Natural Menopause Relief Secrets

Women's Midlife Revolution Summit

The Women's Midlife Revolution Summit is an online event that presents a wonderful opportunity for women to learn, bond and share in the privacy of their homes. The interviews of the day will be online viewable for 24 hours for absolutely FREE, starting at 10:00 am. And every day for eleven days, there will be another set of experts videos releasedfor 24 hours for FREE viewing. This will be 11 days packed with knowledge, experience, inspiration, and wisdom as Arnold interviews 22 female professionals, releasing two new interviews per day over this 11-day period. Female nutritionists, doctors, herbalists, holistic therapists, authors, life coaches, entrepreneurs, hormone experts, and physical trainers have all been gathered to lend credence to the joy of seasoned womanhood. Registration is free. You will be required to fill a registration form. After filling the form you will receive an email to click on a link to confirm your participation. Then 3 days before the event starts, you will receive the Playbook for this event, which you can download.You can join the talks easily on your PC, Tablet, Laptop or Cellphone. It is time to shed light on the myths and lies women are told about aging and let women reclaim their power. Continue reading...

Womens Midlife Revolution Summit Summary


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Highly Recommended

I started using this book straight away after buying it. This is a guide like no other; it is friendly, direct and full of proven practical tips to develop your skills.

As a whole, this book contains everything you need to know about this subject. I would recommend it as a guide for beginners as well as experts and everyone in between.

Have early menopause What does this mean for my bones and will I need treatment

Whether your early menopause (also called premature menopause) is caused by surgery, is for unknown reasons, or because of cancer treatments, your bones are at risk and you may need treatment. When you are trying to cope with the treatments for cancer, it's hard to think about your bones and the possibility of developing osteoporosis so early in life. But the fact is that when you stop having your menstrual periods for whatever reason, your risk of bone loss increases. When you experience a natural menopause around the average age of 51, you can expect to lose bone most rapidly in the 4 to 8 years following menopause (starting one year after your last period). There are several reasons why you might experience menopause much earlier than that and, therefore, need to cope with a larger stretch of your life without estrogen, an important hormone for bone growth. A very small percentage of women (1 ) experience natural menopause before the age of 40. It is not known why these people stop...

Menopausal Cognitive Impairments

Many middle-aged women report that during menopause, whether naturally occurring or surgically induced, they experience for the first time a constellation of persisting symptoms that closely resembles ADD syndrome. They note significant declines in short-term memory, in the ability to screen distractions and to sustain attention, in the organization and prioritizing of tasks, and so on. Some of these women are very competent, well-educated professionals and business executives who until menopause have never experienced significant impairments of ADD syndrome. In addition, women who have been diagnosed before menopause with ADD often report that their ADD symptoms tend to worsen for several days each month at about the time their estrogen level is probably lowest. As they enter menopause, many of these women also report significant exacerbation of their long-standing ADD symptoms. Basic neuroscience research by Bruce McEwen (1991) suggests that estrogen plays an important role in the...

What does menopause have to do with osteoporosis Are there different kinds of osteoporosis

Primary osteoporosis, although occurring in both men and women, is age-related and tends to occur mostly in women and about 10 years earlier than in men. This is because the rate of bone loss is different in women than men. Women rapidly lose bone in the four to eight years after menopause, and then continue with the slower rate of bone loss like men, who also experience bone loss over many years. Bone loss from primary osteoporosis is most common in the hip, but can affect all bones in the body. Menopause The time following menopause, when women rapidly lose bone and may develop osteoporosis. Estrogen-containing products used in the treatment of perimenopausal and menopausal symptoms. Estrogen taken for this purpose is called MHT (menopause hormone therapy). Sensations of heat, occurring during perimenopause and often well into post-menopause, that begin at the head and spread over the entire body. Sweating that occurs at night resulting from hot flashes during peri-menopause and...

Perimenopausal Stage

Estradiol and testosterone parameters during the menopausal transition. The concentrations of estradiol and testosterone, their blood production rates, and their metabolic clearance rates are shown for women at various indicated phases of perimenopause. FSH, follicle-stimulating hormone. (Data from ref. 32.) Burger and associates (35) also conducted longitudinal studies of women through the menopausal transition. As found by others, they noted little, if any, change in total testosterone levels leading up to, during, and for several years after menopause. However, reductions in SHBG levels were observed in concert with the reduction in estradiol observed leading up to the menopause and thereafter. The net effect of declining SHBG levels in the face of unwavering levels of testosterone is to increase the free testosterone fraction by 80 over the interval beginning 4 years prior to menopause and ending 2 years after the menopause. If free testosterone levels are actually...

Which bones are affected by osteoporosis

Menopause hormone therapy (MHT) Type of treatment used for the relief of menopause symptoms also helps to prevent bone loss. In primary osteoporosis, women lose 5 to 10 of cortical bone and 20 to 30 of trabecular bone during the rapid bone loss occurring in the four to eight years following menopause. In contrast, men and women (after the faster postmenopausal bone loss) experience a slower rate of bone loss as a result of aging. Occurring slowly over many years, this type of bone loss accounts for about a 20 to 25 loss of both cortical and trabecular bone. Thus, women are at risk for much greater bone loss than men.

Who gets osteoporosis

Both men and women can develop osteoporosis. Although more people with osteoporosis are women, particularly those who are postmenopausal, about two million men in the United States currently have osteoporosis, and one out of four will experience a fracture related to osteoporosis in his lifetime. Primary osteoporosis, which occurs in both men and women, is a result of aging. It occurs most frequently in postmenopausal women due to the rapid loss in bone associated with the normal drop in estrogen around menopause. The average age of menopause in the United States is 51. The World Health Organization reports that 35 of postmenopausal white women have osteoporosis. Primary osteoporosis or age-related osteoporosis tends to develop toward the end of life in men. The American Academy of Orthopedic Surgeons reports that almost 14 of men over the age of 85 have osteoporosis, while only 2 of men between the ages of 65 and 74 have osteoporosis. Menopausal women and men in later life are not the

Can I change any of my risk factors

You cannot change your age, gender, sex, race, fracture history, family history, menstrual history, time of menopause, genetic factors, and most medical conditions. You can, however, change some risk factors because most of them are related to lifestyle. Here's what you can do to lower your risk of developing osteoporosis or low bone mass Well, being black, I didn't really think it was a big problem for me. But my girlfriend just found out she has osteoporosis, and she has to take medication for it She told me to get tested, so I talked to my doctor about it. He said we don't need to test for it until after my periods stop, that the estrogen I have in my body helps protect my bones, but that after the estrogen goes down due to menopause, then I will need to be tested I asked what else I can do to protect my bones now and he said regular exercise, Vitamins C and D, and calcium. And he said it is good that I dont smoke. So I learned that I can be at risk, too

