Selección de Resúmenes de Menopausia
Semana del 16 al 22 de Diciembre de 2009
Juan Enrique Blümel. Departamento Medicina Sur. Universidad de Chile
Invest Ophthalmol Vis Sci. 2009 Dec 17. [Epub ahead of print]
Postmenopausal
Hormone Therapy Increases Retinal Blood Flow and Protects the Retinal Nerve Fiber Layer.
Deschênes
MC, Descovich D, Moreau M, Granger L, Kuchel GA, Mikkola TS, Fick GH, Chemtob S, Vaucher E, Lesk MR.
Ophthalmology,
PURPOSE:
To investigate whether postmenopausal hormone therapy (HT) increases retinal
and optic nerve head (ONH) blood flow, and protects ONH topography and the
function of retinal ganglion cells in postmenopausal women (PMW). The effect of
estradiol (E(2)) treatment
on retinal tissue perfusion was also investigated in ovariectomized
rats, an animal model for menopause. METHODS: Sixty-four healthy PMW were
recruited, 29 who never used HT (ØHT) and 35 who used HT (+HT) continuously
since menopause onset. Blood flow of the infero-temporal
retinal artery (ITRA), peripapillary retina, and ONH
rim were measured in one eye. The ONH stereometric
parameters and the pattern electroretinogram (PERG)
were also measured. In ovariectomized rats, the
retinal tissue perfusion was assessed using the BF tracer N-Isopropyl-p-[(14)C]-iodoamphetamine ([(14)C]-IMP)
in rats treated with either E(2) (n=7) or placebo (n=5). RESULTS: Compared to
the ØHT group, the +HT group presented significantly greater BF of the ITRA
(p=0.006), greater rim volume for the entire ONH region (p=0.032), and greater
rim volume (p=0.042), height variation contour (p=0.011), mean thickness
(p=0.033) and cross-sectional area (p=0.020) of the retinal nerve fiber layer for the infero-temporal
region of the ONH when adjusted for age, ocular perfusion pressure and age at
menarche. In ovariectomized rats, E(2)
treatment significantly increased the retinal perfusion with a range of 22-45%.
CONCLUSIONS: These findings indicate that estrogens and HT increase retinal
blood flow and protect the retinal nerve fiber layer.
Endocr Rev. 2009 Dec 17. [Epub ahead of print]
Estrogen Therapy and Cognition: A Review of the
Cholinergic Hypothesis.
The
pros and cons of estrogen therapy for use in
postmenopausal women continue to be a major topic of debate in women's health.
Much of this debate focuses on the potential benefits vs. harm of estrogen therapy on the brain and the risks for cognitive
impairment associated with aging and Alzheimer's disease. Many animal and human
studies suggest that estrogens can have significant beneficial effects on brain
aging and cognition and reduce the risk of Alzheimer's-related dementia;
however, others disagree. Important discoveries have been made, and hypotheses
have emerged that may explain some of the inconsistencies. This review focuses
on the cholinergic hypothesis, specifically on evidence that beneficial effects
of estrogens on brain aging and cognition are related to interactions with
cholinergic projections emanating from the basal forebrain. These cholinergic
projections play an important role in learning and attentional processes, and their function is known to
decline with advanced age and in association with Alzheimer's disease. Evidence
suggests that many of the effects of estrogens on neuronal plasticity and
function and cognitive performance are related to or rely upon interactions
with these cholinergic projections; however, studies also suggest that the
effectiveness of estrogen therapy decreases with age
and time after loss of ovarian function. We propose a model in which deficits
in basal forebrain cholinergic function contribute to age-related changes in
the response to estrogen therapy. Based on this
model, we propose that cholinergic-enhancing drugs, used in combination with an
appropriate estrogen-containing drug regimen, may be
a viable therapeutic strategy for use in older postmenopausal women with early
evidence of mild cognitive decline.
