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Sample records for korean premenopausal women

  1. Early menarche is associated with metabolic syndrome and insulin resistance in premenopausal Korean women.

    PubMed

    Lim, Se Won; Ahn, Ju Hyun; Lee, Jun Ah; Kim, Dong Ho; Seo, Ju-Hee; Lim, Jung Sub

    2016-01-01

    In pediatrics, identifying risk factors is important in planning the prevention of cardiovascular disease. The aim of this study was to determine whether there is an independent association between early menarche (<12 years) and metabolic syndrome (MetS) in Korean women. We analyzed data from 4463 premenopausal women from the Fourth Korea National Health and Nutrition Examination Survey-IV (2007-2009). MetS was defined by the International Diabetes Federation for Asians and insulin resistance (IR) was defined as HOMA-IR more than 3.05. The prevalence of MetS and IR was 7.9 and 15.0%. Women (55.6%) with MetS also showed IR. The prevalence of MetS was higher in both women with early menarche and late menarche (≥16 years) compared with the reference group (early, 12.8%; reference, 7.0%; late, 11.0%, both P = 0.002). However, the odds ratio for MetS was 3.54 (95% confidence interval (CI), 2.14-5.87) and for IR was 2.98 (95% CI, 1.99-4.47) after adjusting for age and other confounders such as lifestyle variables, reproductive variables and sociodemographic variables only in women with early menarche Early menarche was associated with an increased risk of MetS and IR in premenopausal Korean women. Early menarche is associated with higher risk of CVD-related death and all-cause mortality in Western studies. Early menarche is associated with higher risk of diabetes in Korean premenopausal women. Early menarche (<12 years) is associated with metabolic syndrome and insulin resistance in nationally representative Korean premenopausal women. However, late menarche (>16 years) is not associated with metabolic syndrome after controlling for age and other confounders.

  2. Differential diagnosis of breast masses in South Korean premenopausal women using diffuse optical spectroscopic imaging

    NASA Astrophysics Data System (ADS)

    Leproux, Anaïs; Kim, You Me; Min, Jun Won; McLaren, Christine E.; Chen, Wen-Pin; O'Sullivan, Thomas D.; Lee, Seung-ha; Chung, Phil-Sang; Tromberg, Bruce J.

    2016-07-01

    Young patients with dense breasts have a relatively low-positive biopsy rate for breast cancer (˜1 in 7). South Korean women have higher breast density than Westerners. We investigated the benefit of using a functional and metabolic imaging technique, diffuse optical spectroscopic imaging (DOSI), to help the standard of care imaging tools to distinguish benign from malignant lesions in premenopausal Korean women. DOSI uses near-infrared light to measure breast tissue composition by quantifying tissue concentrations of water (ctH2O), bulk lipid (ctLipid), deoxygenated (ctHHb), and oxygenated (ctHbO2) hemoglobin. DOSI spectral signatures specific to abnormal tissue and absent in healthy tissue were also used to form a malignancy index. This study included 19 premenopausal subjects (average age 41±9), corresponding to 11 benign and 10 malignant lesions. Elevated lesion to normal ratio of ctH2O, ctHHb, ctHbO2, total hemoglobin (THb=ctHHb+ctHbO2), and tissue optical index (ctHHb×ctH2O/ctLipid) were observed in the malignant lesions compared to the benign lesions (p<0.02). THb and malignancy index were the two best single predictors of malignancy, with >90% sensitivity and specificity. Malignant lesions showed significantly higher metabolism and perfusion than benign lesions. DOSI spectral features showed high discriminatory power for distinguishing malignant and benign lesions in dense breasts of the Korean population.

  3. Effects of Exercise Training on Fat Loss and Lean Mass Gain in Mexican-American and Korean Premenopausal Women.

    PubMed

    Wu, Shenghui; Park, Kyung-Shin; McCormick, Joseph B

    2017-01-01

    We investigated the effect of exercise training on body composition change in women. Nineteen Mexican-American and 18 Korean premenopausal overweight/obese women were randomized into one of the following groups: control, low-intensity training group (LI), and high-intensity training group (HI). Subjects completed 12 weeks of training at 50-56% maximal oxygen consumption (LI) or 65-70% maximal oxygen consumption (HI). Body composition components were measured at baseline and after training using dual-energy X-ray absorptiometry for Mexican-Americans, while whole-body composition was measured by the direct segmental multifrequency bioelectrical impedance analysis and abdominal fat was measured by single-slice computed tomography for Koreans. Data were analyzed using mixed-model repeated measures independent of age, ethnicity, and body mass index (BMI). Exercise training showed a significant effect on BMI, fat percentage, fat mass, lean mass, and visceral adipose tissue area. HI significantly decreased fat mass and fat percentage but increased lean mass (all P < 0.05). LI significantly reduced BMI, fat mass, fat percentage, and visceral adipose tissue area but increased lean mass (all P < 0.05). Exercise training had a beneficial effect on reducing BMI, fat percentage, fat mass, and visceral adipose tissue area but had no effect on increasing lean mass for Mexican-American and Korean premenopausal overweight/obese women.

  4. Z-score discordance and contributing factors in healthy premenopausal women with low bone mineral density: the Korean National Health and Nutrition Examination Survey 2008-9.

    PubMed

    Park, Kyeong Hye; Lim, Jung Soo; Kim, Kyoung Min; Rhee, Yumie; Lim, Sung-Kil

    2016-11-01

    The premenopausal period is important for bone health and prevention of future fractures, but measuring bone mineral density (BMD) at only one site may not be sufficient to determine therapeutic strategies for low BMD in premenopausal women due to the presence of Z-score discordance. In this study, we investigated Z-score discordance in addition to contributing factors of idiopathic low BMD in healthy premenopausal Korean women. We studied 3003 premenopausal women aged 18-50 years, without secondary causes for low BMD and history of fragility fracture, who had participated in the Fourth Korean National Health and Nutrition Examination Surveys (2008-2009). Low body mass index (BMI), low vitamin D level, and low body muscle mass were associated with low BMD even in premenopausal women. Risk factors differed depending on the anatomic site. Low BMI and low vitamin D level were risk factors for low femoral neck BMD (FN-BMD), but not for low lumbar spine BMD (LS-BMD). Only total muscle mass had a slight effect on low LS-BMD. Z-score discordance was much higher than expected, in 75 and 73.8 % of the low LS-BMD and low FN-BMD groups, respectively. Our findings suggest the need to consider BMD discordance in premenopausal women and also to provide information on correctable factors affecting low BMD in younger populations. Long-term follow-up is needed to evaluate the possible effect of Z-score discordance on the prognosis of osteoporosis and subsequent fracture risk.

