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2022 JUN 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on Drugs and Therapies - Antineoplastics have been presented. According [...]

Background It is uncertain whether evidence supports routinely estimating a postmenopausal woman's risk of breast cancer and intervening to reduce risk. Methods We systematically reviewed prospective studies about models and sex hormone levels to assess breast cancer risk and used meta-analysis with random effects models to summarize the predictive accuracy of breast density. We also reviewed prospective studies of the effects of exercise, weight management, healthy diet, moderate alcohol consumption, and fruit and vegetable intake on breast cancer risk, and used random effects models for a meta-analyses of tamoxifen and raloxifene for primary prevention of breast cancer. All studies reviewed were published before June 2008, and all statistical tests were twosided. Results Risk models that are based on demographic characteristics and medical history had modest discriminatory accuracy for estimating breast cancer risk (c-statistics range = 0.58-0.63). Breast density was strongly associated with breast cancer (relative risk [RR] = 4.03, 95% confidence interval [Cl] = 3.10 to 5.26, for Breast Imaging Reporting and Data System category IV vs category I; RR = 4.20, 95% Cl = 3.61 to 4.89, for >75% vs Tamoxifen and raloxifene reduced the risk of estrogen receptor--positive invasive breast cancer and invasive breast cancer overall. Conclusions Evidence from this study supports screening for breast cancer risk in all postmenopausal women by use of risk factors and breast density and considering chemoprevention for those found to be at high risk. Several lifestyle changes with the potential to prevent breast cancer should be recommended regardless of risk.

Background: Risk factors for coronary heart disease events have most commonly been evaluated in healthy men. Objective: To assess risk factors, event rates, and use of secondary prevention treatments in women with preexisting coronary disease. Design: A prospective cohort of clinical trial participants. Setting: 20 U.S. clinical centers. Participants: 2763 postmenopausal women with known coronary disease in the Heart and Estrogen/progestin Replacement Study (HERS). Measurements: Myocardial infarction or death from coronary heat disease. Results: On multivariable analysis, the researchers found 11 risk factors: 6 noted by history (nonwhite ethnicity, lack of exercise, treated diabetes, angina, congestive heart failure, and more than one previous myocardial infarction) and 5 that were measured (blood pressure, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, lipoprotein(a) level, and creatinine clearance). The annual rate of coronary events was 1.3% (95% CI, 0.7 to 2.5%) in women with no risk factors and 8.7% (CI, 7.1% to 10.8%) in women with five or more risk factors (a sixfold increase). At entry into HERS, 83% of participants were receiving aspirin or other antiplatelet agents, 33% were receiving beta-blockers, 18% were receiving angiotensin-converting enzyme inhibitors, and 53% were receiving lipid-lowering drugs. Women with more risk factors were less likely to be taking aspirin (P Conclusions: Women with coronary disease are at high risk for myocardial infarction or death from coronary heart disease even in the absence of other risk factors, and their risk increases up to sixfold when many risk factors are present. Established drugs for secondary prevention, including aspirin, beta-blockers, and lipid-lowering agents, are underused in these women, especially those at highest risk.

Osteoporosis frequently remains unrecognized until the patient - usually a postmenopausal woman - suffers a skeletal fracture. Even when appropriate treatment is prescribed to prevent the disease's onset or slow [...]

PURPOSE: To measure the effect of long-term clinical hormone replacement therapy on brachial artery vasomotor responses, and to compare these responses in premenopausal and postmenopausal women. PATIENTS AND METHODS: We studied 23 postmenopausal women, including 18 who were evaluated prior to starting clinically indicated oral hormone replacement therapy. Twelve postmenopausal women received estrogen alone, the other 6 were treated with estrogen/medroxyprogesterone combinations. Eleven premenopausal volunteers served as a comparison group. Change in brachial artery diameter in response to postischemic hyperemic flow and sublingual nitroglycerin was measured by ultrasound. RESULTS: The 18 postmenopausal subjects receiving hormone replacement showed a progressive improvement in their postischemic vasodilation. Mean ([+ or -] SD) postischemic vasodilation was 0.4% [+ or -] 7.1% prior to estrogen replacement. There were significant increases in postischemic vasodilation of 4.8% [+ or -] 6.6% after 1 month and 8.3% [+ or -] 3.4% after 6 months of estrogen replacement. The response to nitroglycerin was similar at all time points studied. Women with the most abnormal responses to hyperemic flow at baseline demonstrated the greatest improvement after 6 months of hormone replacement therapy. Premenopausal and postmenopausal subjects differed in their response to hyperemic flow, with premenopausal women showing 5.8% vasodilatation compared with a 0.6% vasodilation in postmenopausal women (P = 0.046). CONCLUSIONS: Endothelial Function is abnormal in many postmenopausal women compared with premenopausal women, and in some postmenopausal women it can be enhanced by estrogen replacement therapy. This effect may increase with prolonged use. Am J Med. 1998;104:552-558. [C] 1998 by Excerpta Medica, Inc.

