70 to 1.26) for VET and MHT, respectively. Conclusions In postmenopausal women treated for early-stage estrogen receptor–positive BC, neither VET nor MHT was associated with increased risk of recurrence or mortality. A subgroup analysis revealed an increased risk of recurrence, but not mortality, in patients receiving VET with adjuvant aromatase inhibitors.
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- 2022
3. Association of Hormone Therapy With Depression During Menopause in a Cohort of Danish Women
- Abstract
Importance: During menopause, the levels of estrogen and progesterone decrease and 60% to 70% of women experience menopausal symptoms, including mood disturbances. The latter might be prevented by hormone therapy (HT), yet some studies have suggested that use of HT might be associated with increased risk of depression.Objective: To examine whether use of HT during menopause was associated with a subsequent diagnosis of depression.Design, Setting, and Participants: This nationwide register-based cohort and self-controlled case series study included all women in Denmark aged 45 years between January 1, 1995, through December 31, 2017 (n = 825 238), without prior oophorectomy, breast cancer, or cancer in reproductive organs. Follow-up was completed on December 31, 2018. The statistical analysis was performed from September 1, 2021, through May 31, 2022.Exposures: Redeemed prescriptions of different types of HT identified by the Anatomical Therapeutic Chemical classification system codes (G03C [estrogen] and G03F [estrogen combined with progestin]) in the Danish National Prescription Registry between 1995 and 2017. Type of administration was divided into systemic (oral or transdermal) and local (intravaginal or intrauterine).Main Outcomes and Measures: A hospital diagnosis of depression (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes F32-F33 and International Classification of Diseases, Eighth Revision, codes 296.09, 296.29, 298.0, and 300.49) between 1995 through 2018. Associations were examined in cohort and self-controlled case series analysis using Cox proportional hazards and fixed-effects Poisson regression models.Results: During follow-up from 45 years of age to a mean of 56.0 (range, 45.1-67.7) years, 189 821 women (23.0%) initiated systemically or locally administered HT and 13 069 (1.6%) were diagnosed with depression. Systemically administered HT was mainly initiate
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- 2022
4. Association of Hormone Therapy With Depression During Menopause in a Cohort of Danish Women
- Abstract
Importance: During menopause, the levels of estrogen and progesterone decrease and 60% to 70% of women experience menopausal symptoms, including mood disturbances. The latter might be prevented by hormone therapy (HT), yet some studies have suggested that use of HT might be associated with increased risk of depression.Objective: To examine whether use of HT during menopause was associated with a subsequent diagnosis of depression.Design, Setting, and Participants: This nationwide register-based cohort and self-controlled case series study included all women in Denmark aged 45 years between January 1, 1995, through December 31, 2017 (n = 825 238), without prior oophorectomy, breast cancer, or cancer in reproductive organs. Follow-up was completed on December 31, 2018. The statistical analysis was performed from September 1, 2021, through May 31, 2022.Exposures: Redeemed prescriptions of different types of HT identified by the Anatomical Therapeutic Chemical classification system codes (G03C [estrogen] and G03F [estrogen combined with progestin]) in the Danish National Prescription Registry between 1995 and 2017. Type of administration was divided into systemic (oral or transdermal) and local (intravaginal or intrauterine).Main Outcomes and Measures: A hospital diagnosis of depression (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes F32-F33 and International Classification of Diseases, Eighth Revision, codes 296.09, 296.29, 298.0, and 300.49) between 1995 through 2018. Associations were examined in cohort and self-controlled case series analysis using Cox proportional hazards and fixed-effects Poisson regression models.Results: During follow-up from 45 years of age to a mean of 56.0 (range, 45.1-67.7) years, 189 821 women (23.0%) initiated systemically or locally administered HT and 13 069 (1.6%) were diagnosed with depression. Systemically administered HT was mainly initiate