Bone Resorption Inhibitors

Hormone replacement therapy (HRT) Because the decline in estrogen levels following menopause is a major cause of osteoporosis, estrogen therapy is a logical treatment. Estrogen is most often combined with progesterone in this regimen to reduce the risk of uterine cancer associated with unopposed estrogen. This combination therapy was shown to increase bone mineral density (BMD) but the effect on fracture rate was initially unclear 4,5 . The recently released results of the large, five year, multi-center Women's Health Initiative estrogen plus progesterone (E + P) study indicated that the most commonly prescribed HRT therapy reduces fractures in postmenopausal women by 24 overall, and 33 in the hip 6 . These positive results were tempered by the findings of increased incidences of dementia and ovarian cancer in the same study. Increased caution is thus now recommended when considering the use of HRT for the prevention and treatment of post-menopausal osteoporosis. The study and...

Compounds In Human Clinical Trials

Early clinical results for two nonpeptide GnRH compounds, TAK-013 and NBI-42902 46 , have been reported at scientific meetings although reports have not appeared in a peer-reviewed journal as of this writing 47-50 . NBI-42902 showed good exposure following oral administration to post-menopausal women and dose-dependent suppression of LH 46 . TAK-013 was shown to suppress testosterone in healthy young men following a single oral dose 49 . In a 14-day study, premenopausal women receiving oral TAK-013 each day showed dose-dependent suppression of LH and estradiol, but no significant effect on FSH 48 . Comparison of day 1 and day 14 pharmacokinetics, as well as urinary 6-hydroxycortisol cortisol ratios, suggested that the compound was inducing CYP3A4. A multiple dose study in post-menopausal women confirmed the potential for CYP3A4 induction, but in this population FSH, as well as LH, was suppressed 47 .

Combination Antioxidant Secondary Prevention Trials

20,536 men and women aged 40-80 years, with CHD, diabetes or treated hypertension United Kingdom 423 postmenopausal women with coronary artery disease 8,171 female health professionals aged > 45 years, with CVD or > 3 coronary risk factors United States In the Women's Angiographic Vitamin and Estrogen (WAVE) trial, 423 post-menopausal women with coronary artery disease were randomized to a combination of vitamin E (400 IU twice daily) and vitamin C (500 mg twice daily) or placebo.67 After a mean follow-up of 2.8 years, those assigned to the high-dose antioxidant combination had the suggestion of an increased risk of death, stroke, or nonfatal MI (RR 1.5 95 CI, 0.80-2.9), but the confidence intervals were wide. This study suggested that there may be an increased risk associated with antioxi-dant combination supplements. In the Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) trial, 520 Finnish men and postmenopausal women with hypercholesterolemia were assigned to...

Hormonal Control of Adipogenesis and Osteogenesis 621 Estrogen

It is well-known that estrogen affects the accumulation and distribution of peripheral fat during sexual maturation and menopause (155,156). But there is also some evidence that oophorectomy-induced bone loss is accompanied by increased fat mass in BM (42,157), suggesting that BM fat may also be a target for estrogen.

Are there blood and urine tests that can be used to determine if I have bone loss

By measuring the byproducts of bone breakdown (usually in the urine) and bone formation (usually in the blood), the rate of bone turnover can be determined. If bone turnover is very rapid, like it is in women following menopause, the quality of bone may be poor, thus increasing the risk for fracture. If bone turnover is very rapid, like it is in women following menopause, the quality of bone may be poor, thus increasing the risk of fracture.

What are isoflavones Are they effective for treating osteoporosis

Because isoflavones have been found to act like estrogen in the body, isoflavones are being studied not only for their effects on the hot flashes associated with menopause, but also for their effects on bone health. Several small studies have shown some promise in reducing bone loss and increasing bone mineral density without some of the side effects of estrogen observed in other scientific studies. For example, isoflavones don't seem to increase breast density, increase endometrial thickness, or exert the same negative effects on your heart health. Further study is needed to confirm the bone findings reported when isoflavone supplements are taken. Isoflavones are considered safe when taken with other medications, such as the prescription medications described in Questions 56 to 67.

What types of medication are usually prescribed for osteoporosis

The North American Menopause Society (NAMS) advises that the following women receive prescription medication as part of their treatment for osteoporosis Postmenopausal women who sustain a fracture of a vertebra as a result of osteoporosis. Postmenopausal women whose T scores are lower than -2.5. Postmenopausal women with T scores lower than -2.0 with at least one additional risk factor for fracture. trying to break down old bone. Estrogen therapy (ET) is one of these types of medications and for post-menopausal women has been found to be very effective in the prevention of osteoporosis. ET is appropriate for preventing osteoporosis in postmenopausal women who are experiencing significant menopausal symptoms (see Questions 64-66). Other medications that fall into the group of drugs intended to prevent further loss by slowing down the breakdown of bone include bisphosphonates, calcitonin, and selective estrogen receptor modulators (SERMs). Questions 57 to 65 contain a full discussion of...

Microbiology And Pathogenesis

Normal variations in cervical-vaginal flora are related to the effects of age, pregnancy, and menstrual cycle (2). During early childhood, the normal flora is similar to that of adolescents or adults and includes Enterobacteriaceae and anaerobes. The prepubescent vagina is more supportive of growth of anaerobic bacteria, especially Bacteroides spp., than in adults (3). Also often recovered at that age group is S. epidermidis. In contrast yeasts and Gardnerella vaginalis are isolated in 10 of females (3). The microflora in females before puberty, during the child-bearing years, pregnancy, and after menopause are not uniform. Colonization with lactobacilli is low in prepubertal females and postmenopausal females and high in pregnant women as well as those in their reproductive years who are not pregnant.

Principal investigations continued

Post-test probability of cancer was less than 1 for an asymptomatic post-menopausal woman with an endometrial thickness of less than 5 mm. However, other studies have found that the detection rate for endometrial cancer varies according to the cut-off for abnormality and noted that the median endometrial thickness varies between centres.8 Another large metaanalysis evaluated 9031 patients. Four studies used the cut-off of 5 mm. A positive test raised the probability of carcinoma from a pre-test 14 to a post-test 31 , while a negative test reduced it to 2.5 . The authors concluded that the ultrasound measurement could not be used alone to rule out endometrial cancer. The depth of invasion, size and location of the tumour are also important prognostic factors obtained from ultrasound. They are not used for official staging, but can guide decisions on treatment or the planned surgery. For instance, larger tumours, i.e. > 2 cm, deeper invasion, i.e. > 30 and lower uterine segment...