Osteoporosis is the reduction in bone mass and mineral density, and a common cause of fractures in the elderly. Many patients are diagnosed incidentally, or following an injury. A careful medical history may reveal patients at risk, such as those with a family history, early menopause, a significant loss of height, or other factors. Exercise and adequate dietary calcium and vitamin D can prevent the condition. Hormone replacement therapy and other drugs can reduce bone loss and the risk of fracture.

Postmenopausal osteoporosis is a widespread problem among American women, but prevention and treatment are improving. For women over 50, it eventually causes a bone break in about half of all of them, and half of those with broken hips never walk again. Risk factors, nutrition, exercise, estrogen, bone-resorption inhibitors and bone formation stimulants are covered. Two age-related types of the disease are also detailed.

Background: Previous studies have suggested that cancers of the breast and prostate cluster in families and that the presence of both diseases in a family may be associated with increased risk of breast cancer. Purpose: Our purpose was to evaluate whether 1) prostate cancer aggregates in families with postmenopausal breast cancer, 2) families with cancers of the breast and prostate are the same ones as families with cancers of the breast and ovary, and 3) a family history of prostate cancer is associated with increased risk of postmenopausal breast cancer. Methods: We analyzed data from a large prospective cohort study of Iowa women that were (at baseline) aged 55-69 years in 1986. At the third follow-up survey in 1992, self-reported data on family history of breast, ovarian, and prostate cancers in parents and siblings were provided by 30 883 women. Additional information was collected to ascertain whether the age-of-onset of breast cancer in mothers or sisters was before or after the age of 45 years. Cancer occurrence was documented using the State Health Registry of Iowa. Results: History of prostate cancer in their father or a brother was reported by 3384 (11.0%) of the women, and a total of 4090 women (13.2%) reported breast cancer in their mother or a sister. A positive family history of both cancers was reported by 556 women, significantly (two-sided P

Background. Insulin-like growth factor I (IGF-I) is a potent mitogen for breast cancer cells. The majority of IGF-I in plasma is hound to IGF binding proteins (IGFBPs), which modulate the biologic effects of IGF-I. Methods. Plasma concentrations of IGF-I, IGFBP-I, and IGFBP-3 were compared between 40 postmenopausal breast cancer patients receiving long term tamoxifen therapy and 39 breast cancer patients receiving no hormonal treatment. In an additional group of seven patients, serum levels of IGF-I and IGFBP-1 were determined before and during treatment at 6 and 12 months. Results. The tamoxifen and the control groups did not differ with respect to age, parity, age at menopause, or body mass index. There were no significant differences in the mean concentrations ([+ or -] standard error of the mean) of IGF-I (10.0 [+ or -] 0.4 nmol/l and 11.2 [+ or -] 0.5 nmol/l, respectively) and IGFBP-3 (3.2 [+ or -] 0.1 mg/l and 3.1 [+ or -] 0.1 mg/l, respectively), whereas the mean value of IGFBP-1 was significantly higher in the tamoxifen group (6.0 [+ or -] 0.6 ([mu]g/l versus 2.8 [+ or -] 0.3 [mu]g/l, P = 0.0001). No significant differences were found in the insulin levels. During the treatment, concentrations of IGF-I decreased at 6 months and began increasing at 12 months. IGFBP-1 levels increased at 6 months and remained elevated at 12 months. Conclusions. The tamoxifen-induced increase in IGFBP-1 plasma levels may be an important mechanism modulating IGF-I action at the tissue level. Cancer 1994; 74:618-24.