- Published
- 2022
5. Genome-wide interaction analysis of menopausal hormone therapy use and breast cancer risk among 62,370 women
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Kathryn J. Ruddy, Qin Wang, Joe Dennis, Stacey J. Winham, Janet E. Olson, Thomas U. Ahearn, Rachel A. Murphy, Wing-Yee Lo, David J. Hunter, Manjeet K. Bolla, Douglas F. Easton, Derrick G. Lee, Marike Gabrielson, Gareth D. Evans, Nick Orr, Reiner Hoppe, Minouk J. Schoemaker, Paul L. Auer, Michael Lush, Andrew F. Olshan, Kristan J. Aronson, Ross L. Prentice, Argyrios Ziogas, Martha S. Linet, Melissa C. Southey, Robert J. MacInnis, Michael Jones, Nicole L. Larson, Elke M van Veen, Anthony Howell, Alison M. Dunning, Christopher A. Haiman, Peter Kraft, William G. Newman, Loic Le Marchand, Lauren R. Teras, Jenny Chang-Claude, Mikael Eriksson, Irene L. Andrulis, Graham G. Giles, Heiko Becher, Montserrat Garcia-Closas, Thomas Brüning, A. Heather Eliassen, Pascal Guénel, Cari M. Kitahara, Pooja Middha Kapoor, Hoda Anton-Culver, Niclas Håkansson, Emilie Cordina-Duverger, Xiaoliang Wang, Stephen J. Chanock, Christopher J. Scott, Anthony J. Swerdlow, Ute Krüger, Sara Lindström, Roger L. Milne, Alpa V. Patel, Kristen Brantley, Annelie Augustinsson, Rulla M. Tamimi, Lynne R. Wilkens, Celine M. Vachon, Alicja Wolk, Håkan Olsson, Fergus J. Couch, Ute Hamann, Philippe Wagner, Kamila Czene, Audrey Y. Jung, Rudolf Kaaks, Claire Mulot, Laure Dossus, Angela Brooks-Wilson, Kyriaki Michailidou, Per Hall, Jonine D. Figueroa, Thérèse Truong, Charles M. Perou, Melissa A. Troester, Easton, Douglas [0000-0003-2444-3247], Apollo - University of Cambridge Repository, and Dennis, Joe [0000-0003-4591-1214]
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Oncology ,Male ,medicine.medical_specialty ,Hormone Replacement Therapy ,631/208/205/2138 ,Hormone Replacement Therapy/adverse effects ,Breast Neoplasms ,Genome ,Text mining ,Breast cancer ,SDG 3 - Good Health and Well-being ,692/699/67/2324 ,Risk Factors ,Internal medicine ,medicine ,Breast Neoplasms - chemically induced - epidemiology - genetics ,Humans ,Breast ,Breast Neoplasms/chemically induced ,Medicinsk genetik ,Cancer och onkologi ,Multidisciplinary ,business.industry ,Estrogen Replacement Therapy ,Hormone Replacement Therapy - adverse effects ,article ,Estrogen Replacement Therapy/adverse effects ,Estrogen Replacement Therapy - adverse effects ,medicine.disease ,Cancer and Oncology ,692/699/67/1347 ,Female ,Menopausal hormone therapy ,Menopause ,business ,Medical Genetics ,692/499 - Abstract
Background: Use of menopausal hormone therapy (MHT) is associated with increased risk for breast cancer. However, the relevant mechanisms and its interaction with genetic variants are not fully understood. Methods: We conducted a genome-wide interaction analysis between MHT use and genetic variants for breast cancer risk in 27,585 cases and 34,785 controls from 26 observational studies. All women were post-menopausal and of European ancestry. Multivariable logistic regression models were used to test for multiplicative interactions between genetic variants and current MHT use. We considered interaction p-values-8 as genome-wide significant, and p-values-5 as suggestive. Linkage disequilibrium (LD)-based clumping was performed to identify independent candidate variants.Results: None of the 9.7 million genetic variants tested for interactions with MHT use reached genome-wide significance. Only 213 variants, representing 18 independent loci, had p-values5. The strongest evidence was found for rs4674019 (p-value=2.27x10-7), which showed genome-wide significant interaction (p-value=3.8x10-8) with current MHT use when analysis was restricted to population-based studies only. Limiting the analyses to combined estrogen-progesterone MHT use only or to estrogen receptor (ER) positive cases did not identify any genome-wide significant evidence of interactions. Conclusions: In this large genome-wide SNP-MHT interaction study of breast cancer, we found no strong support for common genetic variants modifying the effect of MHT on breast cancer risk. These results suggest that common genetic variation has limited impact on the observed MHT–breast cancer risk association.