Maturitas. 2009 Dec 15. [Epub ahead of print]
Hormone replacement after gynaecological cancer.
Dept of Gynaecological Oncology,
Treatment
of gynaecological cancer frequently results in the loss of ovarian function and
menopausal symptoms. Symptoms of iatrogenic menopause are usually significantly
more intense than those of natural menopause due to sudden onset of symptoms,
younger age and its effects on common physical and psychological problems of
cancer therapy like body image concerns and sexual dysfunction. The most
effective treatment for menopausal symptoms is hormone replacement therapy
(HRT). However, it is very controversial if HRT is safe in patients after a
gynaecological malignancy. The main concerns are the potential stimulation of
residual cancer and the induction of new hormone-dependent disease. However,
the majority of the most common gynaecological malignancies like squamous cell carcinomas of the cervix, serous papillary
epithelial ovarian carcinomas and squamous cell
carcinomas of the vulva are not oestrogen dependent. Furthermore, current
scientific evidence does not show HRT to adversely affect the outcome in
patients after treatment for hormone sensitive cancers like early stage endometrioid adenocarcinomas of
the endometrium. There are only a small number of
gynaecological malignancies like low grade endometrial stromal
sarcomas in which HRT is an absolute contraindication. Therefore, as
maintaining quality of life and minimising the physical and psychological
impact of treatment side effects is one of the most important factors in cancer
care, it is imperative to give patients unbiased information about their
individual cancer which in most cases will allow them to use HRT without any
detrimental effect on their survival.
Int J Endocrinol. 2010;2010:957174.
Epub 2009 Jul 21.
Simvastatin does not affect vitamin d status, but low
vitamin d levels are associated with dyslipidemia:
results from a randomised, controlled trial.
Rejnmark
L,
Vestergaard P, Heickendorff L, Mosekilde L.
Department of Endocrinology and Metabolism C, Aarhus Sygehus,
Objectives. Statin drugs act as inhibitors of the
3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) reductase enzyme early in the mevalonate
pathway, thereby reducing the endogenous cholesterol synthesis. In recent
studies, it has been suggested from epidemiological data that statins also may improve vitamin D status, as measured by
increased plasma 25-hydroxyvitamin D (25OHD) levels. We now report the results
from a randomised controlled trial on effects of simvastatin
on plasma 25OHD levels. Design and Methods. We
randomised 82 healthy postmenopausal women to one year of treatment with either
simvastatin 40 mg/d or placebo and performed
measurement at baseline and after 26 and 52 weeks of treatment. The study was
completed by 77 subjects. Results. Compared with
placebo, plasma levels of cholesterol and low-density lipoproteins decreased in
response to treatment with simvastatin, but our study
showed no effect of simvastatin on vitamin D status.
However, plasma levels of triglycerides were inversely associated with tertiles of plasma 25OHD levels and changes in plasma
triglycerides levels correlated inversely with seasonal changes in vitamin D
status. Conclusion. Our data do not support a
pharmacological effect of statins on vitamin D
status, but do suggest that vitamin D may influence plasma lipid profile and
thus be of importance to cardiovascular health.
Menopause.. [Epub ahead of print]
The
Acupuncture on Hot Flashes Among Menopausal Women
study: observational follow-up results at 6 and 12 months.
Borud
EK,
Alraek T, White A, Grimsgaard S.
From
the 1The National Research Center in Alternative and
Complementary Medicine, University of Tromsø, Tromsø, Norway; 2Department of General Practice and Primary
Care, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter,
UK; and 3Clinical Research Center, University
Hospital of North Norway, Tromsø, Norway.