Which bones am I more likely to break

Although my ankle fracture occurred about 5 months ago, I think it's going to take me a full year to recover. I never would have guessed that this type of fracture could take so long to heal. I still have some pain and quite a lot of swelling, although I'm able to get around on my own. My orthopedist said that I should expect to have arthritis in the ankle and to go back to the elliptical machine instead of walking as my form of exercise. I have started taking estrogen again for my menopause symptoms, although I had stopped it during my recovery because I was fairly immobile.

Multiple Routes to Impaired Executive Functions

These studies show that many impairments of executive function seen in ADD syndrome can occur in persons who did not have ADHD in their earlier years. For some, head injuries, the hormonal changes of menopause, or cognitive changes of old age create a cluster of impairments that looks very much like ADD without the lifespan history of symptoms. It seems likely that severe chronic substance abuse and a variety of other psychiatric or medical disorders may have similar damaging effects on executive functions. It also seems likely that external challenges like these would cause some individuals who have a lifelong history of ADD syndrome to experience a worsening of their ADD symptoms. I am suggesting that impairments of executive functions are a larger aspect of many psychiatric and learning disorders than has thus far been recognized. If accurate, this interpretation may have important implications for treatment of persons with other disorders. Perhaps some treatments demonstrated...

Dysfunctional Uterine Bleeding

Pelvic infection, or some complication of pregnancy. It may occur at any age between menarche and menopause (Lewis and Chamberlain, 1990). Lewis and Chamberlain (2004) go on to explain that heavy or irregular bleeding without abnormal physical signs on ordinary examination will always suggest this diagnosis, but must never be taken for granted, as curettage may reveal that there is a local cause for the bleeding after all. In anovulatory cycles, which can occur for all women, normal amounts of oestrogen are secreted, but the egg may not ripen in the follicle. As an egg is not released, progesterone is not produced from the corpus luteum to counteract the proliferation of the uterine lining. In time the uterine lining outgrows its blood supply, and sloughs off at irregular intervals. Anovulation may be a result of inadequate signals, for example as a result of polycystic ovarian disease, or it may be pre-menopausal. It may also be caused by impaired positive feedback, for example in...

Benefits and Risks of Mammography

The benefit of screening mammography has been called into question over the last decade. This occurred first for the application of screening mammography to premenopausal women (Fletcher et al., 1993), then more recently for the application of screening mammography to all age groups (Gotzsche and Olsen, 2000 Olsen and Gotzsche, 2001). In light of these criticisms, it is important to review the benefits and risks of screening mammography.

Are there any medications that I should adjust or stop taking while Im being treated for osteoporosis

If you are already taking estrogen, you may not take Evista. If your clinician wants you to opt for Evista, you must stop taking menopause hormone therapy (MHT). Forteo interacts with digoxin, increasing the possibility of digoxin toxicity, so your digoxin levels should be monitored carefully. The response to calci-tonin nasal spray may be decreased if bisphosphonates (Actonel, Boniva, Fosamax) are currently being taken or used immediately prior to the beginning of treatment with calcitonin nasal spray. However, calcitonin nasal spray may occasionally be prescribed for its pain-relieving effects following a vertebral compression fracture (VCF) even if you are already taking a bispho-sphonate. You and your clinician should discuss treatment with MHT (if you're a postmenopausal woman), bisphos-phonates, calcitonin, and synthetic parathyroid hormone. Some clinicians recommend a discussion about medication options when their patients have been on steroids for as little as 3 months....

Evaluation by the International Agency for Research on Cancer

An International Agency for Research on Cancer (IARC) Working Group on the Evaluation of Cancer-Preventive Strategies published a comprehensive evaluation of the available literature on weight and cancer that considered epidemiological, clinical, and experimental data (18). Their 2002 report concluded that there is sufficient evidence in humans for a cancer-preventive effect of avoidance of weight gain for cancers of the endometrium, female breast (postmenopausal), colon, kidney (renal cell), and esophagus (adenocarcinoma) (18). Regarding premenopausal breast cancer, the report concluded that available evidence on the avoidance of weight gain suggests lack of a cancer-preventive effect. For all other sites, IARC characterized the evidence for a cancer-preventive effect of avoidance of weight as inadequate in humans.

In Vitro Fertilization

There are a number of different ovarian-stimulation protocols namely (1) human menopausal gonadotropin (hMG) or FSH, with or without clomiphene citrate, which was typically used in the early 1980s (2) the long, short, ultrashort, and microdose flare protocols using gonadotro-pin-releasing hormone (GnRH) agonists and hMG or FSH, which have gained widespread acceptance since the long protocol was first described in the mid-1980s and, more recently, (3) protocols using hMG or FSH followed by the addition of newer GnRH antagonists. The highest pregnancy and live-birth rates reported in all age groups and for all causes of infertility have been with the long protocol, which induces pituitary desensitization with GnRH agonist followed by ovarian stimulation with hMG or FSH and which is the most widely used protocol today (7).

Optimal Biologic Dose

Another example that demonstrates this concept is the use of the new aromatase inhibitor, anastrozole, for the treatment of metastatic breast cancer. Anastrozole, as opposed to its predecessor, aminoglutethimide, is a selective aromatase inhibitor that blocks the conversion of androstenedione to estrone. The drug is most effective in post-menopausal women with ER-positive tumors, in whom nonovarian sites of aromatase activity predominate (i.e., adipose tissue, liver, muscle) (21). During the development of anastrozole, several doses of drug were evaluated to determine the dose that most effectively suppresses estradiol levels (21). A daily dose of 1 mg anastrozole was optimal, and, even in the pivotal clinical trial, there was no advantage to higher daily doses of anastrozole in terms of ORR. These examples support the notion of seeking the OBD, rather than the MTD, to guide AI development.