  5. The Effect of Korean Red Ginseng on Sexual Function in Premenopausal Women: Placebo-Controlled, Double-Blind, Crossover Clinical Trial

    PubMed Central

    Chung, Ho Seok; Hwang, Insang; Oh, Kyung Jin; Lee, Mi Na; Park, Kwangsung

    2015-01-01

    This study investigated whether Korean red ginseng (KRG) extracts could improve sexual function in premenopausal women. Forty-one premenopausal women participated in this placebo-controlled, double-blind, and crossover clinical study with administration of either three ginseng capsules (1 g per capsule) or placebo daily. After 8 weeks of medication of KRG or placebo, medication was changed for the subjects to placebo or KRG after 2 weeks of washout period. The efficacy of KRG extracts was measured by using Female Sexual Function Index (FSFI). Results. Twenty-three women completed the study. Total FSFI scores increased after KRG treatment (from 20.13 ± 2.87 to 23.98 ± 4.10, p = 0.015) and placebo treatment (from 20.06 ± 2.64 to 23.78 ± 3.28, p = 0.003). However, this change was not significantly different between the two groups (p = 0.702). KRG treatment significantly improved sexual desire, arousal, orgasm, and satisfaction domains; however, there was no treatment effect compared with placebo. There was a case of gastric discomfort after taking KRG extracts. Oral administration of KRG extracts improved sexual function in premenopausal women; however, there were no statistical significant changes compared to placebo. It implies that KRG extracts have a substantial placebo effect in premenopausal women with sexual dysfunction. PMID:26798402

  6. [Osteoporosis in premenopausal women].

    PubMed

    Mitringer, Antje; Pietschmann, P

    2002-01-01

    Osteoporosis is a systemic disease of bone, which is characterized by decreased bone mass and changes in the microarchitecture of bone tissue followed by brittleness of bones and increased risk of fractures. Osteoporosis frequently is a disease of postmenopausal women, nevertheless, in rare cases, osteoporosis can also occur in young adults. There are only few studies on the pathophysiology of "premenopausal osteoporosis"; in addition to idiopathic forms, osteoporosis in young women can be caused by glucocorticoid treatment, by eating disorders or can be associated with pregnancy.

  7. Increased risk of obesity related to total energy intake with the APOA5-1131T > C polymorphism in Korean premenopausal women.

    PubMed

    Lim, Hyo Hee; Choi, Miok; Kim, Ji Young; Lee, Jong Ho; Kim, Oh Yoen

    2014-10-01

    We hypothesized that triglyceride-raising apolipoprotein A5 (APOA5)-1131T > C may contribute to the increased risk of obesity associated with dietary intake in Korean premenopausal women whose minor allele frequency is higher than that in Western people. Genetically unrelated Korean premenopausal women (approximately 20-59 years, n = 1128) were genotyped for APOA5-1131T > C. Anthropometric, metabolic parameters and dietary intakes were analyzed. Odds ratios (ORs) for obesity risk (body mass index, ≥25.0 kg/m(2)) were calculated. Genotype distribution of APOA5-1131T > C of study subjects were like TT: 49.9%, TC: 40.8%, and CC: 9.3%. We found a significant interaction between APOA5-1131T > C and total energy intake (TEI) for obesity after adjusted for age, cigarette smoking, and alcohol consumption (P < .001). The risk of obesity in CC homozygotes compared with T carriers (TT + TC) was significantly increased, when the subjects consume higher TEI (≥2001 kcal/d (8372 kJ/d), median value of the population) (OR, 2.495; 95% confidence intervals, 1.325-4.696; P = .005), particularly, when they maintain negative balance between total energy expenditure and TEI (total energy expenditure/TEI, <1) (OR, 2.917; 95% confidence intervals, 1.451-5.864; P = .003). The contributions of APOA5-1131CC homozygotes to obesity risk in those who consume higher TEI were all significantly high regardless of percentage of energy intake from dietary macronutrients. Whereas, no significant association was observed in those who consume lower TEI (<2001 kcal/d). In addition, serum levels of triglyceride, high-density lipoprotein-cholesterol, and apolipoprotein A5 were associated with APOA5-1131T > C and TEI. These findings suggest that APOA5-1131CC homozygotes may influence the susceptibility of the individual to obesity, particularly, when they consume higher TEI, but the genetic effect may be attenuated, when people maintain low or adequate energy intake. Copyright © 2014 Elsevier Inc. All

  8. Diagnosis of osteoporosis in men, premenopausal women, and children.

    PubMed

    2004-01-01

    The World Health Organization (WHO) classification of bone mineral density is based on population studies in postmenopausal women. However, the increased use of bone densitometry has raised questions regarding the applicability of this classification to men, premenopausal women, and children. These questions were addressed at the International Society for Clinical Densitometry 2003 Position Development Conference. T-scores can be used and a diagnosis of osteoporosis made for T-scores of -2.5 or less (male reference database) in men age 65 yr and older and in men from 50 to 64 yr of age if other risk factors for fracture are present. The WHO classification should not be applied to premenopausal women. Men and premenopausal women with secondary causes of low bone density or bone loss may be clinically diagnosed with osteoporosis, taking bone density into consideration. In children and adolescents (males and females less than 20 yr of age), there are no densitometric criteria for diagnosing osteoporosis. If Z-scores are -2.0 or less (using pediatric databases of age-matched controls), then a characterization such as "low bone density for chronologic age" is appropriate. In men under 50 yr of age, premenopausal women, and children, Z-scores, not T-scores, should be used when reporting bone density results.

  9. Cardiorespiratory fitness and heart rate recovery in obese premenopausal women.

    PubMed

    Carroll, S; Marshall, P; Ingle, L; Borkoles, E

    2012-12-01

    Post-exercise heart rate recovery (HRR) has been proposed as a measure of cardiac autonomic dysfunction in apparently healthy adults. We aimed to determine the effects of a lifestyle intervention on HRR among clinically obese premenopausal women. A randomized controlled trial was conducted to investigate the effects of a 3-month non-dieting lifestyle intervention program on cardiorespiratory fitness (CRF) and HRR among healthy clinically obese premenopausal women. Thirty-one were randomly assigned to 3-month intensive lifestyle intervention and 31 served as controls. Sixty-one participants performed a maximal treadmill walking test with metabolic gas exchange. Baseline anthropometric measures were closely related to HRR at 1 min, which may indicate reduced parasympathetic reactivation. Post-exercise HRR at 60 s (HRR60) increased from 21.3 ± 6.2 to 27.8 ± 10.2 bpm in the intervention group compared with a smaller reduction (26.8 ± 12.3 to 24.5 ± 9.9 bpm) in controls (test for interaction P = 0.0001). HRR120 showed a significant effect of time (P = 0.0002) with no significant interaction with lifestyle intervention. A significant increase in VO2 peak was evident in the lifestyle group (21.6 to 23.6 mL/kg/min) compared with a modest reduction in the controls (22.6 to 21.6 mL/kg/min; test for interaction, P = 0.001). Clinically obese healthy premenopausal women achieved significant improvements in HRR60 and VO peak following a 3-month intensive lifestyle intervention. © 2012 John Wiley & Sons A/S.