OBJECTIVE:: The previously published Acupuncture on Hot Flashes Among
Menopausal Women study compared the effectiveness of individualized acupuncture
treatment plus self-care versus self-care alone on hot flashes and
health-related quality of life in postmenopausal women. This article reports on
the observational follow-up results at 6 and 12 months. METHODS:: The Acupuncture on Hot Flashes Among Menopausal Women
study was a pragmatic, multicenter randomized controlled trial with two
parallel arms, conducted in 2006 to 2007. The 267 participants were
postmenopausal women experiencing, on average, 12.6 hot flashes per 24 h. The
acupuncture group received 10 individualized acupuncture treatments during 12
weeks and advice on self-care, whereas the control group received only advice
on self-care. Hot flash frequency and intensity (0-10 scale) and hours of sleep
per night were registered in a diary. Health-related quality of life was
assessed by the Women's Health Questionnaire. RESULTS::
From baseline to 6 months, the mean reduction in hot flash frequency per 24
hours was
Climacteric.. [Epub
ahead of print]
Optimal
tolerability of ultra-low-dose continuous combined 17beta-estradiol and norethisterone acetate: laboratory and safety results.
Department of Obstetrics and Gynecology, Kvinnokliniken, Universitetssjukhuset,
Objective
To evaluate the influence of two ultra-low doses of
oral continuous combined hormone therapy and placebo on metabolic parameters,
and to assess safety endpoints and overall tolerability in healthy
postmenopausal women. Design In a subpopulation of the Clinical study on
Hormone dose Optimisation In Climacteric symptoms Evaluation (CHOICE) trial,
lipids and parameters of glucose metabolism and hemostasis
were analyzed in Nordic women (n = 158) at baseline and after 12 and 24 weeks
of treatment with 0.5 mg 17beta-estradiol (E2) + 0.25 mg norethisterone
acetate (NETA), 0.5 mg E2 + 0.1 mg NETA or placebo. Adverse events occurring
from the first trial-related activity, whether related or not related to the
study medication, were recorded for the entire population (n = 575) of the
trial. The seriousness, relationship to treatment and the reason for withdrawal
were reported. Results Both ultra-low-dose
combinations were neutral to changes in lipid and lipoprotein, hemostasis parameters and carbohydrate metabolism during
the trial. The incidence of serious adverse events was only 1% in respective
treatment groups. Adverse events were the reason for withdrawal in only 2% and
6% of women in the 0.5 mg E2 + 0.25 mg and 0.1 mg NETA groups, and in 8% in the
placebo group. No weight gain or change in blood pressure was reported during
the trial in any of the study groups. Conclusion The
treatments had neutral effects on metabolic parameters in the study population.
Excellent tolerability of both ultra-low doses resulted in high completion
rates.
Semana del 9 al 15 de Diciembre de 2009
Osteoporos Int. 2009 Dec 9. [Epub ahead of print]
Use of
oral bisphosphonates and risk of venous thromboembolism: a population-based case-control study.
Lamberg AL, Horvath-Puho E, Christensen S, Sørensen HT.
Department of Clinical Epidemiology,
Aarhus University Hospital, Olof Palmes
Allé 43-45, 8200, Aarhus N, Denmark, al@dce.au.dk.
Oral bisphosphonates
are widely used for fracture prevention, but there is a concern regarding
potential adverse cardiovascular effects of bisphosphonates.
In this large, population-based case-control study, we found no evidence of an
association between bisphosphonate use and risk of
venous thromboembolism (VTE). INTRODUCTION: We
examined the relation between the use of oral bisphosphonates
for osteoporosis and the risk of VTE. METHODS: We conducted a population-based
case-control study in
Osteoporos Int. 2009 Dec 9. [Epub
ahead of print]
Pedometer
determined ambulatory activity and bone mass: a population-based longitudinal
study in older adults.
