This investigation was conducted to determine the effect of estrogen replacement therapy (ERT) on vitamin B-6 status of postmenopausal women. Nineteen postmenopausal women served as subjects. Nine (54.7 + 4.7 years) were taking ERT (experimental group); ten (56.8 + 2.3 years) were not (control group). For three consecutive days, subjects recorded their dietary intake and collected their 24-hour urine specimens. On the fourth day, a fasting blood sample was drawn from the subjects. The dietary intake of vitamin B-6, as well as the concentration of total vitamin B-6 in plasma (PB6; and urine (UB6) were measured. PB6 and UB6 were determined by a microbiological method with Saccharomyces uvarum as the assay organism. The mean age, height, hematocrit and hemoglobin values were similar for the two groups. The experimental group was significantly heavier than the control group (p<0.05). The experimental group had a lower mean PB6 than the control group: 47.7 ± 19.7 nmol/L vs. 56.2 + 20.6 nmol/L. These means were not significantly different (p=0.05). PB6 was positively correlated with dietary vitamin B-6 intake (p=0.0001) and vitamin B-6 to protein ratio (p=0.0021). When the means were adjusted for dietary vitamin B-6 and the vitamin B-6 to protein ratio, the mean PB6 of the experimental group (42.7 nmol/L) was significantly lower than that of the control group (60.6 nmol/L) (p<0.05). PB6 was not positively correlated with either age (r=0.20) or the vitamin B-6 dietary history score (r=0.15). UB6 was similar for the two groups. UB6 correlated positively with daily dietary intake of vitamin B-6 (r=0.51, p<0.05) and the ratio of vitamin B-6 to protein (r=0.47, p<0.05), UB6 was not significantly correlated to urine volume (r=0.05). The mean daily intakes of vitamin B-6 and protein were similar for the two groups. One of the 19 subjects had a vitamin B-6 intake that was less than 67 percent of the RDA. Most subjects' (89%) intake of vitamin B-6 was adequate when the ratio of 0.016 mg of vitamin B-6 per g of protein was used as the standard. / Graduation date: 1990

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To determine the effect of estrogen on weight changes in women, eight adult females were followed for a period of six months subsequent to hysterectomy or ovariohysterectomy. Three groups comprised the study: 1) a hysterectomy or control group, 2) an ovariohysterectomy group with estrogen replacement therapy, and 3) an ovariohysterectomy without estrogen treatment group. Body weight, caloric intake, and activity level were recorded for the eight prospective subjects over the six month period. Weight data were gathered from past medical records on an additional 19 patients meeting the treatment criteria. Weight changes between groups were not statistically significant. A trend in weight changes among the groups was noted. The hysterectomy group lost five pounds, ovariohysterectomy treated group lost one pound and the untreated group, 0.2 pound. The same trend in weight changes was noted when data from prospective and retrospective subjects were combined. Caloric intake and activity levels did not explain all changes noted. Detailed information on subjects was presented as case studies. The results supported the concept that endogenous estrogen protects against weight gain; evidence did not support the comparable action of exogenous estrogen. Subjects having ovariohysterectomy stated that they experienced appetite changes such as cravings for sweets, undesirable muscle tone and body contour changes, and difficulty in ability to control weight. Further research with a larger sample size is needed to determine direct relationships between female hormones and suppression of weight gain in women. / Master of Science

Indiana University-Purdue University Indianapolis (IUPUI) / Menopausal symptoms, primarily hot flashes, are a pressing clinical problem for both naturally menopausal women and breast and ovarian cancer patients, with a high societal and personal cost. Hot flashes are poorly understood, and animal modeling has been scarce, which has substantially hindered the development of non-hormonal treatments. An emerging factor in the hot flash experience is the role of anxiety and stress-related stimuli, which have repeatedly been shown to influence the bother, frequency, and severity of hot flashes. Causal relationships are difficult to determine in a clinical setting, and the use of animal models offers the ability to elucidate causality and mechanisms. The first part of this work details the development and validation of novel animal models of hot flashes using clinically relevant triggers (i.e., compounds or stimuli that cause hot flashes in clinical settings), which also increase anxiety symptoms. These studies revealed that these triggers elicited strong (7-9 °C) and rapid hot flash-associated increases in tail skin temperature in rats. In a surgical ovariectomy rat model of menopause, which typically exhibit anxiety-like behavior, hot flash provocation revealed an ovariectomy-dependent vulnerability, which was attenuated by estrogen replacement in tested models. An examination of the neural circuitry in response to the most robust flushing compound revealed increased cellular activity in key thermoregulatory and emotionally relevant areas. The orexin neuropeptide system was hyperactive and presented as a novel target; pretreatment with selective and dual orexin receptor antagonists significantly diminished or eliminated, respectively, the response to a hot flash provocation in ovariectomized rats. The insertion/deletion polymorphism of the serotonin transporter has been linked to increased anxiety-associated traits in humans, and subsequent studies prolonged hot flashes in SERT+/- rats, which also caused hot flashes in highly symptomatic women. These studies indicate the orexin system may be a novel non-hormonal treatment target, and future studies will determine the therapeutic importance of orexin receptor antagonists for menopausal symptoms.

