Background: Serum estradiol levels decline after menopause and the effect on mental health-related quality of life (MHR-QOL) is unclear. Objective: To determine if there is an association between endogenous serum estradiol levels and MHR-QOL in healthy postmenopausal women. Methods: This cross-sectional study used baseline Canadian data from the Mammary Prevention.3 trial. Serum estradiol was measured with liquid chromatography-tandem mass spectrometry. Outcomes for MHR-QOL were the Medical Outcomes 36-Item Short Form Health Survey (SF-36) Mental Health Inventory-5 (MHI-5), Mental Component Summary (MCS), and the Menopause-Specific Quality of Life Questionnaire (MENQOL)-psychosocial domain. Results: There were no statistically significant associations between estradiol levels and MHR-QOL in univariate analyses (n=455). Multivariable linear regression predicted statistically significant differences in MCS (R2=0.10, P=0.03) and MENQOL-psychosocial domain (R2=0.10, P=0.04), however estradiol was not a significant predictor. Conclusions: This study did not find a statistically significant association between endogenous serum estradiol levels and MHR-QOL in healthy postmenopausal women.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 76-85).

Thesis (M.S.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed on Sept. 3, 2009). Includes bibliographical references (p. 50-67).

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 83-91).

abstract: The objective of this study was to examine the potential effects of long term hormone replacement therapy on cardiovascular autonomic nervous system responses to laboratory social stressors. The participants were 38 postmenopausal women, 18 using estrogen and progesterone hormone replacement therapy for at least 2 years and 20 control participants without hormone replacement therapy. All women completed orthostasis (standing and sitting), then speech and math tasks (speech and math were counterbalanced). Cardiovascular measures of sympathetic nervous system (pre-ejection period, PEP) and parasympathetic nervous system (respiratory sinus arrhythmia, RSA) along with heart rate were collected throughout all periods (baseline, orthostasis, and stressors). For orthostasis, results of mixed analyses of variance (ANOVAs) showed expected period effects for heart rate, RSA and PEP, but no group or group by period interaction was significant. For the psychological stressors, period main effects were significant for all three variables, suggesting that the tasks were effective at inducing stress. Also, there was a significant interaction between group and period for RSA, demonstrated by greater decrease during the psychological stressor period in the group using HRT. The interactions between group and period for heart rate and PEP were non-significant. These findings support the notion that HRT may slow age-related decreases in parasympathetic responsiveness. Furthermore, changes in vagal reactivity in relation to use of HRT appear to occur within mechanisms involving response and coping with psychological stressors, rather than mechanisms that accommodate basic physiological task such as orthostasis. / Dissertation/Thesis / M.S. Psychology 2013