Menzies Research Institute,
In this large population-based study, walking was
assessed twice yearly for a week, each time by pedometer, had consistent
clinically important associations with hip areal bone mineral density (aBMD) in both sexes which appears most important in those
over 65 years of age suggesting that walking becomes more important with
increasing age. INTRODUCTION: Walking is advocated as a preventative strategy
for osteoporosis but the evidence is conflicting in females and lacking in
males. The aim of this population-based longitudinal study in community
dwelling older people (n = 875) was to determine the association between
pedometer determined ambulatory activity (PAA) and bone mass. METHODS: Bone
mass was assessed as aBMD at the hip and spine using
dual X-ray absorptiometry. Steps per day were
measured using pedometers for 1 week on four occasions at least 6 months apart.
Data were analysed using linear mixed models.
RESULTS: At baseline, PAA was positively associated with hip aBMD. An age interaction was present with steps having a
stronger association for those aged over 65 years. Longitudinally, the effect
of steps on hip aBMD was constant, but not additive
over time. For those over 65 years, the difference in hip aBMD
between the lowest and highest steps quartiles ranged from 3.1% to 9.4%. With
regard to the spine, the relationship between daily steps and spine aBMD was modified by sex. For males; there was no
significant relationship between steps and spine aBMD.
However, for females, higher steps were associated with higher spine aBMD with the effect being constant over time but not
additive. There was no evidence of a threshold effect. CONCLUSION: In
conclusion, pedometer-determined ambulatory activity has consistent clinically
important associations with hip aBMD in both sexes
which appears most important in those over 65 years of age. The
associations for spine aBMD were both weaker and
inconsistent suggesting site specificity.
Cogn Behav Neurol. 2009 Dec;22(4):205-14.
Aging, estrogens, and episodic memory in women.
Departments of
Health Research and Policy (Epidemiology), and of Neurology and Neurological
Sciences,
OBJECTIVE: To review the relation in
midlife and beyond between estrogen exposures and
episodic memory in women. BACKGROUND: Episodic memory performance declines with
usual aging, and impairments in episodic memory often portend the development
of Alzheimer disease. In the laboratory, estradiol
influences hippocampal function and animal learning.
However, it is controversial whether estrogens affect memory after a woman's
reproductive years. METHOD: Focused literature review, including a summary of a
systematic search of clinical trials of estrogens in which outcomes included an
objective measure of episodic memory. RESULTS: The natural menopause transition
is not associated with the objective changes in episodic memory. Strong
clinical trial evidence indicates that initiating estrogen-containing
hormone therapy after the age of about 60 years does not benefit episodic
memory. Clinical trial findings in middle-aged women before the age of 60 years
are limited by smaller sample sizes and shorter treatment durations, but these
also do not indicate substantial memory effects. Limited short-term evidence,
however, suggests that estrogens may improve verbal memory after surgical
menopause. Although hormone therapy initiation in old age increases dementia
risk, observational studies raise the question of an early critical window
during which midlife estrogen therapy reduces
late-life Alzheimer disease. However, almost no data address whether midlife estrogen therapy affects episodic memory in old age.
CONCLUSIONS: Episodic memory is not substantially impacted by the natural
menopause transition or improved by the use of estrogen-containing
hormone therapy after the age of 60 years. Further research is needed to
determine whether outcomes differ after surgical menopause or whether episodic
memory later in life is modified by midlife estrogenic exposures.
Gynecol Obstet Invest. 2009 Dec 7;69(3):145-152.
[Epub ahead of print]
Association between Bone Mineral Density and Metabolic
Syndrome in Postmenopausal Korean Women.
Department of Orthopedic Surgery,
Background/Aims: We investigated the
relationship between bone mineral density (BMD) of the femur neck or lumbar
spine and metabolic syndrome or its parameters in postmenopausal Korean women.