  10. The Association between Sleep Duration and Hypertension in Non-obese Premenopausal Women in Korea

    PubMed Central

    Song, Mi-Yeon; Sung, En; Lee, Keun-Mi; Keum, Shin-Ho; Ryu, Sun-Dong

    2016-01-01

    Background Previous studies have revealed that sleep duration is linked to both obesity and hypertension. Here, we evaluated the association between sleep duration and hypertension in obese and non-obese premenopausal women using representative national survey data from the Korean population. Methods A total of 4,748 subjects over 20 years of age from the Korean National Health and Nutrition Examination Survey from 2010 to 2012 were included. To control for risk factors, multivariable logistic regression was used to calculate the adjusted odds ratios and 95% confidence intervals of hypertension across the following sleep duration categories: <6, 6-8, and >8 h/d. Results Among the participants, 367 subjects (7.7%) had hypertension. Their mean sleep duration was 7 hours. In the non-obese subjects, after controlling for potential confounding variables, the odds ratio for hypertension was 1.86 fold greater in those with a sleep duration of <6 hours (odds ratio, 1.79; 95% confidence interval, 1.05 to 3.03) as compared to those who slept for 6.8 hours. However, there was no association between sleep duration and the risk of hypertension in obese subjects. Long sleep duration (over 8 h/d) was not associated with hypertension in either the non-obese or the obese subjects in this study. Conclusion Short sleep duration (less than 6 h/d) may be a significant risk factor for hypertension in non-obese premenopausal women. However, there is no association between sleep duration and the risk of hypertension in obese women. PMID:27073613

  11. Cortisol elimination from plasma in premenopausal women with rheumatoid arthritis

    PubMed Central

    Rovensky, J; Imrich, R; Koska, J; Kovalancik, M; Killinger, Z; Payer, J; Vigas, M; Jezova, D

    2003-01-01

    Methods: Twelve premenopausal female patients with RA (39.8 (1.8) years) and nine healthy control women matched for age and body mass index (42 (3.3) years) were enrolled in the study. None of the patients had previously been receiving treatment with glucocorticoids. After dexamethasone suppression (2 mg by mouth) the evening before the study, 20 mg of hydrocortisone was given. Blood and saliva samples were drawn six hours after injection of hydrocortisone. Plasma and salivary cortisol were measured. Results: Dexamethasone administration suppressed plasma cortisol concentrations to an almost undetectable level in all subjects, except one with RA. In this subject, a raised concentration of plasma cortisol was verified by repeated analysis despite the fact that cortisol concentration in the saliva sample measured simultaneously was not raised. No significant difference in the disappearance curve of cortisol in plasma or in salivary cortisol levels was found between the patients with RA and the healthy controls. Conclusions: The profile of disappearance of total cortisol from plasma, and salivary cortisol levels during the elimination phase after its intravenous administration, are unchanged in premenopausal women with RA. Alterations in cortisol clearance are not likely to have a role in cortisol availability in patients with RA. PMID:12810434

  12. Hormonal effects of soy in premenopausal women and men.

    PubMed

    Kurzer, Mindy S

    2002-03-01

    Over the past few years, there has been increasing interest in the possible hormonal effects of soy and soy isoflavone consumption in both women and men. Soy consumption has been suggested to exert potentially cancer-preventive effects in premenopausal women, such as increased menstrual cycle length and sex hormone-binding globulin levels and decreased estrogen levels. There has been some concern that consumption of phytoestrogens might exert adverse effects on men's fertility, such as lowered testosterone levels and semen quality. The studies in women have provided modest support for beneficial effects. One cross-sectional study showed serum estrogens to be inversely associated with soy intake. Seven soy intervention studies controlled for phase of menstrual cycle. These studies provided 32-200 mg/d of isoflavones and generally showed decreased midcycle plasma gonadotropins and trends toward increased menstrual cycle length and decreased blood concentrations of estradiol, progesterone and sex hormone-binding globulin. A few studies also showed decreased urinary estrogens and increased ratios of urinary 2-(OH) to 16alpha-(OH) and 2-(OH) to 4-(OH) estrogens. Soy and isoflavone consumption does not seem to affect the endometrium in premenopausal women, although there have been weak estrogenic effects reported in the breast. Thus, studies in women have mostly been consistent with beneficial effects, although the magnitude of the effects is quite small and of uncertain significance. Only three intervention studies reported hormonal effects of soy isoflavones in men. These recent studies in men consuming soyfoods or supplements containing 40--70 mg/d of soy isoflavones showed few effects on plasma hormones or semen quality. These data do not support concerns about effects on reproductive hormones and semen quality.

  13. Oxidative Stress and Breast Cancer Risk in Premenopausal Women.

    PubMed

    Nichols, Hazel B; Anderson, Chelsea; White, Alexandra J; Milne, Ginger L; Sandler, Dale P

    2017-09-01

    Detrimental effects of oxidative stress are widely recognized, but induction of apoptosis and senescence may also have benefits for cancer prevention. Recent studies suggest oxidative stress may be associated with lower breast cancer risk before menopause. We conducted a nested case-control study (N = 457 cases, 910 controls) within the NIEHS Sister Study cohort of 50,884 women. Premenopausal women ages 35-54 were eligible for selection. We matched controls 2:1 to cases on age and enrollment year and were breast cancer-free at the time of the corresponding case's diagnosis. Oxidative stress was measured by urinary F2-isoprostane and metabolite (15-F2t-isoprostane-M) concentrations. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated with multivariable conditional logistic regression. After multivariable adjustment for body mass index (BMI) and other potential confounders, the OR for breast cancer comparing the >90th (≥2.94 ng/mgCr) to <25th percentile (1.01 ng/mgCr) was 1.1 (CI: 0.65, 1.7) for F2-isoprostane and 0.70 (CI: 0.43, 1.1) for the metabolite. Higher metabolite concentrations were associated with lower breast cancer risk among women who were also premenopausal (353 cases, OR: 0.59, CI: 0.34, 1.0) or <46 years (82 cases, OR: 0.15, CI: 0.06, 0.42) at diagnosis. ORs for the metabolite and breast cancer were inverse among women with BMI 18.5-24.9 kg/m (OR: 0.47, CI: 0.18, 1.2, 208 cases) and >30 kg/m (OR: 0.71, CI: 0.30, 1.7, 107 cases), but not among women with BMI 25-29.9 kg/m (OR: 0.98, CI: 0.39, 2.5, 138 cases). Together with other studies, our results support a possible inverse association between oxidative stress and premenopausal breast cancer risk.

  14. Ovarian Lipid Metabolism Modulates Circulating Lipids in Premenopausal Women.

    PubMed

    Jensen, Jeffrey T; Addis, Ilana B; Hennebold, Jon D; Bogan, Randy L

    2017-09-01

    The premenopausal circulating lipid profile may be linked to the hormonal profile and ovarian lipid metabolism. Assess how estradiol, progesterone, and ovarian lipid metabolism contributes to the premenopausal lipid profile; and evaluate the acute effects of a common hormonal oral contraceptive (OC) on circulating lipids. Experimental crossover with repeated measures. Academic hospitals. Eight healthy, regularly menstruating women. Participants underwent periodic serum sampling during a normal menstrual cycle; a standard 21-day, monophasic combined hormonal OC cycle (30 µg of ethinyl estradiol and 150 µg of levonorgestrel per day); menopause simulated by leuprolide acetate (22.5-mg depot); and an artificial menstrual cycle achieved via transdermal estradiol (50 to 300 µg/d) and vaginal micronized progesterone (100 to 300 mg/d). Primary outcomes included evaluation of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, and the total cholesterol to HDL cholesterol ratio. To estimate the effect of estradiol, progesterone, and ovarian lipid metabolism, all specimens except those from the OC cycle were analyzed. Subgroup analysis was conducted on the follicular and luteal phases. In a separate analysis, the effect of the OC was evaluated relative to the normal menstrual cycle. Estradiol was significantly associated with increased levels of HDL cholesterol throughout the menstrual cycle and in the follicular phase. Ovarian effects were associated with reduced lipid levels, especially during the luteal phase. The OC was associated with an increased total cholesterol to HDL cholesterol ratio and triglycerides. Previously unappreciated factors including ovarian lipid metabolism may contribute to the premenopausal lipid profile.