Im 60years old Is it really worth it to start exercising now Will exercise at my age help prevent osteoporosis

Absolutely Exercising will help you no matter how old you are. Although exercise has been encouraged for many years as part of a healthy lifestyle, we are just beginning to quantify its positive effects on heart disease, obesity, diabetes, menopausal symptoms, and of course osteoporosis. It is never too late to incorporate regular exercise into your lifestyle. It's easy for us to say that we're too old to begin exercising at our age, but that is not true. If you don't already have osteoporosis or osteopenia, exercise is still important even though exercise alone doesn't prevent bone loss. When you are well past the first 4 to 8 years after menopause, during which the greatest amount of bone loss occurs, and if you don't have osteoporosis, you are less likely to develop osteoporosis. If you are only a few years into post-menopause, you may still lose enough bone to be diagnosed with osteoporosis later. Regardless of how many years you are past menopause, get moving And if you're a man,...

Biomarker level determinations

The serum levels of CA125 generally reflect the volume of the disease. Elevated CA125 prior to surgery is useful for following the progress of the patient during and after treatment. CA15-3, CA19-9 and lipophosphatidic acid have been shown to have independent expression to CA125. Lactate dehydrogenase, human chorionic gonadotrophin and Alfa Feto Protein are used in the diagnosis of different types of germ cell tumours. Inhibin is performed only in post-menopausal women with granulose cell tumours.4

Role Of Biologic Sex Clinical Observations

Ischemic stroke occurs with greater frequency in men than in women across diverse ethnic backgrounds and nationalities (1). This sexually dimorphic epidemiology is present until late in life, well beyond the menopausal years. For example, in the Northern Manhattan Stroke Study, stroke rates in women do not equalize to those of men until beyond 75 years of age (2). However, women's strokes occur later in life, perhaps explaining the alarming statistic that more than 60 of stroke fatalities occur in women (3). Although mortality from cardiovascular disease appears to be declining in men, this advance has not been evident in women (470,000 deaths per year in 1970 vs. 500,000 per year in 2001) (3). Knowledge of the mechanisms of ischemic cell death and neuroprotective therapies in both sexes is clearly important however these factors might not be identical in men and women.

Estrogen Multiple Actions Current Controversies

The previous discussion of sex differences does not imply that female or male sex steroids are unimportant to ischemic pathobiology. Without doubt, estrogen is an important endogenous neuroprotectant and might play a large role in women's early protection from stroke. By the year 2015, approximately 50 of women in the United States will be over 45 years of age and facing increasing stroke risk in the context of a postmenopausal physiology, where native estrogens are lost. Accordingly, potential benefits and hazards of hormone replacement therapy (HRT) are currently a subject of much controversy and concern for women. Exogenous estrogens, particularly 17P-estradiol, have been well studied in translational models of brain injury, with positive results, i.e., reduced cell death, reduced infarction size, and improved functional recovery. Nevertheless, these favorable data for acute stroke treatment are frequently submerged by reports from prospective, randomized, clinical trials that show...

Role in Prevention and Clinical Trials

Over the past 30 years, observational studies have found lower risks of coronary heart disease (CHD) and stroke in women who take postmenopausal estrogens, suggesting that estrogen is vasoprotective (24). Observational reports were not as clearly positive for stroke, but most describe no increased risk or some benefit in prevention of fatal strokes (25). The Heart and Estrogen-Progestin Replacement Study (HERS) was the first randomized, blinded trial to use combined estrogen and progestin medroxyprogesterone acetate (MPA) . After four years of hormone replacement therapy (HRT), the HERS found no reduction in the risk for CHD, stroke, or transient ischemic attack, with a threefold increase in venous thromboembolism (26). An important observation in the HERS was that patients who received HRT sustained an early increased risk of cardiovascular events that was offset by a lower event rate in subsequent years. It was presumed that this was due to an early prothrombotic risk, followed by a...

Hormones Contraceptives and Stroke

Stroke in the premenopausal woman is a rare event. However, many women in this age group are treated with sex steroids through estrogen-progestin oral contraceptives (OCs). Currently, OCs are used by more than 10 million women in the United States and more than 78.5 million women worldwide. The potential for enhancement of stroke risk in OC users has been extensively investigated. Early studies of first-generation high-dose estrogen OCs (e.g., 250 g) showed a significant association with increased risk of stroke (37,38). More recent case-control studies indicate that risk is clearly dependent on the estrogen dose (39,40). With the low-dose preparations most

Testosterone Role In Male Sensitivity To Ischemia

Despite the fact that male sex is a well-acknowledged risk factor for human stroke, most research aimed at understanding gender differences in stroke has focused exclusively on female sex steroids. Available epidemiologic studies suggest that testosterone, the major mammalian androgen, has a neutral or favorable effect on cardiovascular disease (43). This possibility is likely related, in part, to beneficial effects on vascular endothelial function and the vasodila-tory properties of testosterone at physiologic concentrations. In the clinical setting, testosterone declines in men after stroke, presumably as a stress response (44). However, testosterone has recently emerged as another sex steroid that has the potential to alter ischemic cell death. For example, surgical castration and subsequent low testosterone decrease histologic damage after focal cerebral ischemia in the young adult male rat (45,46) and negatively affect outcome from experimental spinal cord injury (47). When...

Chronic Complications of Diabetes and Risk Factors

Both men and women with diabetes are at heightened risk of atherosclerosis, with loss of female cardioprotection in diabetes, even prior to the menopause.11 Atheroma develops earlier, progresses at a faster rate than in the non-diabetic population, and extends more distally in the vasculature,18 often making angioplasty and vascular bypass surgery less feasible in patients with diabetes. In addition to quantitative changes in atheroma in diabetes, qualitative changes have also been suggested. This area merits further research, as it may suggest additional interventions for people with diabetes. Nevertheless, in recent clinical trials of lipid and blood pressure lowering agents with vascular end-points, the diabetic groups responded at least as well as the non-diabetic groups,19-21 in keeping with there being common underlying risk factors, pathology, and pathophysiology.

Association Between Obesity and Bony Properties 221 Bone Mineral Density and Content and BMI

Although certain parameters of body composition, such as abdominal obesity, are strongly associated with BMD, gender is arguably the strongest factor that mediates the obesity-BMD relationship. In both men and women, decreased BMD occurs after the age of 50 (32), although women demonstrate greater variability than men. In particular, lean body mass and total fat mass are significant determinants of BMD among postmenopausal women (33). In premenopausal women, lean mass, but not total fat mass, is a significant determinant of BMD. These findings infer that whereas lean body mass is associated with BMD across the female lifespan, adiposity is most strongly associated with BMD after menopause. This may be partly attributable to the interdependence of the increased mechanical forces that occur across the obese skeleton, as well as the metabolic changes, such as the adipose-derived estrogen, that occurs after menopause. Whatever the mechanism, a positive outcome of postmenopausal obesity is...