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- 2022
- Full Text
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6. Overcoming Women’s Lifelong Hormonal Rollercoaster: A Turning Point for Cardiovascular Prevention
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M. Julia Machline-Carrion
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Fatores de Risco ,Mulheres ,Progestins/adverse effects ,Prevenção e Controle ,Risk Factors ,Terapia de Reposição de Estrogênios/efeitos adversos ,Estrogen Replacement Therapy/adverse effects ,Progesterona/efeitos adversos ,Women ,Menopause ,Prevention and Control ,Cardiology and Cardiovascular Medicine ,Menopausa - Published
- 2022
7. The Rise and Fall of Estrogen Therapy: Is Testosterone for 'Manopause' Next?
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Costello, Briana T., Sprung, Keri, and Coulter, Stephanie A.
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ESTROGEN replacement therapy , *CARDIOVASCULAR diseases , *HORMONE therapy for menopause , *TESTOSTERONE , *CARDIOVASCULAR diseases risk factors - Abstract
The article focuses on analysis of estrogen replacement therapy among postmenopausal women for management of risk related to cardiovascular diseases (CVD). Topics discussed include management of randomized controlled trial for hormone replacement therapy (HRT) in postmenopausal women with CVD; analysis of reduction in testosterone levels among men that is influenced by obesity; and assessment of cardiovascular risk under testosterone replacement therapy.
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- 2017
- Full Text
- View/download PDF
8. Endometriosis after menopause: physiopathology and management of an uncommon condition
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Jean-Marie Wenger, Patrick Petignat, Gaitzsch H, and Isabelle Streuli
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Infertility ,Oncology ,medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Endometriosis ,Disease ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Adipose Tissue/drug effects/metabolism ,medicine ,Humans ,Aromatase ,Endometriosis/drug therapy/pathology/physiopathology ,ddc:616 ,Gynecology ,Aromatase Inhibitors/pharmacology ,ddc:618 ,030219 obstetrics & reproductive medicine ,biology ,Aromatase Inhibitors ,business.industry ,Estrogen Replacement Therapy ,Estrogen Replacement Therapy/adverse effects ,Disease Management ,Obstetrics and Gynecology ,Estrogens ,Hormone replacement therapy (menopause) ,General Medicine ,Middle Aged ,medicine.disease ,Postmenopause ,Menopause ,Adipose Tissue ,Estrogen ,030220 oncology & carcinogenesis ,biology.protein ,Female ,Estrogens/biosynthesis ,business - Abstract
Endometriosis is a hormone-dependent inflammatory disease that is usually characterized by infertility and pain symptoms. This disease mainly occurs during the reproductive years and is rarely diagnosed after menopause. We discuss the physiopathology of this condition after menopause as well as treatment options and the risk of malignant transformation. Occurrence or progression of postmenopausal endometriosis lesions could be related to extra-ovarian production of estrogen by endometriosis lesions and adipose tissue, which becomes the major estrogen-producing tissue after menopause. Postmenopausal women with symptomatic endometriosis should be managed surgically because of the risk of malignancy; medical treatments can be used in cases of pain recurrence after surgery. Aromatase inhibitors act by decreasing extra-ovarian estrogen production and by blocking the feed-forward stimulation loop between inflammation and aromatase within endometriosis lesions. The evidence is currently insufficient to support a conclusion about the optimal hormone replacement therapy for women with endometriosis. The question of malignant transformation of endometriosis in response to hormone replacement therapy in women with a history of endometriosis remains unanswered and needs a long-term follow-up study to evaluate the risk of an adverse outcome. Further studies should be performed to determine the optimal management of menopausal women with endometriosis.