  15. Iron and zinc nutriture affect cognition of premenopausal women

    SciTech Connect

    Darnell. L.S.; Sandstead, H.H. )

    1991-03-15

    Effects of changes in iron (Fe) and zinc (Zn) status on cognition of premenopausal women were studied. Research in animals and humans shows that Fe and Zn influence brain function. Effects of mild Fe or Zn deficiencies on cognition of women have received limited attention. Therefore, using a double-blind randomized controlled treatment design the authors supplemented 34 sideropenic non-anemic women, ages 18-40 years, with micronutrients plus Fe, Zn, Fe+Zn, or micronutrients only. The micronutrient supplement was based on NRC guidelines. Eleven nonsideropenic women were also given the micronutrient supplement. Subjects were examined with the Weschler Memory Quotient (MQ) and Booklets Categories (BC) tests before and after treatment. After 8 weeks, significant improvement in MQ was displayed by the Fe, Zn and Fe+Zn groups, but no improvement occurred in the sideropenic subjects who were given only micronutrients. The nonsideropenic group displayed improved MQ when given only micronutrients. In contrast, all but the Fe group improved with the BC Test. The findings suggest that Fe and Zn repletion of sideropenic women improved certain cognitive functions of the women.

  16. Bone mineral density and blood metals in premenopausal women

    SciTech Connect

    Pollack, A.Z.; Mumford, S.L.; Wactawski-Wende, J.; Yeung, E.; Mendola, P.; Mattison, D.R.; Schisterman, E.F.

    2013-01-15

    Exposure to metals, specifically cadmium, lead, and mercury, is widespread and is associated with reduced bone mineral density (BMD) in older populations, but the associations among premenopausal women are unclear. Therefore, we evaluated the relationship between these metals in blood and BMD (whole body, total hip, lumbar spine, and non-dominant wrist) quantified by dual energy X-ray absorptiometry in 248 premenopausal women, aged 18-44. Participants were of normal body mass index (mean BMI 24.1), young (mean age 27.4), 60% were white, 20% non-Hispanic black, 15% Asian, and 6% other race group, and were from the Buffalo, New York region. The median (interquartile range) level of cadmium was 0.30 {mu}g/l (0.19-0.43), of lead was 0.86 {mu}g/dl (0.68-1.20), and of mercury was 1.10 {mu}g/l (0.58-2.00). BMD was treated both as a continuous variable in linear regression and dichotomized at the 10th percentile for logistic regression analyses. Mercury was associated with reduced odds of decreased lumbar spine BMD (0.66, 95% confidence interval: 0.44, 0.99), but overall, metals at environmentally relevant levels of exposure were not associated with reduced BMD in this population of healthy, reproductive-aged women. Further research is needed to determine if the blood levels of cadmium, lead, and mercury in this population are sufficiently low that there is no substantive impact on bone, or if effects on bone can be expected only at older ages.

  17. [The clinical characteristics of women with uterine hemorrhages in premenopause].

    PubMed

    Rachev, E

    1989-01-01

    The clinical characteristics was studied on 431 women with uterine bleedings during the premenopaussal phase of the climacterium. The author established that menarche, duration of menstrual interval and the menstruation itself before the bleeding did not differ from those of female population in the country. The same was referred to the reproductive characteristics. Premenopausal bleeding reached its peak between 46 and 48 years of age as its duration was relatively great. It was connected with frequent neuro-endocrine and metabolic pathology. The most frequent manifestations were obesity and hypertension. The number of the former hepatitis patients was comparatively large. Diseases of the uterine body were frequent in the structure of genital pathology. The frequency of benign, precancerous and malignant neoplastic processes (without myoma) was high-12.7%.

  18. [Diagnostic yield of video capsule endoscopy in premenopausal women with iron-deficiency anemia].

    PubMed

    Garrido Durán, Carmen; Iyo Miyashiro, Eduardo; Páez Cumpa, Claudia; Khorrami Minaei, Sam; Erimeiku Barahona, Alicia; Llompart Rigo, Alfredo

    2015-01-01

    Clinical practice guidelines recommend video capsule endoscopy (VCE) studies in patients with iron-deficiency anemia (IDA) after conventional upper and lower endoscopies but there is a need for studies demonstrating the diagnostic yield, clinical impact, and cost in some patient subgroups. 1.To determine the diagnostic yield of VCE in premenopausal women with IDA compared with that in men and postmenopausal women. 2. To identify the presence of VCE predictors in premenopausal women. 3. To estimate the cost-clinical impact relationship associated with VCE in this indication. We retrospectively analyzed 408 patients who underwent VCE. Patients with IDA were enrolled (premenopausal, postmenopausal women, and men), with previous normal work-up by conventional endoscopies. A total of 249 patients were enrolled: 131 women (52.6%), of which 51 were premenopausal and 80 were post-menopausal, and 118 men. The mean age was 60.7±16 years. The diagnostic yield of VCE for the diagnosis of IDA was 44.6% (95% CI 39.9 - 50.8). Diagnostic yield was 50.8% vs 38.9% in men vs women (p=0.05) and was 55% vs 13.7% in postmenopausal vs premenopausal women (p<0.001). No predictors of small bowel lesions were found in premenopausal women. The most common findings in the postmenopausal group were angioectasias (70.5%) and erosions (57.1%) in the premenopausal group. The cost in premenopausal women was 44.727€ and 86.3% of the procedures had no clinical impact. The diagnostic yield of VCE is low in the etiological study of IDA in premenopausal women and there is no cost-effectiveness in relation to clinical impact. No predictors of small bowel lesions were found in this group. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  19. Abdominal obesity, muscle composition, and insulin resistance in premenopausal women.

    PubMed

    Ross, Robert; Freeman, Jennifer; Hudson, Robert; Janssen, Ian

    2002-11-01

    The independent relationships between visceral and abdominal sc adipose tissue (AT) depots, muscle composition, and insulin sensitivity were examined in 40 abdominally obese, premenopausal women. Measurements included glucose disposal by euglycemic clamp, muscle composition by computed tomography, abdominal and nonabdominal (e.g. leg) AT by magnetic resonance imaging and cardiovascular fitness. Glucose disposal rates were negatively related to visceral AT mass (r = -0.42, P < 0.01). These observations remained significant (P < 0.01) after control for nonabdominal and abdominal sc AT, muscle attenuation, and peak oxygen uptake. Total, abdominal, or leg sc AT or muscle attenuation was not significantly (P > 0.10) related to glucose disposal. Subdivision of abdominal sc AT into anterior and posterior depots did not alter the observed relationships. Further analysis matched two groups of women for abdominal sc AT but with low and high visceral AT. Women with high visceral AT had lower glucose disposal rates compared with those with low visceral AT (P < 0.05). A similar analysis performed on two groups of women matched for visceral AT but high and low abdominal sc AT revealed no statistically different values for insulin sensitivity (P > 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal, abdominal sc AT, muscle composition, and cardiovascular fitness. Subdivision of abdominal sc AT did not provide additional insight into the relationship between abdominal obesity and metabolic risk.