Methods: This study included 399 postmenopausal women, for whom the BMD of
their L2s-L4s and femur necks were examined in association with metabolic
syndrome. Results: Subjects with metabolic syndrome had a higher BMD of the
femur neck than those without metabolic syndrome when adjusted for age (0.85
+/- 0.09 vs. 0.82 +/- 0.12 g/cm(2), p = 0.011), while
there was no statistical difference at lumbar spine. When adjusted for age and
BMI, high-density lipoprotein cholesterol (HDL-C) was weakly and negatively
correlated with BMD of the lumbar and femur neck (r = -0.107, p = 0.033; r =
-0.111, p = 0.028 respectively). Conclusion: Metabolic syndrome was partly
associated with higher BMD in our postmenopausal Korean women. Our study also
showed that HDL-C levels were negatively associated with BMD of the lumbar
spine and femur neck which means that subjects with lower HDL-C levels could
have higher BMD. The results of our retrospective study revealed that metabolic
syndrome could be associated with higher BMD in our postmenopausal Korean
women.
Int J Gynecol Cancer. 2009 Dec;19(9):1556-9.
Normal production of human chorionic gonadotropin in perimenopausal
and menopausal women and after oophorectomy.
Cole LA, Khanlian SA, Muller
CY.
The
BACKGROUND: The normal pituitary
production of human chorionic gonadotropin (hCG)alongside luteinizing hormone,
and its presence in women after bilateral oophorectomy,
during perimenopause and menopause, as measured in
serum and urine, has been known for 30 years and is described in numerous
publications. Last year our group discussed this finding in a correspondence to
the editor in the March 15th issue of
Semana
del 2 al 9 de Diciembre de 2009
Osteoporos Int. 2009 Dec 5. [Epub
ahead of print]
Poor bisphosphonate adherence for treatment of osteoporosis
increases fracture risk: systematic review and meta-analysis.
Imaz I, Zegarra P, González-Enríquez J, Rubio B, Alcazar R, Amate JM.
Agency for Health
Technologies Assessment, Instituto de Salud Carlos III. Science and
Innovation Ministry, 5 Monforte de Lemos, Madrid, 28029, Spain, imaz@isciii.es.
Systematic review of adherence to bisphosphonates for the treatment of osteoporosis finds
suboptimal levels of persistence and compliance. Poor bisphosphonate
compliance increases fracture risk. INTRODUCTION: The objectives of the study
were to measure the persistence and compliance with bisphosphonates
for the treatment of osteoporotic patients, and to estimate the influence of
compliance on fracture risk. METHODS: A systematic review of bisphosphonate adherence in clinical practise provided new
evidence to perform a meta-analysis of the means of bisphosphonate
persistence and compliance, with a subsequent meta-analysis of fracture risk
comparing poorly versus highly compliant patients. RESULTS: Fifteen articles,
totalling 704,134 patients, met our inclusion criteria. Most of the patients
were postmenopausal women treated with bisphosphonates.
The 3.95% of the patients received hormone replacement therapy, but the rest
received bisphosphonates. The meta-analysis of five
articles totalling 236,540 patients, who were followed for 1 year, provided a
pooled persistence mean of 184.09 days. The meta-analysis of five articles,
totalling 234,737 patients, who were also followed for 1 year, provided a
pooled medication possession ratio mean of 66.93%. The meta-analysis of six
articles, totalling 171,063 patients, who were followed for varying periods of
time between 1 and 2.5 years, provided a pooled 46% increased fracture risk in
non-compliant patients versus compliant patients. The increased fracture risk
was lower for non-vertebral (16%) and hip (28%) than for clinical vertebral
fractures (43%). CONCLUSIONS: Persistence and compliance are suboptimal for
postmenopausal women undergoing bisphosphonate
therapy for osteoporosis. The clinical consequence of this low compliance is an
increased risk of fracture, which is lower for non-vertebral than for clinical
vertebral fractures.
World J Gastroenterol. 2009 Dec 7;15(45):5693-9.
Hepatic
steatosis in overweight/obese females: New screening
method for those at risk.
Tarantino G, Pizza G, Colao A, Pasanisi F, Conca P, Colicchio P, Finelli C, Contaldo F, Di Somma C, Savastano S.