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- 2017
9. Alterações na Modulação Autonômica Cardíaca em Mulheres com Câncer de Mama em Uso de Inibidores de Aromatase e sua Relação com Variáveis Bioquímicas
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Gonzaga, Luana Almeida, de Paulo, Thais Reis Silva, Viezel, Juliana, Vanzella, Laís Manata, Freitas Jr., Ismael Forte, Vanderlei, Luiz Carlos Marques, Universidade Estadual Paulista (Unesp), and Universidade Federal do Rio Grande do Norte (UFRN)
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Male ,Blood Glucose ,lcsh:Diseases of the circulatory (Cardiovascular) system ,030204 cardiovascular system & hematology ,Cardiovascular System ,Estrogen Replacement ,chemistry.chemical_compound ,0302 clinical medicine ,Heart Rate ,Risk Factors ,Medicine ,Heart rate variability ,Aromatase ,Cardiovascular Dieases/prevention and control ,biology ,Aromatase Inhibitors ,Blood Glicose ,Inibidores de Aromatases ,Middle Aged ,Postmenopause ,C-Reactive Protein ,Editorial ,Cholesterol ,Glycemic index ,Predictive value of tests ,Cardiology ,Original Article ,Female ,Cardiology and Cardiovascular Medicine ,Colesterol ,Glicemia ,Doenças Cardiovasculares/prevenção e controle ,medicine.medical_specialty ,Breast Neoplasms ,Autonomic Nervous System ,cardiovascular Diseases/prevention & control ,03 medical and health sciences ,Breast cancer ,Predictive Value of Tests ,Statistical significance ,Internal medicine ,Heart rate ,Humans ,Triglycerides ,business.industry ,Cholesterol, HDL ,Terapia de Reposição de Estrogênios/efeitos adversos ,Estrogen Replacement Therapy/adverse effects ,medicine.disease ,Cross-Sectional Studies ,Socioeconomic Factors ,chemistry ,Glycemic Index ,lcsh:RC666-701 ,biology.protein ,Neoplasias da Mama ,business - Abstract
Background: The use of autonomic modulation as a predictor of cardiovascular risk in women with breast cancer is important. Objective: To evaluate the cardiac autonomic modulation of postmenopausal women using aromatase inhibitors for breast cancer treatment, as well as its relation with the following biochemical variables. Methods: Postmenopausal women who did not have breast cancer (n = 33) and postmenopausal women with breast cancer (n = 15). For evaluation of the autonomic modulation the heart rate was recorded beat-to-beat for 30 minutes and the series of RR intervals obtained were used to calculate the following heart rate variability indices: Mean RR ms, SDNN (standard deviation of all normal RR intervals, expressed in milliseconds) ms, Mean HR, RMSSD (square root of the mean of the squared differences between adjacent normal RR interval) ms, NN50 (number of pairs of successive NNs that differ by more than 50 ms) count, pNN50% (proportion of NN50 divided by total number of NNs), RRtri (RR triangular), TINN (triangular interpolation of NN interval) ms, SD1 ms, SD2 ms, LF ms2, HF ms2, LH/HF ms2. The values of biochemical variables (fasting glycemia, triglycerides, HDL-cholesterol, and C-reactive protein) were analyzed by blood