Ovarian hormone replacement therapy (HRT) appears to be a well-tolerated, effective adjunct treatment to conventional therapy for rheumatoid arthritis (RA) in postmenopausal women. RA is a chronic systemic disease usually affecting the joints. Postmenopausal women with RA are at an increased risk for fracture. Researchers randomly assigned 44 women to receive either HRT (31) or placebo (13) twice weekly for 48 weeks. Overall well-being, increased energy levels and improved emotional state were noted in the HRT group by weeks 12 and 48. No changes in these measures were noted in the placebo group. Estradiol levels were significantly increased in the HRT group, but levels were unchanged in the placebo group. Bone density measurements (BMD) of the lumbar spine were increased in the HRT group. No significant changes in BMD were noted in the placebo group. No decrease in disease activity was noted in both groups.

Postmenopausal women with active rheumatoid arthritis (RA) who lead sedentary lives may have an increased risk of osteoporosis. RA is a chronic systemic disease usually affecting the joints. Osteoporosis is abnormal bone resorption. Researchers measured bone mineral density (BMD) at the spine and femoral neck of 143 women with RA and 1611 healthy women (control group). Advanced age, lighter body weight and less physical activity were related to low BMD measurements for the spine and thigh bone. Corticosteroid drug use also was associated with low BMD measurements. These results indicate that RA increases the risk of fractures as the disease progresses.

The purpose of this article was to review, with special attention to the hypothesized mechanisms of atherosclerosis and thrombosis, the literature on the association of estrogens and progestins with cardiovascular disease. The data sources included recent reviews and their citations as well as literature searches of Medline. For coronary heart disease, we relied on a recent meta-analysis; for the lipid effects of estrogens and progestins, we refer to recent reviews and studies; for stroke, we identified all cohort and case-control studies; and for the effects of hormones on coagulation factors, we identified all relevant studies. The lipid effects of estrogens in postmenopausal women probably prevent atherosclerosis, and we would expect long duration of use rather than current use to provide the greatest benefit. Few epidemiologic studies have, however, assessed duration of estrogen use. High doses of estrogens are likely to be thrombogenic during current use, and it is possible that even moderate doses may increase the risk of clotting among women who smoke or who have existing coronary atherosclerosis. Compared with the lipid effects of estrogens alone, the lipid effects of combined therapy with progestins may increase atherosclerosis. The effect of progestins on coagulation factors is largely unknown, and no epidemiologic study has assessed the risk of cardiovascular disease associated with the use of combined hormone therapy in postmenopausal women. Cardiovascular risk or benefit associated with the use of postmenopausal hormones may involve several competing mechanisms, including effects on prostaglandins and vascular tone as well as atherosclerosis and thrombosis. (Arch Intern Med. 1993; 153:1421-1427)

PURPOSE: To determine if bone mineral density is decreased in postmenopausal women treated with 1-thyroxine, and, if any decrease is observed, whether it is related to overtreatment with thyroid hormone, to deficiency of calcitonin, or to other factors. PATIENT'S AND METHODS: The study consisted of 19 postmenopausal women between 50 and 75 years of age treated with 1-thyroxine for 5 years or longer, and 19 matching control subjects with no thyroid disease. Bone mineral density of the spine and hip was measured by dual-photon absorptiometry. Plasma calcitonin concentrations and serum thyroid hormone levels were determined by radioimmunoassays. RESULTS: The 1-thyroxine-treated women had lower bone density in the lumbar spine (1.013 g/ CM2 [95% confidence interval, 0.945 to 1.0811 versus 1.134 g/CM2 [1.026 to 1.242], p = 0.043); in the femoral neck (0.736 g/CM2 [0.694 to 0.778] versus 0.809 g/CM2 [0.747 to 0.872], p = 0.040); in Ward's triangle (0.576 g/CM2 [0.530 to 0.623] versus 0.694 g/CM2 [0.617 to 0.770], p = 0.011); and in the trochanteric area (0.626 g/CM2 [0.581 to 0.672] versus 0.722 g/CM2 [0.651 to 0.794], p = 0.027). The maximal increase in calcitonin following calcium infusion was 1.37 ng/L (95% confidence interval, -0.44 to 3.17) in the 1-thyroxine-treated patients versus 18.8 ng/L (95% confidence interval, 10.0 to 27.5) in normal women, p CONCLUSIONS: Long-term 1-thyroxine therapy is associated with decreased density of the spine and hip. Since subclinical hyperthyroidism, decreased calcitonin responsiveness, and a history of hyperthyroidism were demonstrated in some or all of these patients, these factors must be considered as possible causes of the decreased bone density., Bone mineral density was assessed in 19 women aged 50 to 75 years, who were past the stage of menopause and were receiving treatment with l-thyroxine. The relationships among changes in bone mineral density, thyroid hormone treatment, and levels of the thyroid hormone calcitonin (important in bone metabolism) were also examined. The results were compared with those obtained in 19 women without thyroid disease. Women treated with l-thyroxine had lower bone density in the lumbar (lower) spine and portions of the thigh bone as compared with untreated women. The calcitonin response, or release of calcitonin following administration of calcium into the circulation, was lower in l-thyroxine-treated women than untreated women. Although thyroxine levels were normal in 16 of 19 treated women, thyroid stimulating hormone levels were low in 13 of 19 women; this suggests that hormone treatment produced greater than physiological levels of l-thyroxine. The group of treated women was then divided into two subgroups: those with and those without a history of hyperthyroidism. Seven of 19 patients had a history of hyperthyroidism, or increased activity of the thyroid gland, and they had reduced bone mineral density in the hip. The remaining 12 patients did not have a significant loss of bone density when considered separately from the seven who had hyperthyroidism. The findings suggest that long-term l-thyroxine treatment is associated with a decrease in bone mineral density in the spine and hip. Subclinical hyperthyroidism, a decreased calcitonin response, and a history of hyperthyroidism may be factors that contribute to the decrease in bone density. (Consumer Summary produced by Reliance Medical Information, Inc.)