  20. Prenatal diethylstilbestrol exposure and reproductive hormones in premenopausal women.

    PubMed

    Wise, L A; Troisi, R; Hatch, E E; Titus, L J; Rothman, K J; Harlow, B L

    2015-06-01

    Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women in the mid-1900s, is a potent endocrine disruptor. Prenatal DES exposure has been associated with reproductive disorders in women, but little is known about its effects on endogenous hormones. We assessed the association between prenatal DES exposure and reproductive hormones among participants from the Harvard Study of Moods and Cycles (HSMC), a longitudinal study of premenopausal women aged 36-45 years from Massachusetts (1995-1999). Prenatal DES exposure was reported at baseline (43 DES exposed and 782 unexposed). Early follicular-phase concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol were measured at baseline and every 6 months during 36 months of follow-up. Inhibin B concentrations were measured through 18 months. We used multivariable logistic and repeated-measures linear regression to estimate odds ratios (OR) and percent differences in mean hormone values (β), respectively, comparing DES exposed with unexposed women, adjusted for potential confounders. DES-exposed women had lower mean concentrations of estradiol (pg/ml) (β=-15.6%, 95% confidence interval (CI): -26.5%, -3.2%) and inhibin B (pg/ml) (β=-20.3%, CI: -35.1%, -2.3%), and higher mean concentrations of FSH (IU/I) (β=12.2%, CI: -1.5%, 27.9%) and LH (IU/I) (β=10.4%, CI: -7.2%, 31.3%), than unexposed women. ORs for the association of DES with maximum FSH>10 IU/I and minimum inhibin B<45 pg/ml--indicators of low ovarian reserve--were 1.90 (CI: 0.86, 4.22) and 4.00 (CI: 0.88-18.1), respectively. Prenatal DES exposure was associated with variation in concentrations of FSH, estradiol and inhibin B among women of late reproductive age.

  1. Korean women's breast cancer experience.

    PubMed

    Im, Eun-Ok; Lee, Eun Ok; Park, Young Sook

    2002-11-01

    The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) "I did wrong," (b) "I cannot ask male physicians." (c) "I don't want to show the operation site to my husband." and (d) "I do household tasks by myself." The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women's health/illness experience.

  2. Effect of energy deficiency on estrogen metabolism in premenopausal women.

    PubMed

    Westerlind, Kim C; Williams, Nancy I

    2007-07-01

    Physical activity has been associated with decreased breast cancer risk, potentially through changes in estrogen metabolism. Two-hydroxyestrone (2-OHE1) and 16alpha-hydroxyestrone (16alpha-OHE1) have different biological properties, and the ratio of these metabolites (2/16) has been proposed to predict breast cancer risk. Diet and exercise have been found to influence estrogen metabolism, particularly when a state of negative energy balance is achieved. We sought to determine whether 4 months of moderate-intensity exercise coupled with calorie restriction would result in changes in urinary 2-OHE1, 16alpha-OHE1, or 2/16 in sedentary, premenopausal, eumenorrheic women. Average age was 31.5 yr, average body fat was 31.6%, and average BMI was 23.7. Urinary estrogen metabolites were measured in 24 women during the baseline and for four intervention months in the midfollicular and midluteal phases. The intervention produced a significant drop in body fat (4.5%) and body weight (3.7 kg). Aerobic fitness increased significantly (26%; P < 0.001). Overall, there were no significant effects of the diet and exercise intervention on 2-OHE1, 16alpha-OHE1, or 2/16. However, when divided into tertiles according to baseline 2/16, the intervention resulted in significant increases in 2/16 in women in the lowest tertile. Women in the lowest tertile (average 2/16 = 0.91) did not differ from the other tertiles in baseline estradiol concentrations, body fat, weight, fitness, or changes in these variables with the intervention. The data suggest that women at higher risk for developing breast cancer because of low 2/16 may reduce their risk by participating in lifestyle interventions such as exercise/calorie restriction.

  3. A Cutoff for Age at Menarche Predicting Metabolic Syndrome in Egyptian Overweight/Obese Premenopausal Women.

    PubMed

    Elsehely, Ibrahim; Abdel Hafez, Hala; Ghonem, Mohammed; Fathi, Ali; Elzehery, Rasha

    2017-04-01

    Previous studies showed that early age at menarche is associated with increased risk of metabolic syndrome. However, the definition of early menarche at these studies was based on background data in the communities at which these studies was carried on. The aim of this work is to determine a cutoff for age at menarche discriminating presence or absence of metabolic syndrome in overweight/obese premenopausal women. This study included 204 overweight/obese women. Metabolic syndrome was defined according to NCEP-ATP III (National Cholesterol Education Program Adult Treatment Panel III) criteria. Of a total 204 participants, 82 (40.2%) had metabolic syndrome. By using receiver operating characteristic analysis, age at menarche ≤12.25 year discriminated individuals with from those without metabolic syndrome. The area under the curve was 0.76 (95% confidence interval, 0.70 to 0.83). Sensitivity, specificity, negative predictive value, and positive predictive value were 82%, 70%, 85%, and 64%, respectively. Age at menarche ≤12.25 years predicts the presence of metabolic syndrome in overweight/obese women. Copyright © 2017 Korean Diabetes Association.

  4. Has testosterone passed the test in premenopausal women with low libido? A systematic review

    PubMed Central

    Reed, Beverly G; Bou Nemer, Laurice; Carr, Bruce R

    2016-01-01

    Background There are limited evaluation and treatment options for low libido in premenopausal women. This review sought to evaluate the available evidence supporting the evaluation of testosterone serum levels and testosterone treatment of premenopausal women with low libido. Methods MEDLINE, PubMed, and ClinicalTrials.gov were searched for articles that referenced the evaluation of testosterone serum level and/or testosterone treatment on premenopausal women with low libido from 1995 to 2015. Additional references were obtained from the reference sections of other papers and from peer review. Studies that included only postmenopausal women were excluded. A total of 13 studies were reviewed in detail. Nine studies examined the relationship between testosterone serum levels and sexuality, an additional three studies examined the effect of testosterone treatment on premenopausal women with low libido, and one study examined both the topics. Results Six of the ten testosterone serum evaluation studies failed to show a significant association between testosterone serum level and libido. Only one out of four studies examining testosterone treatment in premenopausal women was able to show any clear improvement in libido; however, the effect was limited to only the intermediate dose of testosterone, with the low and high doses of testosterone not producing any effect. Conclusion The currently available evidence does not support testosterone serum evaluation or treatment in premenopausal women with low libido. Hence, further studies are warranted. PMID:27785108

  5. Osteoporosis and milk intake among Korean women in California: relationship with acculturation to U.S. lifestyle.

    PubMed

    Irvin, Veronica L; Nichols, Jeanne F; Hofstetter, C Richard; Ojeda, Victoria D; Song, Yoon Ju; Kang, Sunny; Hovell, Melbourne F

    2013-12-01

    The Korean population in the US increased by a third between 2000 and 2010. Korean women in the US report low calcium intake and relatively high rate of fractures. However, little is known about the prevalence of osteoporosis among Korean American women. This paper examined the relationship between prevalence of osteoporosis and milk consumption, and their relationship with acculturation among a representative sample of immigrant California women of Korean descent. Bilingual telephone surveys were conducted from a probability sample (N = 590) in 2007. Lower acculturation significantly related to lower milk consumption for women during the age periods of 12-18 and 19-34 years. Acculturation was related to higher prevalence of osteoporosis among post-menopausal, but not pre-menopausal Korean women in California. Future research should include larger cohorts, objective measures of osteoporosis, other sources of calcium specific to Korean cuisine, and assessment of bone-loading physical activity.