sample. Results: Lower values of heart rate variability indices were observed in postmenopausal women with breast cancer in relation to postmenopausal women who did not have breast cancer: Mean RR (p = 0.03); SDNN (p = 0.03); RMSSD (p = 0.03); NN50 count (p = 0.03); pNN50 % (p = 0.03); RRtri (p = 0.02); SD1 (p = 0.01); SD2 (p = 0.02); LF ms2 (p = 0.01); HF ms2 (p = 0.03).There was an inversely proportional correlation between the indices SDNN, SD2, and HFms2 with triglycerides (SDNN p = 0.04; SD2 p = 0.04; HF ms2 p = 0.04). No statistically significant correlations were found between heart rate variability indices and others variables. Statistical significance was set at 5% for all analyses. Conclusion: Women with breast cancer present reduced autonomic modulation and in these women of heart rate variability indices are inversely correlated with triglyceride values. Resumo Fundamentos: A modulação autonômica como um preditor de risco cardiovascular em mulheres com câncer de mama é importante. Objetivos: Avaliar a modulação autonômica em mulheres pós-menopausa em uso de inibidores de aromatase como tratamento de câncer de mama, e sua relação com algumas variáveis bioquímicas. Métodos: Foram avaliadas mulheres pós-menopausa sem câncer de mama (n = 33) e mulheres pós-menopausa com câncer de mama (n = 15). Para avaliação da modulação autonômica, a frequência cardíaca (FC) foi registrada batimento a batimento por 30 minutos, e as séries de intervalos RR obtidas foram usadas para o cálculo dos seguintes índices de variabilidade da frequência cardíaca: média de RR ms, SDNN (desvio padrão de todos os intervalos RR normais) ms, FC, RMSSD (raiz quadrada da média das diferenças ao quadrado entre os intervalos RR normais adjacentes) ms, contagem NN50 (número de pares de NNs sucessivos que se diferem em mais de 50 ms), pNN50% (proporção de NN50 dividida pelo número total de NNs), RRtri (RR triangular), TINN (interpolação triangular do intervalo NN) ms, DP1 ms, DP2 ms, LF (baixa frequência) ms2, HF (alta frequência) ms2, LH/HF ms2. Os valores das variáveis bioquímicas (glicemia de jejum, triglicerídeos, HDL-colesterol, e proteína C reativa) foram analisadas das amostras de sangue. O nível de significância adotado nas análises estatísticas foi de 5%. Resultados: As mulheres pós-menopausa com câncer de mama apresentaram menores índices de variabilidade da frequência cardíaca em comparação àquelas sem câncer de mama: média de RR (p = 0,03); SDNN (p = 0,03); RMSSD (p = 0,03); contagem NN50 (p = 0,03); pNN50% (p = 0,03); RRtri (p = 0,02), DP1 (p = 0,01), DP2 (p = 0,02); LF ms2 (p = 0,01); HF ms2 (p = -0,03). Observou-se uma correlação inversamente proporcional dos índices SDNN, DP2 e HF ms2 com triglicerídeos (SDNN p = 0,04, DP2 p = 0,04; HF ms2 0,04). Não houve correlação significativa entre os índices de variabilidade da frequência cardíaca e as demais variáveis. Conclusão: Mulheres com câncer de mama apresentam modulação autonômica diminuída e índices de variabilidade da FC inversamente correlacionados com valores de triglicerídeos.