Estrogen replacement in postmenopausal women can be potentially beneficial by altering levels of cholesterol-containing particles in ways that discourage development of cardiovascular disease. Most studies have suggested that estrogen replacement is generally protective in terms of cardiovascular morbidity (disease), while a minority have shown an increase in heart attacks and strokes. Because men given estrogen have heart attacks more frequently, physicians have been reluctant to recommend estrogen therapy for postmenopausal women with heart disease. The effects of estrogen replacement therapy on morbidity and mortality were studied in 1,178 postmenopausal women with severe coronary artery disease, 644 women with mild or moderate coronary artery disease, and 446 women without such disease. Coronary artery disease was confirmed by angiography rather than by reports of chest pain. Postmenopausal women with coronary artery disease who used estrogen had a significantly lower mortality than those who did not. Estrogens were more protective in those with more severe disease. Those without coronary artery disease achieved little benefit from estrogen, probably because there was lower mortality among them than among those with coronary artery disease. Although estrogen does increase the risk of gall bladder disease and cancer of the uterine lining, the risk of death from these causes is less than that from coronary artery disease. The results suggest that postmenopausal women with coronary artery disease can benefit from estrogen replacement therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background: Epidemiologic and experimental data suggest that estrogen has a salutary effect on Trichomonas vaginalis. Case: A metronidazole-allergic postmenopausal woman was cured of vaginal trichomoniasis in association with discontinuation of estrogen replacement therapy. Conclusion: Hormonal manipulation should be studied for the management of women with trichomoniasis who are allergic to metronidazole or who are infected with metronidazole-resistant strains of Trichomonas vaginalis., Discontinuing hormone replacement therapy may prove effective in postmenopausal women infected with Trichomonas (T.) vaginalis who are unresponsive or allergic to metronidazole. Increased estrogen levels may increase the risk for developing T. vaginalis infections. A 55-year-old woman taking estrogen therapy developed a T. vaginalis infection, was treated with metronidazole, and later developed an allergic reaction to the treatment. Vaginal examinations and laboratory tests showed no evidence of the infection after she stopped taking the estrogen therapy.

To examine the effects of estrogen replacement on lipids and angiographically defined coronary artery disease (CAD) in postmenopausal women, lipid profiles were obtained in 90 consecutive post-menopausal women undergoing diagnostic coronary angiography. Eighteen women (20%) were receiving estrogen and 72 (80%) were not. CAD (defined as [is greater than or equal to]25% luminal diameter narrowing in a major coronary artery) was present in only 22% of women (4 of 18) receiving estrogen and in 68% (49 of 72) who were not (p On multiple logistic regression analysis, absence of estrogen use was the most powerful independent predictor of the presence of CAD (p Thus, among 90 consecutive postmenopausal women undergoing diagnostic coronary angiography, estrogen replacement therapy was associated with an 87% reduction in the prevalence of CAD, and those receiving estrogen has a significantly higher mean HDL cholesterol level and lower mean total/HDL cholesterol ratio.

Letrozole (Femara) following surgery is an optimal treatment for postmenopausal women with early-stage breast cancer compared with tamoxifen, according to results of the Breast International Group 1-98 trial. BIG 1-98 [...]