Immunoassays for the Quantification of uPAR

The median in cytosolic extracts were significantly associated with a shorter overall survival. The amounts of uPAR extracted with the acidic Triton X-100 buffer had less prognostic impact. In a group of node positive post-menopausal women, cytosolic uPAR was found to be a very strong predictor of overall as well as relapse-free survival 37 . In a different study measuring cytosolic extracts from 878 primary breast tumors, the prognostic significance of these forms of uPAR was confirmed. The E1 ELISA was slightly modified in this study using nonbiotinylated mAbs and an HRP-conjugated goat anti-mouse pAb for detection 126 . Higher levels of uPAR were measured in steroid hormone receptor negative tumors in this study, but the uPAR levels were found to be unrelated to menopausal status or grade of differentiation. The performances of E6, E7, and a commercial uPAR ELISA have been compared in another study. Only the combined levels of uPAR(I-III) and uPAR(I) measured with E6 in tumor...

Ovarian Selective Serms

Along these lines, SERMs such as tamoxifen 1 and raloxifene 2 have been clinically evaluated for the treatment of leiomyoma. Tamoxifen lacks sufficient efficacy to reduce tumor size in pre-menopausal women due, in part, to the uterine agonist characteristics exhibited by this SERM 28,29 . In addition, treatment with tamoxifen has resulted in ovarian cysts, an undesired side-effect that severely limits the use of this compound for the treatment of fibroids in ovulatory women. These stimulatory effects on the ovaries have been attributed to the inhibitory properties that tamoxifen has on the hypothalamic-pituitary-ovarian (HPO) axis, i.e., this SERM acts as an estrogen antagonist at the hypothalamus resulting in increased gonadotropin levels (luteinizing hormone, follicle-stimulating hormone) and, ultimately, in hyperstimulation of the ovaries. In fact, inhibition of the HPO axis by SERMs such as clomiphene has been clinically exploited to induce ovulation in women 30 . Raloxifene, a...

Osteonecrosis Avascular Necrosis or Aseptic Necrosis

And renal transplantation a risk assessment. Lupus 12(7) 555-559 Meroni PL, Peyvandi F, Foco L, Bernardinelli L, Fetiveau R, Mannucci PM et al (2007) Anti-beta 2 glycoprotein I antibodies and the risk of myocardial infarction in young premenopausal women. J Thromb Haemost 5(12) 2421-2428 Paran D, Chapman J, Korczyn AD, Elkayam O, Hilkevich O, Groozman GB et al (2006) Evoked potential studies in the antiphospho-lipid syndrome differential diagnosis from multiple sclerosis. Ann Rheum Dis 65(4) 525-528 Ruiz-Irastorza G, Khamashta MA (2007) Antiphospholipid syndrome in pregnancy. Rheum Dis Clin North Am 33(2) 287-297 Sangle SR, D'Cruz DP, Jan W, Karim MY, Khamashta MA, Abbs IC et al (2003) Renal artery stenosis in the antiphospho-lipid (Hughes) syndrome and hypertension. Ann Rheum Dis 62(10) 999-1002

What about the new lowdose hormone patch Menostar estradiol that is used to prevent osteoporosis

Menostar (estradiol) was FDA-approved in 2004 for the prevention of postmenopausal osteoporosis. It is a dime-sized transdermal patch that delivers about 14 micrograms of estrogen per day. A new patch is applied every week. Because your body absorbs the estrogen from the patch through the skin, you can avoid the liver first-pass effect, meaning that the hormone is not metabolized through your liver. Instead, it can go directly into the bloodstream. The estrogen that is used in this patch is estradiol, one of the three estrogens made by the human body. Estradiol is the one in greatest abundance until menopause. Then levels drop off to near zero. Although estrone The blood levels of estrogen resulting from Menostar are high enough to preserve bone but not high enough to treat the vasomotor symptoms of menopause. If you need your symptoms treated, Menostar probably does not provide adequate estrogen levels for you to get relief. The levels of estrogen needed to effectively treat...

Regulation of Pilosebaceous Unit Activity

Pilosebaceous Unit

In contrast to the stimulatory effect of androgens on the sebaceous glands, estrogens and compounds that have estrogenic activity, such as phenol red (113), reduce lipo-genesis in vitro. In vivo, the effect of estrogens is contradictory, although at pharmacological doses estrogens are sebosuppressive in rat preputial gland (114) and in humans also producing feminizing side effects (115). This action of estrogens is indirect and occurs by inhibiting the adrenals and gonads via the pituitary, thereby reducing the production of androgens. During hormonal treatments, such as hormone replacement therapy (HRT), the effect on skin surface lipids depends on the predominant hormone given. Skin surface lipids are increased during combined HRT, possibly reflecting stimulatory effects of the progestogen component on sebaceous gland activity, while estrogen alone has a sebum-suppressive action (116).

Prototypic Victims Of Enzyme Induction

In another study, premenopausal women were treated with 35 ng ethinylestradiol 1 mg norethindrone (91). Subjects received 14 days of rifampicin (600 mg per day) from days 7-21 of their menstrual cycle. Rifampicin significantly decreased the mean area of the concentration of ethinylestradiol (66 ) and norethindrone (51 ). The mean Cma* decreased by 43 from base line for ethinylestradiol and the tic decreased by 48 . The mechanism of this interaction was attributed to CYP3A4 induction. Interestingly, troglitazone administration (600 mg daily, 22 days) reduced AUC values for ethinylestradiol on day 21 by -30 , and it was reported that troglitazone may enhance the conjugation pathways of ethinylestradiol metabolism (72). This is one of the few reports citing the up-regulation of Phase 2 pathways as a mechanism by which ethinylestradiol interacts with other drugs.

What is Evista raloxifene What is a SERM and why is it effective in the treatment of osteoporosis

Evista (raloxifene) is the only FDA-approved selective estrogen receptor modulator (SERM) for the prevention and treatment of osteoporosis in postmenopausal women. You may be more familiar with tamoxifen, a SERM used in the treatment of breast cancer. A SERM binds with some estrogen receptor sites around the body. Although raloxifene is not a hormone, it has an estrogen-like effect in some body tissues such as bone and has an estrogen-blocking effect on other tissues such as breast and uterus. Evista increases bone mineral density, decreases the risk of fractures, and is FDA-approved for the prevention and treatment of osteoporosis in post-menopausal women. The dosage of Evista for both osteoporosis treatment and prevention is 60 mg per day taken as one tablet. Evista, unlike the bisphos-phonates, may be taken with or without food. In addition to Evista's positive effects on bone, it also decreases low-density lipoprotein (LDL) cholesterol (the bad cholesterol) as well as total...