Department of Clinical and Experimental
Medicine, Section of Hepatology in Internal Medicine,
Federico II University Medical School of Naples, Via Sergio Pansini,
5 80131 Naples, Italy. tarantin@unina.it.
AIM: To identify which parameters could
help to distinguish the "metabolically benign obesity", which is not accompanied by insulin resistance (IR) and early
atherosclerosis. METHODS: Eighty two of 124 overweight/obese females
formed the study population, which was divided into two groups (52 and 30
subjects, respectively) with and without IR according to a HO meostatic Metabolic Assessment (HOMA) cut-off of 2, and
were studied in a cross-sectional manner. The main outcome measures were waist
circumference, serum uric acid, high-density lipoprotein-cholesterol and
triglycerides, alanine aminotransferase,
blood pressure and the two imaging parameters, hepatic steatosis
and longitudinal diameter of the spleen, which were measured in relation to the
presence/absence of IR. RESULTS: A variable grade of visceral obesity was
observed in all subjects with the exception of three. Obesity of a severe grade
was represented more in the group of IR individuals (P = 0.01). Hepatic steatosis, revealed at ultrasound, was more pronounced in
IR than in non-IR subjects (P = 0.005). The two groups also demonstrated a
clear difference in longitudinal spleen diameter and blood pressure, with
raised and significant values in the IR group. Metabolic syndrome was frequent
in the IR group, and was not modified when adjusted for menopause (P = 0.001).
At linear regression, the beta values of waist circumference and body mass
index predicting HOMA were 0.295, P = 0.007 and 0.41, P = 0.0001, respectively.
Measures of spleen longitudinal diameter were well predicted by body mass index
(BMI) values, beta = 0.35, P = 0.01, and by HOMA, beta = 0.41, P = 0.0001.
Blood pressure was predicted by HOMA values, beta = 0.39, P = 0.0001). HOMA and
hepatic steatosis were highly associated (rho = 0.34,
P = 0.002). Interestingly, IR patients were almost twice as likely to have
hepatic steatosis as non-IR patients. Among the MS
criteria, blood pressure was very accurate in identifying the presence of IR
(AUROC for systolic blood pressure 0.66, cut-off
Cerebrovasc Dis. 2009 Dec 1;29(2):130-136.
[Epub ahead of print]
Low
Bone Mineral Density Is an Independent Risk Factor for Stroke and Death.
Nordström A, Eriksson M, Stegmayr B, Gustafson Y, Nordström P.
Department of
Community Medicine and Rehabilitation, Rehabilitation Medicine,
Background: Recent studies suggest a
relationship between atherosclerotic disease and osteoporosis. The aim of the
study was to investigate whether bone mineral density (BMD) was prospectively
related to stroke and death. Methods: BMD (g/cm(2))
was measured in 4,302 men and women (mean age 59 years, range 40-75) at
baseline. The main outcome measures included validated strokes and death.
Results: After a mean follow-up time of 5.6 years (range 0-15.8 years), 139
strokes were registered and 224 subjects had died. After adjustment for age,
sex and body mass index, decreased femoral neck BMD and osteoporosis were found
to be independent predictors of stroke (hazard ratio, HR, for each standard
deviation decrease in BMD = 1.23, 95% CI = 1.01-1.49, and HR for osteoporosis =
1.92, 95% CI = 1.11-3.30). After adjustment for the same variables, the risk of
death during follow-up was related to femoral neck BMD (HR = 1.41, 95% CI =
1.21-1.64) and osteoporosis at baseline (HR = 2.05, 95% CI = 1.28-3.29). Adjustment
also for smoking, hypertension, hyperlipidemia and
diabetes did not change any of these results. Conclusions: We found that
decreased BMD as well as osteoporosis of the femoral neck are independently
associated with stroke and death. Given the impact of osteoporosis and stroke
on morbidity and mortality, this relationship is of high interest for further
studies.