Orientador: Lúcia Helena Simões da Costa Paiva / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T17:10:16Z (GMT). No. of bitstreams: 1 Leao_RogeriodeBarrosFerreira_M.pdf: 2600347 bytes, checksum: 3c70f4a08f6a98df16d66375a85ccd5f (MD5) Previous issue date: 2012 / Resumo: Introdução: O tamoxifeno é utilizado no tratamento do câncer de mama receptor de estrogênio positivo. Seu mecanismo de ação está na inibição do crescimento das células malignas por antagonismo competitivo com estrógenos pelos receptores estrogênicos. A ação do tamoxifeno nestes receptores é variável e, dependendo do tecido, pode ter ação antagonista ou agonista. Em mulheres menopausadas usuárias de tamoxifeno, observa-se uma maior incidência de patologias endometriais, sendo o pólipo endometrial a alteração mais frequente. Sua patogênese não está bem estabelecida, mas parece estar relacionada a fatores hormonais. Objetivos: Comparar a expressão de receptor de estrógeno (RE) e de receptor de progesterona (RP) em pólipos endometriais de usuárias de tamoxifeno com pólipos endometriais e endométrio atrófico de não usuárias na pós-menopausa. Material e métodos: Entre mulheres submetidas à histeroscopia cirúrgica no Hospital da Mulher Prof. Dr. Aristodemo Pinotti - CAISM/UNICAMP de janeiro de 1998 a dezembro de 2008, foram selecionadas 84 mulheres na pós-menopausa usuárias de tamoxifeno, com pólipo endometrial benigno. Esse grupo foi comparado a 84 amostras de endométrio atrófico e 252 pólipos benignos de mulheres na pós-menopausa não usuárias de tamoxifeno e sem antecedente de terapia hormonal. As expressões de RE e RP foram avaliadas através de imuno-histoquímica segundo a porcentagem de células coradas, intensidade da coloração nuclear e escore final. A expressão de RE e RP no epitélio glandular e no estroma dos pólipos de usuárias de tamoxifeno foi comparada com o endométrio atrófico e os pólipos de não usuárias separadamente, utilizando o Teste de Mann-Whitney, corrigido pelo método de Bonferroni, teste exato de Fisher ou Qui-quadrado. Resultados: os pólipos de usuárias de tamoxifeno apresentaram maior expressão de RE e RP no epitélio glandular e estroma, em relação ao endométrio atrófico (p<0,0001). Em relação aos pólipos de não usuárias, as usuárias apresentaram maior expressão de RP no epitélio glandular (p=0,0014) e estroma (p=0,0056), não apresentando diferença significativa em relação ao RE. A maioria dos pólipos das usuárias e não usuárias de tamoxifeno apresentavam RE/RP positivos enquanto a maioria dos endométrios atróficos era RE/RP negativos. Conclusões: Os pólipos apresentam aumento frequente de RE, independentemente do uso do tamoxifeno. Por outro lado, os altos níveis de RP parecem consistentes com os efeitos agonistas da droga / Abstract: Introduction: Tamoxifen has been used for the treatment of strogen receptor-positive breast cancer. The effect of tamoxifen in breast cancer is the it inhibition cancer cell growth by competitive antagonism with strogen for strogen receptor (ER). The mechanism of action of tamoxifen in this receptor varies among different tissues, with antagonist effect (e.g. in breast) ou agonist (e.g. in endometrium). Thus, in menopausal women who use tamoxifen, a higher incidence of endometrial alterations is observed and endometrial polyps are the most common. The pathophysiology of endometrial polyp is still not definitely established but it seems to be related to hormone influence. Objectives: To compare the expression of estrogen receptors (ER) and progesterone receptors (PR) in endometrial polyps of tamoxifen users to atrophic endometrium and endometrial polyps of postmenopausal nonusers of tamoxifen. Material and methods: Among women undergoing surgical hysteroscopy in Hospital da Mulher Prof. Dr. Aristodemo Pinotti - CAISM/UNICAMP, from January 1998 to December 2008, 84 tamoxifen users with benign endometrial polyp were selected. This group was compared to 84 samples of atrophic endometrium and 252 benign polyps of postmenopausal women who were non-users of tamoxifen and no previous history of hormone therapy use. ER/PR expression was assessed by immunohistochemistry study according to the percentage of stained cells, intensity of nuclear color and final score. The expression ER and PR in the glandular epithelium and stroma of polyp tissue from tamoxifen users was compared to atrophic endometrium and polyps from non-users separately, using the Mann-Whitney test corrected by the Bonferroni method, Fisher's exct test or Chi-square test. Results: Polyps of tamoxifen users had a higher expression of ER and PR in the glandular epithelium and stroma, in relation to the atrophic endometrium (p<0.0001). Regarding polyps of women not treated with tamoxifen, users had a higher PR expression in the epithelium (p=0.0014) and stroma (p=0.0056), without any difference in ER expression. Most of polipys expressed ER/PR positives while atrophic endometrium were ER/PR negatives. Conclusions: Polyps frequently exhibit increase in ER expression, independent of the use of tamoxifen. High levels of PR seem to be consistent with agonist effects of the drug / Mestrado / Fisiopatologia Ginecológica / Mestre em Ciências da Saúde

Although many women find relief from menopause through hormone therapy (HT), current guidelines recommend that HT be used only for short-term relief of symptoms. Women who attempt to stop HT often encounter troublesome recurrent symptoms leading to a diminished quality of life (QoL); 25% of women who discontinue eventually resume HT. Unfortunately, there is little information for women and their health care providers as to the best way to discontinue HT or how to prepare and guide women through this process. An in-depth description of women‘s experiences during HT discontinuation and the factors influencing recurrent symptoms, QoL and discontinuation outcome would provide knowledge to develop much needed counseling and support interventions. The purpose of this study was to explore women‘s experiences discontinuing hormone therapy for menopause. This Internet-based mixed-methods study used a dominant Qualitative Descriptive design with embedded quantitative QoL measurements. Participants completed the quantitative questionnaires online while open-ended questions were completed either online or by telephone. Interview data were analyzed through Qualitative Content Analysis; descriptive statistics were used to explore the quantitative measures. Participants were stratified by discontinuation status for comparison of variations in discontinuation experiences, QoL and influencing factors. Thirty-four women (20 stopped, 9 resumed, 4 tapering) were enrolled. One overarching theme--'a solitary journey'--emerged: although all women embarked on this journey, each woman traveled her own path. Two subthemes--'burden and interference' and 'appraising risk'--encompassed the symptom factors (severity, interference and sensitivity) that influenced women's experiences and the manner in which women evaluated their options. Other influencing factors included: readiness viii and reasons for stopping HT, beliefs about menopause and roles. QoL was strongly connected to symptoms for many but not all women. Information from health care providers was inconsistent; women desired more support from providers and other women. The rich description of women's experiences stopping HT highlights the need for providers to assess women's sensitivity to symptoms and readiness to discontinue to determine which women might benefit from more support. Greater health literacy would enhance women's understanding of HT risks. More research is needed on symptom clusters and interference and strategies for minimizing their impact.