  6. Osteoporosis and Milk Intake among Korean Women in California: Relationship with Acculturation to U.S. Lifestyle

    PubMed Central

    Irvin, Veronica L.; Nichols, Jeanne F.; Hofstetter, C. Richard; Ojeda, Victoria D.; Song, YoonJu; Kang, Sunny; Hovell, Melbourne F.

    2013-01-01

    Background The Korean population in the U.S. increased by a third between 2000 and 2010. Korean women in the U.S. report low calcium intake and relatively high rate of fractures. However, little is known about the prevalence of osteoporosis among Korean American women. This paper examined the relationship between prevalence of osteoporosis and milk consumption, and their relationship with acculturation among a representative sample of immigrant California women of Korean descent. Methods Bilingual telephone surveys were conducted from a probability sample (N = 590) in 2007. Results Lower acculturation significantly related to lower milk consumption for women during the age periods of 12-18 and 19-34 years. Acculturation was related to higher prevalence of osteoporosis among post-menopausal, but not pre-menopausal Korean women in California. Discussion Future research should include larger cohorts, objective measures of osteoporosis, other sources of calcium specific to Korean cuisine, and assessment of bone-loading physical activity. PMID:23338905

  7. Sleep and the menopause - do postmenopausal women experience worse sleep than premenopausal women?

    PubMed

    Kalleinen, Nea; Polo-Kantola, Päivi; Himanen, Sari-Leena; Alhola, Paula; Joutsen, Atte; Urrila, Anna S; Polo, Olli

    2008-09-01

    To examine the sleep characteristics in three cross-sectional populations: young, premenopausal and postmenopausal women, and the associations between sleep, menopause, mood and cognitive performance. Twenty-one premenopausal (45-51 years), 29 postmenopausal (59-71 years) and 11 young (20-26 years, using oral contraceptives) women were recruited. Polysomnography was used to measure objective sleep quality. Subjective sleep quality, sleepiness and mood were assessed using questionnaires. Cognitive performance was investigated by means of three attentional tests. Total sleep time in pre- and postmenopausal women was similar (404.9 and 384.7 minutes), but shorter than in young women (448.2 minutes, P = 0.030 and <0.003, respectively). Sleep efficiency followed the same pattern, being 84.3% in premenopausal (P = 0.027), 80.2% in postmenopausal (P < 0.003) and 93.4% in young women. Pre- and postmenopausal women had less slow wave sleep (duration or activity) and more wake time after sleep onset (duration or frequency). Insomnia complaints were more frequent after the menopause (P = 0.023). Sleepiness and mood scores were similar in all groups. Reaction speeds slowed with increasing age. After the menopause, better cognitive performance was associated with more rapid eye movement sleep. Objective sleep measures differed significantly between the young and postmenopausal groups. These differences may be more because of the physiology of ageing than the rapid changes across the menopause, since similar sleep characteristics were already present in the premenopausal women. The increase in sleep complaints after menopause was not associated with sleepiness or disturbances in objective sleep quality, mood or cognitive performance.

  8. Bone mineral density in premenopausal women receiving levothyroxine suppressive therapy.

    PubMed

    Nuzzo, V; Lupoli, G; Esposito Del Puente, A; Rampone, E; Carpinelli, A; Del Puente, A E; Oriente, P

    1998-10-01

    Osteoporosis is a well-known complication of thyrotoxicosis. Prolonged subclinical hyperthyroidism due to L-thyroxine treatment has been associated with reduced bone mass and thus with the potential risk of premature development of osteoporosis. The aim of this study was to assess the effect of a chronic L-thyroxine suppressive treatment on bone mineral density (BMD) in a group of premenopausal women. Forty consecutive patients (mean age +/- SE = 40.95 +/- 1.56 years) affected by non-toxic goiter underwent bone mineral densitometry (dual energy X-ray absorptiometry; DEXA) of the lumbar spine (L1-L4) and right femoral neck. At the time of the study the patients had been under thyroid stimulating hormone (TSH) suppressive therapy for 74.95 +/- 10.34 months (range 17-168 months). Baseline levels of free thyroxine (fT4), free triiodothyronine (fT3), TSH, calcium and phosphorus were measured and correlated with BMD. The age of starting, duration of treatment, main daily dose, cumulative dose of treatment and body mass index (BMI) were also correlated with BMD. Statistical analysis was performed by multiple linear regression. BMD among female patients was not significantly different from that of the general population matched for age and sex. With the use of the regression model, no significant correlation was found between BMD and the variables considered. In conclusion, our data suggest that L-thyroxine suppressive therapy, if carefully carried out and monitored, has no significant effect on bone mass.

  9. Equol production changes over time in pre-menopausal women.

    PubMed

    Franke, Adrian A; Lai, Jennifer F; Pagano, Ian; Morimoto, Yukiko; Maskarinec, Gertraud

    2012-04-01

    Equol (EQ) is a metabolite produced by gut bacteria through the chemical reduction of the soya isoflavone daidzein (DE), but only by 30-60% of the population. EQ is believed to provide benefits derived from soya intake and its production is widely viewed as a relatively stable phenomenon. In a randomised, cross-over intervention with soya foods, seventy-nine pre-menopausal women were challenged with a high-soya and a low-soya diet each for 6 months, separated by a 1-month washout period. Overnight urine was collected at three time points during each diet period and analysed for DE and EQ by liquid chromatography tandem MS. Remaining an EQ producer (EP) or non-producer (NP) or changing towards an EP or NP was assessed using an EQ:DE ratio of ≥0·018 combined with a DE threshold of ≥2 nmol/mg creatinine as a cut-off point. We observed 19 and 24% EP during the low-soya and high-soya diet periods, respectively, and found that 6-11% of our subjects changed EQ status 'within' each study period (on an average of 1·2 times), while 16% changed 'between' the two diet periods. The present finding challenges the widely held conviction that EQ production within an individual remains stable over time. The precise factors contributing to changes in EQ status, however, remain elusive and warrant further investigation.

  10. Bicycle Riding, Walking, and Weight Gain in Premenopausal Women

    PubMed Central

    Lusk, Anne C.; Mekary, Rania A.; Feskanich, Diane; Willett, Walter C.