Eur J Clin Nutr. 2009 Dec 2. [Epub ahead of print]
Relationship of 25-hydroxyvitamin D with all-cause and
cardiovascular disease mortality in older community-dwelling adults.
Semba RD, Houston DK, Bandinelli S, Sun K, Cherubini A, Cappola AR, Guralnik JM, Ferrucci L.
Department of Ophthalmology, The
Background/Objectives:Vitamin D deficiency is associated with
cardiovascular disease, osteoporosis, poor muscle strength, falls, fractures
and mortality. Although older adults are at a higher risk of vitamin D
deficiency, the relationship of serum 25-hydroxyvitamin D (25(OH)D) with all-cause and cardiovascular disease mortality has
not been well characterized in the elderly. We hypothesized that low serum
25(OH)D levels predicted mortality in older adults.Subjects/Methods:Serum
25(OH)D as well as all-cause and cardiovascular disease mortality were examined
in 1006 adults, aged >/=65 years, who participated in the InCHIANTI (Invecchiare in
Chianti, Aging in the Chianti Area) study, a population-based, prospective
cohort study of aging in Tuscany, Italy. Serum 25(OH)D
levels were measured at the time of enrollment in
1998-1999, and participants were followed up for mortality.Results:During
6.5 years of follow-up, 228 (22.7%) participants died, of whom 107 died due to
cardiovascular diseases. Compared with participants in the highest quartile of
serum 25(OH)D (>26.5 ng/ml) (to convert to nmol/l, multiply by 2.496), those in the lowest quartile
(<10.5 ng/ml) had increased risk of all-cause
mortality (Hazard Ratio (H.R.) 2.11, 95% Confidence Interval (95% C.I.):
1.22-3.64, P=0.007) and cardiovascular disease mortality (H.R. 2.64, 95% C.I.:
1.14-4.79, P=0.02), in multivariate Cox proportional hazards models that adjusted
for age, sex, education, season, physical activity and other potential confounders.Conclusions:Older community-dwelling adults
with low serum 25(OH)D levels are at higher risk of all-cause and
cardiovascular disease mortality.
Maturitas. 2009
Dec 5. [Epub ahead of print]
Progestational effects of dydrogesterone
in vitro, in vivo and on the human endometrium.
Institute for Medical Research and Education, Hufelandstrasse 55, D-45122
Dydrogesterone has a molecular
structure closely related to that of natural progesterone, but it has enhanced
oral availability compared with progesterone. The hormonal profile and the progestational potency of dydrogesterone
has been determined in vitro, in vivo and in humans,
in combination with estrogens or without. It showed varying affinity for
progesterone-binding proteins in uterine tissue in vitro, depending on the
species. It exerted a clear progestational response
in the rabbit in vivo, although the potency was influenced somewhat by the
route of administration. When used in hormone replacement therapy, 10mg dydrogesterone given sequentially provides adequate
protection against endometrial hyperplasia in postmenopausal women using 2mg estradiol. Similarly, a dydrogesterone
dose of 5mg also protects the endometrium when
continuously combined with 1mg estradiol. Dydrogesterone also has beneficial effects in women with
amenorrhea/oligomenorrhea, dysfunctional uterine
bleeding and irregular cycles. In conclusion, having a similar profile to
progesterone but with better oral availability, dydrogesterone
has been used successfully to treat disorders related to absolute or relative
progesterone deficiency.
Int J Psychiatry Med. 2009;39(3):283-95.
The effects of female reproductive
hormones in generalized social anxiety disorder.
van Veen
JF, Jonker BW, van Vliet
IM, Zitman FG.
Department of Psychiatry B1-P,
OBJECTIVE: Although generalized social anxiety
disorder (gSAD) is more prevalent in women, the role
of female reproductive hormones in gSAD has never
been investigated. Therefore, our aim was to make a first inventory of the
influence of female reproductive hormones on gSAD
symptoms. METHOD: Female patients with gSAD who had
previously participated in our research projects in the