Thesis (MA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: The popular media ("Media" here referring to newspapers, magazines. television, internet) adds to confusion and panic when reporting on the risks and benefits of Hormone Replacement Therapy for women (HRT). Most reports show bias, cast scientists as villains, or leave the reader more confused than before about terminology. The Southern African media does in general aspire to objectivity towards both the pharmaceutical and natural health industry. However, shallow or inept reporting, the need to generalise complicated findings and dramatise what's regarded as cold scientific news, create this bias and confusion. Misleading health reporting, in South Africa as much as anywhere else in the world, can change health behaviour and can even cost lives. Ethical health reporting can therefore be described as a matter of life and death. This paper aims to analyse the media for biased, confusing and alarmist reporting. It then aims to explain reasons for the bias or confusion. Fourteen reports are analysed. One Time magazine report, and 13 reports selected from the Southern African media. / AFRIKAANSE OPSOMMING: Berigte oor Hormoonvervangingsterapie (HVT) vir vroue in die media ("Media") hier verwys na koerante, tydskrifte, televisie, internet) dra by tot verwarring en paniek. Die meerderheid berigte is bevooroordeeld, in die sin dat medici as booswigte uitgebeeld word. Indien hulle nie bevooroordeeld is nie, is berigte verwarrend, soms juis in 'n poging om konsepte te vereenvoudig. Die media in Suider Afrika aspireer wel tot objektiwiteit, teenoor beide die farmaseutiese sowel as die holistiese (kruie) industrie. Nietemin, oppervlakkige/oningeligte verslaggewing en die behoefte om ingewikkelde navorsing te vereenvoudig/interessant te maak, dra by tot vooroordeel en verwarring. Misleidende mediese beriggewing in Suid Afrika, net soos in die res van die wêreld, kan mense hoop om besluite te neem wat hul gesondheid kan skaad. Die belang van etiese verslaggewing kan dus as 'n kwessie van lewe en dood beskryf word. Hierdie studie ontleed berigte en ondersoek vooroordeel, verwarring of sensasionalisering. Redes vir bogenoemde word dan bespreek. Veertien berigte word ontleed. (een berig uit die Amerikaanse tydskrif Time, en 13 uit die Suider Afrikaanse media)

No description available.

Low physical activity levels and high serum C-reactive protein (CRP) levels are risk factors for coronary artery disease (CAD) in both men and women. However, postmenopausal women who take hormone replacement therapy (HRT) may have increased risk of CAD because of HRT-related increases in serum CRP. There are two manuscripts in this dissertation. The purpose of the first manuscript was to determine whether higher physical activity energy expenditure was associated with lower serum CRP, independent of oral HRT status and body fatness, in 133 postmenopausal women. Higher physical activity energy expenditures were significantly associated with lower serum CRP levels (r=-0.21, p=0.0l9), independent of oral HRT use, age, smoking behavior, alcohol consumption, aspirin use, and statin use. However, in the complete multivariate model, which included body fat, the association between higher physical activity and lower serum CRP levels was abolished. The purpose of the second study was to quantify the biological variability of insulin resistant CAD risk factors in a sample of 8 postmenopausal women. Risk factor outcomes, including serum total cholesterol, serum triglycerides (TG), serum high-density lipoprotein cholesterol (HDL-C), serum glucose, plasma insulin, serum CRP, waist and hip circumferences, abdominal sagittal diameter, body fat, systolic (SBP) and diastolic blood pressure, and self-reported physical activity energy expenditure, were measured on two occasions, 7-12 days apart. High absolute biological variability values (by standard error of measurement) were observed for serum TG (32.0 mg/dl), serum CRP (5.6 mg/l), SBP (4.0 mmHg), and physical activity (9.4 kcal/kg/week). High relative biological variability (by within-subjects coefficient of variation ���27.3%) was also observed for serum TG, serum CRP, and physical activity. Bland-Altman plots identified individual outliers for serum TG, serum CRP, plasma insulin, and SBP. Together, the results suggest that the correlations between lower levels of serum CRP and higher levels of physical activity, though significant, may have been attenuated by the high biological variability of both serum CRP and physical activity. Thus, the importance of higher levels of physical activity, in decreasing serum CRP and the concomitant risk of heart disease, may be underestimated in the absence of serial measurement of serum CRP and physical activity. / Graduation date: 2002