    2011-01-01

    Context No research has been conducted on bicycle riding and weight control in comparison to walking. Objective To assess the association between bicycle riding and weight control in premenopausal women. Design, Setting, and Participants This was a 16-year follow-up of 18, 414 women in the Nurses’ Health Study II. Main Outcome Measures Weight change between 1989 and 2005 was the primary outcome and odds of gaining >5% of baseline body weight (BBW) by 2005 the secondary outcome. Results At baseline, only 39% walked briskly while only 1.2% bicycled for ≥30 min/d. For a 30 min/d increase in activity between 1989 and 2005, weight gain was significantly less for brisk walking (−1.81 kg; 95% confidence interval (CI) = −2.05,−1.56), bicycling (−1.59 kg; 95%CI= −2.09, −1.08), and other activities (−1.45 kg; 95%CI= −1.66, −1.24) but not for slow walking (+0.06 kg; 95%CI= −0.22, 0.35). Women who reported no bicycling in 1989 and increased to as little as 5 minutes/day in 2005 gained less weight (−0.74 kg; 95%CI= −1.41, −0.07, P-trend<0.01) than those who remained non-bikers. Normal weight women who bicycled ≥ 4 hours/week in 2005 had lower odds of gaining >5% of their BBW (Odds Ratio (OR) =0.74, 95%CI=0.56–0.98) compared with those who reported no bicycling; overweight/obese women had lower odds at 2–3 hours/week (OR=0.54, 95%CI=0.34–86). Conclusions Bicycling, similar to brisk walking, is associated with less weight gain and an inverse dose-response relationship exists, especially among overweight/obese women. Future research should focus on brisk walking but also on greater time spent bicycling. PMID:20585071

  11. Urinary Estrogen Metabolites in 2 Soy Trials with Premenopausal Women

    PubMed Central

    Maskarinec, Gertraud; Morimoto, Yukiko; Heak, Sreang; Isaki, Marissa; Steinbrecher, Astrid; Custer, Laurie; Franke, Adrian A.

    2012-01-01

    Background Soy consumption may protect against breast cancer through modification of estrogen metabolism. Objective We examined the effect of soy foods on urinary estrogens and the 2-hydroxy (OH)/16α-OH estrone (E1) ratio in 2 dietary interventions with premenopausal women. Methods BEAN1 was a 2-year randomized trial and BEAN2 a 13-month randomized crossover study. In both interventions, study participants consumed a high-soy diet with 2 soy food servings/day and a low-soy diet with <3 servings of soy/week. Urine samples were collected at baseline and at the end of the diet periods, analyzed for 9 estrogen metabolites by liquid chromatography mass spectrometry, and adjusted for creatinine levels. For BEAN1, 2 samples for 188 participants and for BEAN2, 3 samples for 79 women were analyzed. We applied mixed-effects regression models with log-transformed values of estrogen metabolites and soy intake as the exposure variable. Results In BEAN1, no effect of the high-soy diet on individual estrogen metabolites or hydroxylation pathways was observed. The median 2-OH/16α-OH E1 ratio decreased non-significantly in the intervention group from 6.2 to 5.2 as compared to 6.8 and 7.2 in the control group (p=0.63). In BEAN2, only 4-OHE1 was significantly lower after the high-soy diet. Interaction terms of the high-soy diet with equol producer status, ethnicity, and weight status revealed no significant effect modification. Conclusions Contrary to our hypothesis and some previous reports, the results from 2 well controlled dietary interventions do not support an effect of a high-soy diet on a panel of urinary estrogen metabolites and the 2-OH/16α-OHE1 ratio. PMID:22713773

  12. Chronic sleep complaints in premenopausal women and their association with sleep-disordered breathing.

    PubMed

    Tantrakul, Visasiri; Guilleminault, Christian

    2009-01-01

    In clinical practice, we have found that premenopausal women have delayed diagnosis of sleep-disordered breathing (SDB). During a 4-year period, we systematically collected the clinical and polysomnographic variables for all women referred for sleep complaints using preestablished questionnaires, scales, clinical grid, polygraphic montage, and scoring criteria. The variables collected on premenopausal SDB women were analyzed and compared to those of postmenopausal women within 5 years of menopause. Of 977 women, 316 were premenopausal with SDB. Complaints of chronic insomnia and sleepwalking were the most common reasons for referral, had been present for a mean of 6.4 +/- 5.4 years, and had lead to unsuccessful symptomatic treatment. The normal-weight premenopausal SDB group had anatomically small upper airways, while those with body mass index (BMI) >/= 25 kg/m(2) complained more frequently of snoring and daytime sleepiness and their clinical presentation was closer to those of the postmenopausal SDB comparison group. Premenopausal women often had a low apnea-hypopnea index (AHI), but there was a discrepancy between the low AHI and the amount of continuous positive airway pressure (CPAP) needed to control the SDB, and there was a need for higher pressures in overweight premenopausal SDB women (mean 9.1 +/- 1.9 and 10.1 +/- 2.6 cmH(2)O). Normal-weight premenopausal SDB women often present with atypical sleep complaints of chronic insomnia and parasomnias. Clinical attention paid to craniofacial features and use of specific scales such as Mallampati help with the suspicion of the presence of SDB, and a low AHI is unrelated to the positive clinical impact of nasal CPAP treatment.

  13. Determinants of volumetric breast density in Chilean premenopausal women.

    PubMed

    Pereira, Ana; Garmendia, Maria Luisa; Uauy, Ricardo; Neira, Paulina; Lopez-Arana, Sandra; Malkov, Serghei; Shepherd, John

    2017-04-01

    High mammographic breast density (BD) is a strong risk factor of breast cancer; however, little is known in women under 40 years of age. Recently, dual-energy X-ray Absorptiometry (DXA) has been developed as a low-dose method to measure BD in young populations. Thus, our aims were to describe BD in relation to risk factors in Chilean women under 40 years old and to explore the equivalence of DXA to mammography for the measurement of BD. We selected 192 premenopausal Chilean female participants of the DERCAM study for whom we have anthropometric, sociodemographic, and gyneco-obstetric data. The subjects received both digital mammograms (Hologic) and breast DXA scans (GE iDXA). Mammographic BD was estimated using a fully automated commercial method (VOLPARA(®)) and BI-RADS. Breast DXA scans were performed using a standardized protocol and the % fibroglandular volume (%FGV) was estimated considering a two-compartment model of adipose and fibroglandular tissue. The mean age was 37 years (SD = 6.5) and 31.6% of the subjects were obese. The median %FGV and absolute FGV (AFGV) measured by DXA were 9% and 198.1 cm(3) and for VOLPARA(®), 8.6% and 58.0 cm(3), respectively. The precision for %FGV after reposition was 2.8%. The correlation coefficients for %FGV, AFGV, and breast volume between DXA and mammography were over 0.7. Age and body mass index (BMI) were inversely associated with %FGV, and BMI was positively related to AFGV as estimated with DXA or mammography. We did not observe an association with gyneco-obstetric characteristics, education, and %FGV and AFGV; smoking was only associated with AFGV as measured by VOLPARA(®). DXA is an alternative method to measure volumetric BD; thus, it could be used to continuously monitor BD in adult women in follow-up studies or to assess BD in young women.