Sexual Desire and Aging

Among women, biological changes leading to menopause may extend over a 20-year period, with onset generally in the mid 30s and occasionally extending beyond the mid 50s. After menopause, the intensity of sexual response may be reduced, and for some postmenopausal women intercourse may be painful due to vaginal dryness. For many women, estrogen replacement therapy can relieve vaginal dryness and other symptoms of menopause and may help restore sexual desire.

The Relationships Between Lipid Profile Levels Depression and Suicide Attempts

Depressive symptoms are common in patients with physical illness, including cardiovascular disease, diabetes mellitus, end-stage renal disease, and women in pregnancy, delivery, or menopause. The depressive symptoms in patients with physical illness include apathy, anorexia, sleep disorder, fatigue, and cognitive deficits 42 . Depression and Women in Pregnancy, Postpartum, or Menopause. Lipids and lipoproteins are known to increase substantially during pregnancy and to decrease rapidly after delivery. The factors responsible for the changes have not been identified however, they could be related to changes in one or more of the endocrine hormones 77-80 . During pregnancy, the total serum cholesterol concentration rises up to 45 , followed by a rapid fall after delivery. Schwertner et al. found that the increases in cholesterol during pregnancy and labor could be, in part, a result of the Nasta et al. also tried to investigate the relationship between cholesterol and mood...

Estimating the Economic Burden of PCOS

The overall costs associated with the treatment and, if appropriate, the diagnosis of the various morbidities evident in the premenopausal women with PCOS are outlined in Table 3. This conservative estimate of the health care-related economic burden of premenopausal women with PCOS exceeded 4 billion annually in the United States alone. Approximately 40 of the burden is a result of the increased prevalence of diabetes associated with PCOS 30 arises from the treatment of the associated menstrual dysfunction AUB, 14 from the treatment of hirsutism, and 12 the provision of infertility services. Notably, the costs of the diagnostic evaluation of all patients accounted for a relatively small portion of the calculated economic burden, about 2 . The calculated economic burden of patients with PCOS during their reproductive years is about threefold that of hepatitis C ( 1 billion in 1998) (65) and about one-third that of morbid obesity ( 11 billion in 2000) (66).

Medical History and Physical Examination in Patients With Possible Androgen Excess

Polycystic Appearing Ovaries

The timing and pace of pubertal development and its relation to complaints of unwanted hair growth, hair loss, acne, and or obesity should be established. The onset and progression of these complaints should also be established. Drug or medication use and exposure or use of skin irritants should be elicited. A detailed menstrual history should be obtained, with an emphasis on determining whether evidence of ovulatory function (e.g., premenstrual molimina) is present. Change in skin pigmentation or texture, extremity or head size, and changes in facial contour should be noted. A detailed family history of endocrine, reproductive, or metabolic disorders should be obtained. A family history of similar hyperandrogenic signs and symptoms is a powerful clue to the inherited basis of the disorder, although a familial association can be noted for PCOS, HAIR-AN syndrome, NCAH, and IH patients. Clinicians should note that the etiology of hirsutism can often be suspected from the history alone....

Asymptomatic Bacteriuria

Asymptomatic bacteriuria or asymptomatic UTI is the isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen obtained from a person without symptoms or signs of urinary infection. Asymptomatic bacteriuria is common but its prevalence varies widely with age, gender, and the presence of genitourinary abnormalities or underlying diseases. For example, the prevalence of bacteriuria increases with age in healthy women from as low as about 1 among school girls to greater than or equal to 20 among women 80 years of age or older living in the community while bacteriuria is rare in healthy young men.13 Because its clinical significance was controversial (asymptomatic bacteriuria precedes UTI but does not always lead to asymptomatic infection), guidelines were recently published for the diagnosis and treatment of asymptomatic bacteriuria in adults older than 18 years of age.13 The foundation of these guidelines rests on the premise that screening of...

Serms For Hot Flushes

Hot flushes (flashes) are characterized by a warming sensation that begins in the chest and moves towards the neck and head, and are often accompanied by sweating, palpitations and cutaneous flushing. The episodes generally last from 30 s to 10min. The majority of postmenopausal women experience hot flushes, with a significant percentage of these women continuing to suffer symptoms for more than 5 years 13,14 . The hot flush event is thought to be centrally mediated, resulting from a transient lowering of the thermoregulatory set point in the hypothalamus 15 . Regulation of the thermoregulatory process may involve hormones or neurotransmitters such as catecholamines, estrogen, testosterone, opioids and serotonin, among others 16 . In fact, compounds which modulate the signaling pathways of each of these have been evaluated clinically for the treatment of hot flushes. Unfortunately, all of the therapies investigated to date suffer from poor efficacy, are associated with unacceptable...

Distribution in Tumors

In the Mainz experience, oxygen tensions measured in the normal breast of16 patients revealed a mean (median) pO2 value of 65 mmHg in 18 cancers of the breast (stages pT 1-4), the median pO2 was 28 mmHg. Six of 18 breast cancers exhibited pO2 values between 0 and 2.5 mmHg. Thirty-three percent of the tumors investigated contained hypoxic areas, and the proportion of pO2 readings between 0 and 2.5 mmHg ranged from 4 (in a T4 breast cancer) to 64 (in a T3 tumor). Furthermore, the oxygenation patterns did not correlate with the histological grades, menopausal status, tumor histology (ductal vs lobular), or extent of necrosis or fibrosis (49,56).

Glucose Insulin and Potential Mechanisms of Vascular Stiffening

Increased arterial stiffening is a hallmark ofboth type 1 and 2 diabetes. The accompanying dyslipidemia, hypertension, visceral obesity and sedentary lifestyle also contribute to structural changes in the arterial wall. Premenopausal women may also have increased arterial stiffening compared to men, suggesting a role for estrogens. Fracture of elastin fibers and increased deposition of collagen associated with aging leads to gradual widening and decreased distensibility of the aorta and the consequent loss of its buffering capacity. These clinical features act through a variety of mechanisms, including insulin resistance, oxidative stress, endothelial dysfunction, and formation of AGEs and pro-inflammatory cytokines, to increase arterial stiffening and increase the risk of CVD. Fig. 1. Increased arterial stiffening is a hallmark ofboth type 1 and 2 diabetes. The accompanying dyslipidemia, hypertension, visceral obesity and sedentary lifestyle also contribute to structural...

