Individual hormone replacement therapy

Tuimala, Risto; Vihtamäki, Tarja

doi:10.1016/0378-5122(96)01019-5

Cited by 5 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Unfortunately, many women discontinue the use of HRT after a couple of years, mainly because of fear of cancer and advice by physicians (23). There is no consensus, at present, whether serum E 2 levels should be followed during ERT; however, it has been pointed out by us and other authors that the relief of climacteric symptoms does not necessarily guarantee protection against osteoporosis and other diseases of elderly women believed to be related to the deficiency of E 2 (6,7,24). To investigate these questions, we have developed a self-adjusted model of HRT based on a model where patients increase their daily E 2 use until they feel comfortable with the medication (6, 7).…”

Section: Discussionmentioning

confidence: 97%

Self-adjusted postmenopausal hormone replacement therapy: effects on the biological and immunological profile of FSH and correlation to climacteric symptoms

Vihtamäki

Simoni²,

Tuimala³

et al. 2002

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: The purpose of the present study was to evaluate the hormonal profile of patients of postmenopausal age during estrogen replacement therapy (ERT) with special reference to the serum levels of biologically active FSH (B-FSH) in a self-adjusted ERT model. Design:The hormonal values found have been correlated to climateric symptoms reported by the patients (scored by the Kupperman menopausal index (KI)). Methods: B-FSH was measured using an assay based on a cell system transfected permanently with FSH receptor cDNA. All women ðn ¼ 32Þ applied estradiol percutaneously using 1 mg estradiol17b (E 2 ) as an initial dose and were encouraged to increase the daily dose until they felt comfortable according to a specific scheme. Twelve of the 32 women were hysterectomized and treated, accordingly, with ERT only; 20 women received megestrol acetate monthly for 10 days. Results: The initial average KI was 30 (range 10-54). A high degree of correlation ðr ¼ 0:83; P , 0:001Þ was observed between B-FSH and immunologically active FSH (I-FSH). Serum I-FSH and E 2 correlated negatively ðr ¼ 20:21; P , 0:001Þ; similarly, a negative correlation ðr ¼ 20:15; P , 0:01Þ was observed between serum B-FSH and E 2 levels. Serum I-FSH and KI showed modest but significant positive correlation ðr ¼ 0:13; P , 0:01Þ; a somewhat higher degree of correlation ðr ¼ 0:19; P , 0:005Þ was observed when B-FSH and KI were compared. E 2 showed positive correlation to serum sex-hormone binding globulin levels ðr ¼ 0:22; P , 0:001Þ: Conclusions: This study shows that the transdermal self-adjusted hormone replacement therapy (HRT) model introduced is suitable for studies on endocrine changes during postmenopausal ERT. The finding of poor correlation between serum E 2 levels and KI emphasizes the importance of hormonal measurements during postmenopausal HRT.

show abstract

Section: Discussionmentioning

confidence: 97%

Self-adjusted postmenopausal hormone replacement therapy: effects on the biological and immunological profile of FSH and correlation to climacteric symptoms

Vihtamäki

Simoni²,

Tuimala³

et al. 2002

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…La educación e información previa de las pacientes tiene un notable rol favorecedor para la aceptación de la TRH. Todos éstos, también son factores que mejoran sustancialmente el mejor cumplimiento a mediano y largo plazo del tratamiento (18,26,27). Muchas mujeres que inician el tratamiento, lo abandonan a los pocos meses, sea por desconocimiento de los beneficios del mismo a largo plazo.…”

Section: Tabla I Causas De No Inicio De Trh (14)unclassified

Incorporación Y Cumplimiento De La Terapia De Reemplazo Hormonal Del Climaterio Femenino Antes Y Después Del Estudio Del Whi: Revisión De La Evidencia

Arena¹

2005

Rev. chil. obstet. ginecol.

View full text Add to dashboard Cite

Objetivo: analizar los factores que afectan y/o determinan el inicio y cumplimiento de la terapia hormonal en el climaterio, y el efecto de como el estudio WHI y los trabajos vinculados a éste han impactado sobre esta terapéutica. Metodología: Se realizó una búsqueda de la información que hace referencia al tema en cuestión en las bases de datos MEDLINE y LILACS, seleccionando los trabajos para el análisis que presentaran mayor rigor científico, que fueran publicados en revistas arbitradas que no generaran conflicto de intereses según el financiamiento presentado, y que analizaran casuísticas significativas o que por su metodología original incorporan un aporte valioso al análisis del tema. Resultados: Encontramos en primer lugar que hay factores tales como la presencia de síndrome climatérico, la información que los pacientes tuvieran precedentemente en el tema, el seguimiento estrecho por parte del equipo de salud, y una mayor predisposición a la incorporación de intervenciones de prevención primaria en salud cumplían un rol favorecedor de la incorporación y mantenimiento de la terapia hormonal de reemplazo en el climaterio femenino. Por el contrario son factores negativos en la resiliencia a dicha intervención la mala tolerancia a dicha terapéutica, el sedentarismo, la obesidad, la no concomitancia de pareja, el inicio a edades más tardía, y la no presencia de síndrome climatérico. Conclusiones: Si bien la bibliografía no abunda aún al respecto, el impacto del estudio del WHI indudablemente que ejerció una fuerte retracción en la incorporación de esta terapéutica así como una menor compliance y una mayor tasa de abandono de la misma.

show abstract

“…Individualisation of therapy will become one of the challenges in prescribing of hormone replacement therapy (HRT) in the future. 1 The use of HRT is growing worldwide. While it is mainly taken short term to control symptoms, the long-term benefits such as the prevention of osteoporosis and reduction in risk of cardiovascular disease are increasing in importance.…”

Section: Introductionmentioning

confidence: 99%

“…Osteoporosis has been defined by the World Health Organisation as "a disease characterised by low bone mass and micro-architectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk". 1 Women lose bone rapidly following the menopause. Osteoporosis is less common in men who in general only develop it late in life -men have a much higher peak bone mass than women and do not have an endocrine menopause.…”

Section: Introductionmentioning

confidence: 99%

Individualisation of hormone replacement therapy

Huber

2000

British Menopause Society Journal

View full text Add to dashboard Cite

Recent publications provide clear evidence linking HRT and VTE; with a relative risk of between 2 and 4 and an absolute risk of around 3 per 10,000 users per year. 6 The baseline risk in menopausal women is of the order of 1 in 10,000 per year. This means that for 10,000 women years of use, HRT would be responsible for two extra cases of VTE that would otherwise not have occurred. HRT affects some haemostatic parameters. 7 Women commencing HRT should be evaluated for VTE risk factors on an individual basis and advised not only of the potential benefits but also of the risk of venous thrombosis. When taking the history it is essential to assess the family history, the severity of any personal event and whether or not it was objectively confirmed. A personal history of VTE is the single biggest risk for a future episode, risk of recurrence being 5% per annum.

show abstract

Individual hormone replacement therapy

Cited by 5 publications

References 5 publications

Self-adjusted postmenopausal hormone replacement therapy: effects on the biological and immunological profile of FSH and correlation to climacteric symptoms

Self-adjusted postmenopausal hormone replacement therapy: effects on the biological and immunological profile of FSH and correlation to climacteric symptoms

Incorporación Y Cumplimiento De La Terapia De Reemplazo Hormonal Del Climaterio Femenino Antes Y Después Del Estudio Del Whi: Revisión De La Evidencia

Individualisation of hormone replacement therapy

Contact Info

Product

Resources

About