- Effect of oral phytoestrogens on endometrial thickness and breast density of perimenopausal and postmenopausal women: A systematic review and meta-analysis. [Review]
- MMaturitas 2019; 124:81-88
- CONCLUSIONS: Phytoestrogens have no effect on endometrial thickness or breast density, when administered at various doses and for various durations, in perimenopausal and postmenopausal women. However, the high heterogeneity of the studies makes it necessary to conduct RCTs with less risk of systematic error.
- Symptom severity and quality of life in the management of vulvovaginal atrophy in postmenopausal women. [Journal Article]
- MMaturitas 2019; 124:55-61
- CONCLUSIONS: Postmenopausal women with VVA receiving treatment complained of more severe symptoms than those untreated. Women on systemic treatment had fewer and milder VVA symptoms and presented with better vaginal and vulvar health than women on other treatments. Many women request effective local treatment too late, when VVA symptoms are already severe. Our data suggest that VVA treatments should ideally be initiated when symptoms commence and cause distress, rather than later, when symptoms may have become more severe and even a cause of intolerable distress for the woman.
- Menopause and Sleep Apnea. [Review]
- MMaturitas 2019; 124:35-38
- Obstructive sleep apnea (OSA) is a chronic and common adult disorder characterized by recurrent episodes of upper-airway obstruction and reopening during sleep. OSA is associated with intermittent hy…
Obstructive sleep apnea (OSA) is a chronic and common adult disorder characterized by recurrent episodes of upper-airway obstruction and reopening during sleep. OSA is associated with intermittent hypoxia, sympathetic overactivity, oxidative stress and high cardiovascular mortality and morbidity. It is known to be more common in men than women, partly due to differences in anatomy and functional respiratory components. There are also gender differences in reported symptoms, leading to potential under-diagnosis in females. This gender difference tends to decrease after menopause, demonstrating a role of menopausal status itself in OSA phenotypes. Aging, fat mass distribution, sex hormones and upper-airway collapsibility are postulated to play a major role in these findings. This review focuses on the most recent studies exploring gender differences in the prevalence, pathogenesis and clinical features of OSA. It discusses the role of menopause in this, and explore the underlying pathophysiological mechanisms.
- Evaluating attitudes about aging and body comparison as moderators of the relationship between menopausal status and disordered eating and body image concerns among middle-aged women. [Journal Article]
- MMaturitas 2019; 124:25-31
- CONCLUSIONS: These findings suggest that the effects of menopause on dietary restraint may be stronger for some women than others.
- H19 lncRNA identified as a master regulator of genes that drive uterine leiomyomas. [Journal Article]
- OOncogene 2019 May 15
- Uterine leiomyomas or fibroids (UFs) are benign tumors characterized by hyperplastic smooth muscle cells and excessive deposition of extracellular matrix (ECM). Afflicting ~80% of women, and symptoma…
Uterine leiomyomas or fibroids (UFs) are benign tumors characterized by hyperplastic smooth muscle cells and excessive deposition of extracellular matrix (ECM). Afflicting ~80% of women, and symptomatic in 25%, UFs bring tremendous suffering and are an economic burden worldwide; they cause severe pain and bleeding, and are the leading cause of hysterectomy. Yet, UFs are severely understudied with few effective treatment options available; those that are available frequently have significant side effects such as menopausal symptoms. Recently, integrated genome-scale studies have revealed mutations and fibroid subtype-specific expression changes in key driver genes, with MED12 and HMGA2 together contributing to nearly 90% of all UFs, but their regulation of expression is poorly characterized. Here we report that the expression of H19 long noncoding RNA (lncRNA) is aberrantly increased in UFs. Using cell culture and genome-wide transcriptome and methylation profiling analyses, we demonstrate that H19 promotes expression of MED12, HMGA2, and key ECM-remodeling genes via multiple mechanisms including a new class of epigenetic modification by TET3. Our results mark the first example of an evolutionarily conserved lncRNA in pathogenesis of UFs and regulation of TET expression. Given the link between a H19 single-nucleotide polymorphism (SNP) and increased risk and tumor size of UFs, and the existence of multiple fibroid subtypes driven by key pathway genes regulated by H19, we propose a unifying mechanism for pathogenesis of uterine fibroids mediated by H19 and identify a pathway for future exploration of novel target therapies for uterine leiomyomas.