Im worried that my daughter who is 40 will get osteoporosis How can she prevent this from happening to her

Women beginning midlife should make themselves aware of all the risk factors for developing osteoporosis. First, at the age of 40, unless she is one of the 1 who experience premature menopause (natural and total cessation of menstrual periods before the age of 40), she is likely to still be making the necessary estrogen to protect her bones. She should continue to take adequate calcium and Vitamin D for her age, which means 1,000 to 1,200 mg of elemental calcium and 400 IU of Vitamin D per day. This may mean assessing her diet and supplementing it if she does not get enough calcium through dairy products and other foods (see Table 4 in Question 48). If she smokes, she should stop. If she drinks excessive alcohol, she should stop that, too. Equally important, she should develop an exercise routine that puts the necessary stress on her bones for them to continue to remodel appropriately. Making exercise a habit is critical to keeping bones strong through midlife and beyond (see...


Male-like hair growth and masculinization of women and the ambiguity of genders has fascinated mankind for millennia, frequently appearing in mythology and the arts. The earliest reports of androgen excess, beginning 400 years bc, focused on the appearance of male-like hair growth and features in women, often accompanied by menstrual cessation. The first etiologies identified as a cause of androgenization in the female were adrenal disorders, primarily adrenocortical neoplasms, but also eventually adrenal hyperplasia. The first report of a patient with nonclassic adrenal hyperplasia (NCAH) was made in 1957. The Achard-Thiers syndrome, which was originally reported in 1921 and was felt to primarily affect postmenopausal women, included the development of diabetes mellitus, hirsutism, and menstrual irregularity or amenorrhea in conjunction with adrenocortical disease. Androgen production by the ovary was not recognized until the early 1900s, with the first case of a patient with glucose...

Hormonal Lifting

But hormones should be treated with caution. Hormone replacement therapy must not mislead patients into swallowing lifestyle pills uncontrollably because they increase the risk of stroke, heart attack, a thromboembolic event, as well as breast and prostate cancer. The Woman's Health Initiative (WHI) study in the USA involving 16,000 female test persons who were on long-term oestrogen-gestagen therapy was


Males and prepubescent females have only rudimentary glandular tissue. In the western world, a young woman's glandular tissue begins to proliferate early in her second decade, although maturation may be earlier or later. By the time a woman has completed puberty, her glandular tissue usually has developed to its maximum size. Hormonal variations related to menstrual cycles, pregnancy, and lactation cause the size of the glandular tissue to wax and wane. At menopause, glandular tissue gradually recedes, causing the breast to flatten somewhat, and become pendulous and less firm.


In pregnancy, circulating levels of testosterone, A4, and DHT are all increased relative to those in nonpregnant women, although circulating levels of DHEAS at term are 50 or less than those in nonpregnant women. Interestingly, the maternal concentrations of DHEAS, A4, and testosterone have recently been shown to decrease with increasing maternal age in women in late gestation. The serum levels of testosterone and A4 are fairly stable for about 3 years prior to menopause, with a tendency to decline progressively thereafter. Alternatively, the age-associated declines in DHEA and DHEAS, consistent with the fact that these steroids are primarily of adrenal origin, are more related to age per se than to abrupt changes in ovarian function during the perimenopausal period. The ste-roidogenic defect that occurs in aging appears to be localized primarily to the zona reticularis of the adrenal. Although the role of the ovary in androgen production in postmenopausal women has been the topic of...

Clinical Data

Fourteen-day administration of 50 mg balicatib to post-menopausal Japanese women was safe and well-tolerated and showed an elimination half-life of 15.5 h 71 . A 12-week placebo-controlled dose-ranging study of balicatib in postmenopausal women at 5, 10, 25 and 50 mg daily (n 28 group) showed a dose-dependent decrease in serum CTx, a biochemical marker of bone resorption. At the 50 mg dose, a 70 reduction in sCTx was observed (22). A subsequent 1-year study at the same doses (n 135 group) found a 61 decrease in sCTx at 50 mg qd and a 55 decrease in urinary NTx. Serum osteocalcin and bone-specific alkaline phosphatase, markers of bone formation, were similar to placebo after 1 year of dosing 72 . This apparent decoupling of bone resorption and bone formation, based on bone turnover markers, distinguishes Cat K inhibition from other anti-resorptives such as bisphosphonates, denosumab and SERMs, all of which suppress markers for both resorption and formation. Increases in bone mineral...

Animal Selection

Most researchers use solely male animals for brain ischemia studies, a practice well justified, as this approach avoids experimental variability caused by female hormones. The relationship between biologic sex and ischemic stroke outcome has been greatly explored mainly in rodents. The overwhelming majority of published studies reported that female rodents sustain smaller infarctions than males following focal brain ischemia (12-14), although one study showed no difference between genders (15). The menstrual cycle might be critical, as female rats in proestrus (high endogenous estradiol levels) developed significantly smaller infarcts than those in the metestrus phase (low endogenous estradiol levels), indicating that estrogen itself might have neuroprotec-tive properties (16). Furthermore, gender differences could be abolished following ovariectomy (12) or after menopause (17). Estrogen administration to female, intact male, and castrated male rats reduced infarct sizes in almost all...


Oocytes are retrieved after pituitary desensitization with a gonadotropin-releasing hormone agonist and follicle stimulation with a combination of human menopausal gona-dotropins (hMG) (Pergonal, Serono, Waltham, MA Humegon, Organon Inc., West Orange, NJ), and FSH (Gonal-F, Serono Follistim, Organon). Human chorionic gonadotropin (hCG) is administered when criteria (e.g., ultrasound, estradiol levels) for oocyte maturity are met, and retrieval is performed 35 h later by vaginal ultrasound-guided puncture. Under the inverted microscope at 100x, the cumulus-corona-cell complexes are scored as mature, slightly immature, completely immature, or slightly hypermature. Thereafter, the oocytes are incubated up to 4 h depending on their state. Immediately before micromanipulation, the cumulus-corona cells are necessarily removed for oo-cyte observation and accurately controlled by the use of the holding and or injecting pipette. Such removal involves oocyte exposure to M-HEPES containing 40 IU...


Selection was based on hypercholesterolemia. The patient population is very varied as patient recruitment and monitoring was not specifically aimed at measuring bone parameters or outcomes. The incidence of fractures is influenced dramatically by factors such as age and sex. Smaller and shorter trials have been completed in post-menopausal women but often the trial size or duration has been insufficient to come to a firm conclusion.