- Published
- 2019
10. Global burden of cancer attributable to high body-mass index in 2012: a population-based study
- Author
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Gretchen A Stevens, Andrew G Renehan, Graham Byrnes, J. Jaime Miranda, Isabelle Soerjomataram, Majid Ezzati, Jacques Ferlay, Melina Arnold, David Forman, Nirmala Pandeya, Rajesh Dikshit, and Isabelle Romieu
- Subjects
Adult ,Male ,Gerontology ,Time Factors ,Population ,Overweight ,Global Health ,Weight Gain ,Article ,Body Mass Index ,Age Distribution ,Sex Factors ,Breast cancer ,Neoplasms/diagnosis/ epidemiology/prevention & control ,Risk Factors ,Neoplasms ,purl.org/pe-repo/ocde/ford#3.02.21 [https] ,medicine ,Global health ,Humans ,Obesity ,Sex Distribution ,education ,Developing Countries ,Aged ,education.field_of_study ,business.industry ,Incidence ,Incidence (epidemiology) ,Estrogen Replacement Therapy ,Smoking ,Age Factors ,Estrogen Replacement Therapy/adverse effects ,Cancer ,Middle Aged ,medicine.disease ,Neoplasms/diagnosis/epidemiology/prevention & control ,Obesity/diagnosis/epidemiology/prevention & control ,Oncology ,Relative risk ,Female ,Obesity/diagnosis/ epidemiology/prevention & control ,Smoking/adverse effects/epidemiology ,medicine.symptom ,business ,Body mass index ,Demography - Abstract
Summary Background High body-mass index (BMI; defined as 25 kg/m 2 or greater) is associated with increased risk of cancer. To inform public health policy and future research, we estimated the global burden of cancer attributable to high BMI in 2012. Methods In this population-based study, we derived population attributable fractions (PAFs) using relative risks and BMI estimates in adults by age, sex, and country. Assuming a 10-year lag-period between high BMI and cancer occurrence, we calculated PAFs using BMI estimates from 2002 and used GLOBOCAN2012 data to estimate numbers of new cancer cases attributable to high BMI. We also calculated the proportion of cancers that were potentially avoidable had populations maintained their mean BMIs recorded in 1982. We did secondary analyses to test the model and to estimate the effects of hormone replacement therapy (HRT) use and smoking. Findings Worldwide, we estimate that 481 000 or 3·6% of all new cancer cases in adults (aged 30 years and older after the 10-year lag period) in 2012 were attributable to high BMI. PAFs were greater in women than in men (5·4% vs 1·9%). The burden of attributable cases was higher in countries with very high and high human development indices (HDIs; PAF 5·3% and 4·8%, respectively) than in those with moderate (1·6%) and low HDIs (1·0%). Corpus uteri, postmenopausal breast, and colon cancers accounted for 63·6% of cancers attributable to high BMI. A quarter (about 118 000) of the cancer cases related to high BMI in 2012 could be attributed to the increase in BMI since 1982. Interpretation These findings emphasise the need for a global effort to abate the increasing numbers of people with high BMI. Assuming that the association between high BMI and cancer is causal, the continuation of current patterns of population weight gain will lead to continuing increases in the future burden of cancer. Funding World Cancer Research Fund International, European Commission (Marie Curie Intra-European Fellowship), Australian National Health and Medical Research Council, and US National Institutes of Health.
- Published
- 2015
11. Differential associations of oral estradiol and conjugated equine estrogen with hemostatic biomarkers
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Laura B. Harrington, Nicholas L. Smith, Susan R. Heckbert, Bruce M. Psaty, Kerri L. Wiggins, A. van Hylckama Vlieg, Marc Blondon, Barbara McKnight, Kenneth Rice, and F. R. Rosendaal
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medicine.medical_treatment ,Administration, Oral ,Estrogens, Conjugated (USP)/administration & dosage/adverse effects ,Protein S ,chemistry.chemical_compound ,Risk Factors ,Medroxyprogesterone acetate ,estrogen replacement therapy ,ddc:616 ,Estrogens, Conjugated (USP) ,Factor VII/metabolism ,Factor VII ,biology ,Antithrombin ,Thrombin ,Hematology ,Middle Aged ,Postmenopause ,Female ,venous thrombosis ,hormones, hormone substitutes, and hormone antagonists ,estrogens ,medicine.drug ,medicine.medical_specialty ,medicine.drug_class ,Hemostasis/drug effects ,Estradiol/administration & dosage/adverse effects ,Antithrombins ,Article ,Antithrombins/metabolism ,estradiol ,Internal medicine ,medicine ,Humans ,Aged ,Protein S/metabolism ,Thrombin/metabolism ,business.industry ,Venous Thrombosis/blood/chemically induced ,Estrogen Replacement Therapy/adverse effects ,thromboembolism ,Cross-Sectional Studies ,Endocrinology ,chemistry ,Estrogen ,Hemostasis ,hemostasis ,biology.protein ,Hormone therapy ,business ,Biomarkers ,Biomarkers/blood - Abstract