In the United States, falls are the leading cause of unintentional death with one of every three people 65 years and older falling each year. Falls account for approximately 95% of hip fractures among older adults and falls to the side predominate hip fracture related falls in this population. However, risk factors for side and frequent falls are poorly understood. Furthermore, few data exist to explain differences in bone mineral density among older postmenopausal women. In particular, data regarding the timing of hormone replacement therapy (HRT) among older women is scarce. In the first aim of this dissertation, we examined changes in mobility and balance-related risk factors for side falls as well as differences in these risk factors according to fall status in a population of 107 independent, elderly women (>70 yrs), who were followed over 2 years. We found hip abduction strength decreased (p<.001) in all subjects, with side-fallers exhibiting weaker hip abduction strength (p=.008), greater sway velocity (p=.027), and slower performances on the tandem walk (p=.039) and Get Up and Go (p<.001) compared to non-fallers. For the second study, in the same population, we examined 2-year changes in balance self-efficacy (BSE) and the relationship of BSE to side fall risk factors and falls incidence. Results showed BSE at baseline was predictive of Get Up and Go, hip abduction strength and tandem walk at follow-up (p<.008), but that BSE decreased only among the non-fallers (p=.013). In the third study, we examined 3-yr hip bone mineral density (BMD) changes in women with distinct hormone replacement therapy (HRT) profiles: 1) no hormone replacement therapy (N0HRT), 2) HRT continually since menopause (Continual), 3) HRT begun 10 years after menopause (Late), 4) HRT initiated within 5 years (New), and compared the change in BMD of the hip across HRT groups. Only the NoHRT group lost bone over the 3 years (p=.014). We also assessed BMD of the lateral spine across levels of estrogen use in a sub-sample of participants and found long-term HRT users had significantly higher lateral spine BMD (p=.041) compared to women who had never been on HRT. / Graduation date: 2003

Findings released from recent pivotal clinical trials on hormone therapy (HT) benefits and risks have stimulated a growing trend towards lower doses and earlier discontinuation of HT for menopausal women. Yet, there is little knowledge regarding women's personal experiences with the resultant earlier and possibly abrupt withdrawal of HT. The purpose of this study was to explore postmenopausal women's vasomotor symptom experiences after discontinuing HT. The data for this study was collected from menopausal women who discontinued HT. The study questionnaire was created through an extensive review of the literature as well as an expert panel review. The questionnaire was also piloted with a small group of women prior to its use in this study. Data analysis consisted of descriptive analysis with means and standard deviations and/or frequency distributions with percentages for demographic data, health behaviors, factors influencing HT decisions, use of CAM and perceived efficacy. Chi-square analysis, Spearman Rho correlation, and logistic regression analysis were conducted for contextual factors and vasomotor symptom experiences. A McNemar test was performed to assess within group differences for vasomotor symptoms experiences pre and post HT. Questionnaires were received from 563 menopausal women throughout the United States. This study revealed that 80% of participants experienced vasomotor symptoms after discontinuing HT. The most common predictors which accounted for only 13% of variance in the occurrence of vasomotor symptoms were younger age, type of menopause and the occurrence of vasomotor symptoms prior to initiation of HT. Of the 563 women participating in the study, less than half reported the use of CAM to treat reemerging vasomotor symptoms. For the most part, less than half of the women felt their treatment choices were helpful in relieving their reemerging vasomotor symptoms Because a woman's experience of menopause can be highly individualized, an adaptation of Bronfenbrenner's ecological theory was used guide this exploratory study. The study findings supported the usefulness of the adaptation of Bronfenbrenner's ecological theory as a model through which to view the vasomotor experiences of menopausal women who have discontinued HT. / text

The effects of exogenous estrogen administration on aspects of memory and cognition in women were examined in two studies. In Study 1, women receiving estrogen replacement therapy were compared to untreated women on four measures of verbal memory. Those receiving estrogen had significantly better scores on a measure of delayed memory for propositional material. In Study 2, women in the early stages of Alzheimer's Disease (AD) were administered either estrogen or placebo on a double-blind basis for six months. Women given estrogen showed improvement on a measure of verbal memory and spatial attention compared to the placebo controls. The combined results of these studies provide evidence that estrogen enhances aspects of verbal memory in both healthy postmenopausal women and in postmenopausal women in the early stages of AD as measured by neuropsychological tests. These effects might be mediated by actions of estrogen on neuronal morphology and physiology in brain areas important for memory and cognition.