ABSTRACT Several large, prospective trials have evaluated tamoxifen compared with placebo for breast cancer risk reduction in women at increased risk for breast cancer. Analysis of the large, prospective breast [...]

Table of Contents Abstract Introduction Case Discussion References Abstract Vaginal evisceration after a motor vehicle crash caused by a pessary has not been reported. This case was missed at the [...]

Table of Contents Abstract Introduction Methods Results Discussion References Abstract Osteoporosis is a chronic and progressive disorder characterized by reduced bone strength and increased susceptibility to fracture by minor trauma. [...]

ROCKVILLE, Maryland-Femara (letrozole, Novartis) has received FDA approval for use in treating early breast cancer in postmenopausal women following surgery. The agency based its approval on findings from the BIG [...]

Osteoporosis continues to be underrecognized and undertreated in postmenopausal women, despite its prevalence and debilitating effects on their health. According to the National Osteoporosis Foundation (NOF), as many as eight [...]

2001 JUL 12 - (NewsRx Network) -- A routine test can measure levels of a protein in urine samples and may reveal early, symptomless cardiovascular disease in postmenopausal women. Scientists [...]

Coronary heart disease is the single leading cause of death in women and a significant cause of disability. Menopause adversely affects several risk factors for coronary heart disease, suggesting that hormones influence the risk of coronary heart disease in postmenopausal women. This article reviews the observational and clinical trial data evaluating the relation between cardiovascular disease and hormone replacement therapy. Biological mechanisms of estrogen and the impact of adding progestins are emphasized. Potential risks and benefits of therapy are discussed. The relative effects of other estrogen and lipid-lowering therapies for preventing coronary heart disease in postmenopausal women are highlighted. Arch Intern Med. 2000;160:2263-2272

Results of the HERS, ERA, and WHI trials suggest a conservative approach to use of HRT in women with evidence of CHD. Dose and duration of therapy may be key [...]

Background: Antioxidant vitamins may play a role in the prevention of stroke because they scavenge free radicals and prevent LDL oxidation. Epidemiologic studies that have examined this relation produced conflicting results. Objective: We examined the association between antioxidant vitamin intakes and death from stroke. Design: This was a prospective cohort study of 34 492 postmenopausal women. Results: During follow-up, 215 deaths from stroke were documented. Total vitamin A, carotenoid, and vitamin E intakes were not associated with death from stroke after multivariate adjustment. Relative risks (RRs) and 95% CIs of the highest compared with the lowest category were 0.79 (0.45, 1.38; P for trend = 0.33) for vitamin A, 0.80 (0.45, 1.40; P for trend = 0.40) for carotenoids, and 0.91 (0.55, 1.52; P for trend = 0.86) for vitamin E. The test for trend for total vitamin C intake was significant, although the association appeared somewhat U-shaped, not monotonic. An inverse association was seen between death from stroke and vitamin E intake from food. RRs (and 95% CIs) of death from stroke from the lowest to highest intake categories were 1.0, 0.80 (0.51, 1.26), 0.93 (0.58, 1.49), 0.67 (0.39, 1.14), 0.40 (0.20, 0.80); P for trend = 0.008. The results suggest inverse associations between death from stroke and intakes of the most concentrated vitamin E food sources consumed by this cohort: mayonnaise, nuts, and margarine. Conclusions: Our results suggest a protective effect of vitamin E from foods on death from stroke but do not support a protective role for supplemental vitamin E or other antioxidant vitamins. However, given the number of deaths from stroke in the present cohort, a small-to-moderate association could not be ruled out. Am J Clin Nutr 2000;72:476-83. KEY WORDS Antioxidant vitamins, stroke, diet, postmenopausal women, food-frequency questionnaire, prospective cohort study, cardiovascular disease, Iowa Women's Health Study

Make use of therapies proven to slow CAD, such as cholesterol-lowering drugs. ANAHEIM, CALIF. -- Hormone replacement therapy does not slow the progression of coronary artery disease in postmenopausal women [...]

SCHAIRER AND COLLEAGUES REPORTED THE RESULTS OF A cohort study. The population base was 46,355 postmenopausal women followed as part of the Breast Cancer Detection Demonstration Project, a nationwide breast [...]

QUESTION What is the feasibility and effectiveness of screening for ovarian cancer in postmenopausal women? DESIGN AND SETTING Randomized (concealed), unblinded, controlled trial with 7-year follow up in the United [...]