Summary Background The risk of venous thrombosis (VT) associated with oral hormone therapy (HT) may differ by type of estrogen compound. Objective To compare the thrombotic profile of women using oral conjugated equine estrogens (CEE) with that of women using oral estradiol (E2). Methods In postmenopausal, female, health maintenance organization (HMO) members with no history of VT, we measured thrombin generation, levels of factor VII activity, antithrombin activity and total protein S antigen. Mean levels of hemostasis biomarkers were cross-sectionally compared by use and type of estrogen using multiple linear regressions. The type of estrogen used was determined primarily by the HMO formulary, which changed its preferred estrogen from CEE to E2 during the study period. Results The sample included 92 E2 users and 48 CEE users, with a mean age of 64.1 years and mean BMI of 29.1 kg m−2. Twenty-seven per cent of HT contained medroxyprogesterone acetate. Compared with E2 users, CEE users had greater thrombin generation peak values and endogenous thrombin potential, and lower total protein S (multivariate adjusted differences of 49.8 nm (95% CI, 21.0, 78.6), 175.0 nm × Min (95% CI, 54.4, 295.7) and −13.4% (95% CI, −19.8, −6.9), respectively). Factor VII and antithrombin levels were not different between E2 and CEE users. Results were similar in subgroups of users of unopposed HT, opposed HT, low-dose estrogen and standard dose estrogen. Conclusion The hemostatic profile of women using CEE is more prothrombotic than that of women using E2. These findings provide further evidence for a different thrombotic risk for oral CEE and oral E2.
- Published
- 2014
12. Seksuel dysfunktion i menopausen. Status over forekomst, farmakologiske behandlingsmuligheder og risici
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Nina Gregersen, Christina Bjerre Hilmand, Pernille Tine Jensen, and Elena Giraldi, Annamaria G.
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Adult ,Norpregnenes/administration & dosage ,Incidence ,Libido/drug effects ,Testosterone/administration & dosage ,Estrogen Replacement Therapy/adverse effects ,Sexual Dysfunction, Physiological/drug therapy ,Phosphodiesterase Inhibitors/administration & dosage ,Piperazines/administration & dosage ,Menopause/drug effects ,Middle Aged ,Androgens/administration & dosage ,Sildenafil Citrate ,Estrogen Receptor Modulators/administration & dosage ,Purines ,Risk Factors ,Humans ,Female ,Postmenopause/drug effects ,Sulfones - Abstract
The frequency of female sexual dysfunction increases with age, and the menopause has a negative influence on sexual life. Pharmacological treatment options of female sexual dysfunctions in the menopause include hormone therapy and sildenafil. Few randomised controlled studies have been done, and there is evidence suggesting that systemic hormone therapy, such as estrogen, estrogen/progesterone, estrogen/testosterone and tibolone, has a positive impact on sexual dysfunction in the menopause. There is evidence that local estrogen relieves vaginal dryness and dyspareunia. The recent discoveries of the side effects of hormone therapy necessitate careful evaluation of the indication for hormone therapy, and the duration of treatment is recommended to be as short as possible. The long-term side effects of testosterone in women have not yet been fully investigated. Sildenafil has shown a positive effect on female sexual dysfunction only in a limited group of women: those with arousal problems without desire problems. This result demands a focus on new pharmaceutical products, and at present the effect of testosterone and selective estrogen receptor modulators on female sexual dysfunction is being investigated.
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