Endometrial biopsy

The largest study of the prognostic value of endometrial sampling involved a meta-analysis of 39 studies involving 7914 women. The results of endometrial sampling were compared to more invasive techniques, such as dilatation and curettage, hysteroscopy and hysterectomy. The detection rates for endometrial cancer were 99.6 in post-menopausal women and 91 for pre-menopausal women. The overall detection rate for atypical hyperplasia was 81 . The specificity for all sampling types was in the range 98-100 . An insufficient sample was returned in as many as 5 of patients.5 Therefore, endometrial biopsy might be an appropriate initial diagnostic test for ruling out endometrial cancer in symptomatic women. More invasive diagnostic methods may be considered in cases where the sample was inadequate. The overall grade for the patient's tumour is based on the worse sample obtained, whether from the biopsy, dilatation and curettage or hysterectomy specimen.

Gender Differences

The classic comedy statement women are different from men apparently holds true for focal and global cerebral ischemia, as well. Postmenopausal women are at high risk for stroke (focal ischemia) and cardiac arrest (global ischemia), but the benefit of hormone replacement therapy (HRT) in stroke prevention is controversial, and HRT in cardiac arrest CPR is almost completely uninvestigated. Recent clinical trials demonstrated lack of benefit and even potential harm of HRT in stroke, in contrast to earlier epidemiologic studies that demonstrated reduced risk and better outcome from stroke with HRT (48). In experimental models of stroke, estradiol has consistently been shown to reduce lesion size and neuronal death after experimental cerebral ischemia (49) and after cardiac arrest CPR (50). Adult female mice sustain less histopathologic injury after cardiac arrest CPR than do age-matched male mice. The sex difference in injury disappears after surgical ovariectomy. It has also been shown...

The Menstrual Cycle

Historically, and for women as hunter-gathers, menarche occurred later and menopause earlier. It was also normal for lactation to continue for three to four years. As a result, women would have five to six children. Consequently, because of protracted amenorrhagia, women would experience only thirty menstruations in their lifetimes.


Fibroids are derived from single myometrial cells, though G - 6 PD type may vary between individual fibroids within the same uterus (West, 1998). It is thought that fibroid growth is dependent on ovarian hormones, as they do not occur prior to menarche and normally reduce in size following menopause. Fibroids appear to develop and be maintained in response to oestrogen, and progesterone may have a major role to play in the control of fibroid growth.

Endometrial Cancer

The probable mechanism for the increase in risk of endometrial cancer associated with obesity in postmenopausal women is the obesity-related increase in circulating estrogens (38). In premenopausal women, endometrial cancer risk is also increased among women with polycystic ovary syndrome, which is characterized by chronic hyperinsulinemia and progesterone deficiency (39). Thus, in both pre- and postmenopausal women, endo-metrial cancer is increased by the mitogenic effects of estrogens on the endometrium when these effects are not counterbalanced by sufficient levels of progesterone. Many studies have shown large increases in endometrial cancer risk among postmenopausal women who take unopposed estrogen replacement therapy (i.e., estrogen in the absence of progesterone) (40), as well as increases in risk among women with higher circulating levels of total and bioavailable estrogens (18).

Pregnancy Rates

Most early studies were of an observational nature and have also been reported in the context of large reviews (2,3). An unfortunate feature of many of the papers that describe laparoscopic treatment wedge resection is the poor characterization of the patients such that many appear to have been ovulating prior to treatment. Furthermore, as the polycystic ovary becomes more sensitive to either endogenous or exogenous FSH after LOD, many practitioners have taken a pragmatic approach by commencing ovarian stimulation with either clomiphene or gonadotropins if ovulatory activity is not immediately induced (30,31). The first RCT suggested that LOD was as effective as routine gonadotropin therapy in the treatment of clomiphene-insensitive PCOS (29). In this study 88 patients were randomized prospectively to receive either human menopausal gonadotropin, FSH, or LOD. There were no differences in the rates of ovulation or pregnancy between the two groups, although those treated with LOD had...

Degree of Adiposity

Data from 115,886 women in the Nurses' Health Study showed that even mild-to-moderate overweight (BMI 25.0-28.9) increased the risk of nonfatal CHD in middle-aged women after adjustment for age and smoking (RR 1.8 95 CI 1.2-2.5). Among those with a BMI > 29, the risk increased more than threefold (RR 3.3 95 CI 2.3-4.5). The effect was substantially reduced after adjusting for other CVD risk factors but remained significant among those with a BMI > 29 (RR 1.9 95 CI 1.3-2.6) (55). Willett et al. (56) concluded that higher levels of body weight within the normal range, as well as modest weight gain (more than 5 kg) after 18 yr of age, appear to increase risks of CHD in middle-aged women. After controlling for age, smoking, menopausal status, hormone replacement therapy, and parental history of CHD, significant increases in risk were still observed among those with a BMI 23 compared with those with a BMI less than 21. The RRs for CHD were 1.5 (95 CI 1.2-1.8) for a BMI 23.0 to 24.9,...

Female Breast Cancer

Many epidemiological studies since the 1970s have assessed the association between anthropometric measures and female breast cancer occurrence and or prognosis (18,47). Early studies established that the association between body size and risk of breast cancer varied based on menopausal status that heavier women were at increased risk of postmenopausal, but not premenopausal, breast cancer (18). In fact, among pre-menopausal women, there is consistent evidence of a modest reduction in risk among women with high (> 28) BMI. This reduction in risk could be due to the increased tendency for young obese women to have anovulatory menstrual cycles and lower levels of circulating steroid hormones, notably progesterone and estradiol (17). Obesity has been shown consistently to increase rates of breast cancer in post-menopausal women by 30 to 50 (Table 3) (48-53). Some studies have found central adiposity to be an independent predictor of postmenopausal breast cancer risk beyond the risk...


Feature of chronic inflammatory disease is anemia and to the extent that underlying inflammatory disease is unrecognized, coexisting anemia might be miscategorized as UA. Artz and colleagues (2) recognized this and in their nursing home series of UA patients (mentioned above), excluded from analysis those with an elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). However, even with this screen, it is likely undiag-nosed inflammatory processes contribute to some extent to the composite picture of UA. Compounding this, it is now generally accepted that the serum levels of certain proinflammatory cytokines rise with age, even in the absence of inflammatory disease. For example, interleukin-6, now considered a biochemical marker of frailty, is typically measurable only in sub-picogram quantities in the absence of acute inflammation in young adults but rises gradually after menopause (or andropause) and its level correlates with several features of the frail...



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