- The clavipectoral fascia as the unique anatomical criteria for distinguishing breast parenchymal lesions from axillary lymph node metastasis. [Case Reports]
- JSJ Surg Case Rep 2019; 2019(5):rjz135
- Diagnosing primary breast tumors of the axillary tail of Spence may be extremely challenging, since several lesions may be located in the axillary fossa. In the presented case, a 54-year-old post-men…
Diagnosing primary breast tumors of the axillary tail of Spence may be extremely challenging, since several lesions may be located in the axillary fossa. In the presented case, a 54-year-old post-menopausal Caucasian female patient presented to our institution complaining about a lump in her left axilla. The preoperative imaging modalities could not clarify whether the tumor is part of the tail of Spence or metastasis of the axillary lymph nodes. The diagnosis of primary adenocarcinoma of the axillary tail of Spence was made during a quadrantectomy of the left breast after the clavipectoral fascia, which constitutes the sole anatomical boundary between breast and axilla, was identified.
- Effects of conjugated estrogen and bazedoxifene on hemostasis and thrombosis in mice. [Journal Article]
- ECEndocr Connect 2019 May 01
- Estrogen-progestin therapy was previously considered as the standard of care for managing bothersome symptoms associated with menopause, but it increases risks of breast cancer and of thromboembolism…
Estrogen-progestin therapy was previously considered as the standard of care for managing bothersome symptoms associated with menopause, but it increases risks of breast cancer and of thromboembolism. The combination of conjugated estrogen (CE) with bazedoxifene (BZA) named tissue-selective estrogen complex (TSEC) was designed to minimize or even abrogate the undesirable effects on breast, while maintaining the beneficial effects such as prevention of osteoporosis and suppression of climacteric symptoms. The risk on thromboembolism associated with TSEC is unknown, although the clinical available data are reassuring. The aim of this study was to define the impact of a chronic administration of CE, BZA or CE+BZA on hemostasis and thrombosis in ovariectomized mice. As expected, CE, but not BZA neither CE+BZA, induced uterine and vagina hypertrophy. As previously demonstrated for 17beta-estradiol (E2), we found that CE: i) increased tail-bleeding time, ii) prevented occlusive thrombus formation in injured carotid artery, and iii) protected against collagen/epinephrine-induced thromboembolism. Thus, whereas BZA antagonized CE action on reproductive tissues, it had no impact on the effect of CE on hemostasis, thromboembolism and arterial thrombosis in mice. CE+BZA shared the anti-thrombotic actions of CE in these mouse models. If a similar process is at work in women, CE combined with BZA could contribute to minimize the risk of thrombosis associated with hormone replacement therapy.
- Preliminary utilization of radiomics in differentiating uterine sarcoma from atypical leiomyoma: Comparison on diagnostic efficacy of MRI features and radiomic features. [Journal Article]
- EJEur J Radiol 2019; 115:39-45
- CONCLUSIONS: Ill-defined tumor margin and interrupted uterine endometrial cavity of older women were predictors of uterine sarcoma. Radiomic analysis was feasible. Optimal radiomic model showed comparable diagnostic efficacy with experienced radiologists.
- StatPearls: Estrogen Therapy [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Estrogen therapy (ET), a form of hormone replacement therapy (HRT), is a useful way of combating the uncomfortable symptoms that often accompany menopause. Roughly 1.5 million women between the ag…
Estrogen therapy (ET), a form of hormone replacement therapy (HRT), is a useful way of combating the uncomfortable symptoms that often accompany menopause. Roughly 1.5 million women between the ages of 45 and 55 experience menopausal symptoms, which often involve hot flashes, flushing, and night sweats, also known as vasomotor symptoms. Additional symptoms include irritability, mood and sleep disturbances, fatigue, decreased libido, dyspareunia, and atrophic vaginitis. The Women's Health Initiative trial has made the use of estrogen therapy obsolete in terms of preventing vasomotor symptoms, osteoporosis, and cardiovascular diseases. Although estrogen therapy remains a controversial treatment in symptomatic menopausal women, due to the risks potentially outweighing the benefits, there is a definite need for estrogen therapy, particularly in the non-systemic form, in women experiencing distressing symptoms. Without it, a third of women experience at least itching, irritation, dryness, and dyspareunia, leading to decreased quality of life. Localized estrogen treatment often relieves these symptoms and significantly increases the quality of life, which includes life-changing improvements in sexuality, the incidence of urinary tract infections, and incontinence. The method of estrogen delivery is vital in assessing its benefits and uses. For example, the use of estrogen transdermally, in stark contrast to orally, has been linked to a lower risk of deep vein thrombosis, cholecystitis, osteoporosis, and stroke. The use of estrogen therapy has also been beneficial in a patient with an increased risk of osteoporotic fractures with long-term use.
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- Prevalence of sarcopenia and associated factors in climacteric women of the Colombian Caribbean. [Journal Article]
- MMenopause 2019 May 06
- CONCLUSIONS: Sarcopenia was present in this middle-aged female Colombian Caribbean sample and associated with various factors such as ethnicity, age, and menopausal symptoms and status.