  14. Role of Ovarian Function Suppression in Premenopausal Women with Early Breast Cancer

    PubMed Central

    2016-01-01

    Historically, endocrine therapy for breast cancer began with ovarian ablation (OA) for the treatment of premenopausal patients. After the identification of estrogen receptors and the development of many antiestrogens, tamoxifen has been approved and used as the standard endocrine therapy for hormonal receptor (HR)-positive premenopausal patients to date. With the development of luteinizing hormone-releasing hormone agonists, the paradigm of endocrine therapy for premenopausal women with HR-positive breast cancer began to change from OA to ovarian function suppression (OFS). To date, the indication for OFS was limited to those premenopausal patients with HR-positive breast cancer who were unable to use tamoxifen as the primary adjuvant endocrine therapy. However, following the definitive demonstration of the therapeutic role of OFS added to tamoxifen or aromatase inhibitor after chemotherapy in large randomized trials, such as Tamoxifen and Exemestane Trial or Suppression of Ovarian Function Trial, the American Society of Clinical Oncology guidelines for the use of endocrine therapy in premenopausal HR-positive breast cancer were recently updated to recommend OFS in high-risk patients who required adjuvant chemotherapy. In contrast, the role of OFS to protect ovarian function during chemotherapy in premenopausal women has remained controversial, and some evidence showing the protective effect of OFS on the ovaries during chemotherapy as well as its therapeutic effect for breast cancer in premenopausal women with HR-negative breast cancer was recently published. Further evaluation is necessary to determine its exact role. In conclusion, the role of OA or OFS has been evolving, not only to improve the efficacy of breast cancer treatment, but also to preserve ovary function. OFS remains a main strategy for premenopausal women with HR-positive early breast cancer, though its exact role should be determined in further studies. PMID:28053622

  15. Practice points in gynecardiology: Abnormal uterine bleeding in premenopausal women taking oral anticoagulant or antiplatelet therapy.

    PubMed

    Maas, Angela H E M; Euler, Mia von; Bongers, Marlies Y; Rolden, Herbert J A; Grutters, Janneke P C; Ulrich, Lian; Schenck-Gustafsson, Karin

    2015-12-01

    A growing number of premenopausal women are currently using antithrombotic and/or (dual) antiplatelet therapy for various cardiovascular indications. These may induce or exacerbate abnormal uterine bleeding and more awareness and knowledge among prescribers is required. Heavy and irregular menstrual bleeding is common in women in their forties and may have a variety of underlying causes that require different treatment options. Thus using anticoagulants in premenopausal women demands specific expertise and close collaboration between cardiovascular physicians and gynecologists. In this article we summarize the scope of the problem and provide practical recommendations for the care for young women taking anticoagulants and/or (dual) antiplatelet therapy. We also recommend that more safety data on uterine bleeding with novel anticoagulants in premenopausal women should be obtained. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Adjuvant endocrine therapy of premenopausal women with early breast cancer: an overview.

    PubMed

    Hubalek, Michael; Brantner, Christine; Marth, Christian

    2010-04-01

    Tamoxifen is currently the standard of care for premenopausal women with hormone receptor-positive early breast cancers. However, endocrine strategies in premenopausal women include not only estrogen receptor blockade with tamoxifen but also temporary suppression of ovarian estrogen synthesis by luteinizing hormone-releasing hormone (LHRH) agonists, or permanent interruption of ovarian estrogen synthesis with oophorectomy or radiotherapy. Luteinizing hormone-releasing hormone agonists have proven to be as effective as surgical oophorectomy in adjuvant treatment of premenopausal breast cancer. The addition of LHRH agonists compared to no therapy reduces the annual odds of recurrence and death in premenopausal women aged less than 50 years with estrogen receptor-positive tumors. Luteinizing hormone-releasing hormone agonists alone or in combination with tamoxifen have shown disease-free survival rates similar to chemotherapy with CMF (cyclophosphamide/methotrexate/5-fluorouracil) and other second-generation chemotherapies. The role of aromatase inhibitors in combination with ovarian suppression is still not established, especially as a large phase III randomized study (Austrian Breast and Colorectal Cancer Study Group Trial 12) did not show superior efficacy compared with ovarian suppression plus tamoxifen in premenopausal early stage disease. Patients currently continue to receive ovarian suppression and tamoxifen. CYP2D6 status may become an important discriminator for the type of endocrine therapy for the premenopausal patient in the future.

  17. Effects of soy foods on ovarian function in premenopausal women

    PubMed Central

    Wu, A H; Stanczyk, F Z; Hendrich, S; Murphy, P A; Zhang, C; Wan, P; Pike, M C

    2000-01-01

    It has been proposed that the high intake of soy foods among Asians may partly explain their lower rates of breast cancer, perhaps by lowering endogenous oestrogen levels, although this has been inadequately studied. Twenty healthy cycling premenopausal women (ten Asians and ten non-Asians) participated in a 7-month soy intervention study which was designed to investigate the effect of supplementation on ovarian function. Asian soy foods (tofu, soymilk, green soybean peas) in the amount of approximately 32 mg of isoflavones per day were added to the women's diets for three menstrual cycles. The women's baseline (two cycles) serum hormone levels were compared to levels during soy intervention (three cycles) and levels after intervention (two cycles). During the entire study period, subjects provided almost daily overnight urine samples and blood specimens during specified days of their menstrual cycles. The day of urinary luteinizing hormone (LH) peak was used as a marker for the day of ovulation. Knowledge of day of ovulation allowed comparison of hormone measurements at baseline to those obtained during intervention and recovery cycles with standardization of day of cycle. Soy intervention was associated with a statistically significant reduction in serum luteal oestradiol level (–9.3%, P< 0.05), but there were no significant changes in follicular phase oestradiol, follicular or luteal phase progesterone, sex hormone-binding globulin or menstrual cycle length. This significant reduction in luteal phase oestradiol was, however, observed only among Asian (–17.4%) but not among non-Asian (–1.2%) participants; urinary excretion of isoflavones was higher among Asians than non-Asians (29.2 vs 17.1 μmol day−1, P = 0.16) during the intervention period. Thus, supplementation using traditional soy foods reduced serum oestradiol levels among Asian participants in this study. Differences in the type of soy products (i.e. traditional soy foods versus soy protein

  18. Nighttime awakenings responding to gabapentin therapy in late premenopausal women: a case series.

    PubMed

    Guttuso, Thomas

    2012-04-15

    Insomnia related to nighttime awakenings is known to be more prevalent in women than men. Three cases are presented here of late premenopausal women experiencing frequent nighttime awakenings that responded well to bedtime treatment with gabapentin. In one case, what started as isolated nighttime awakenings slowly progressed to awakenings accompanied by typical menopausal night sweats. This led to the theory that the initial isolated nighttime awakenings in this patient may have been secondary to a menopausal etiology related to low serum estradiol levels. In the subsequent 2 cases, early follicular phase serum estradiol was confirmed to be low. It is theorized that isolated nighttime awakenings in some premenopausal women may be caused by low serum estradiol, triggering events physiologically related to menopausal night sweats. Further research is needed to determine if low early follicular phase serum estradiol is associated with nighttime awakenings in premenopausal women not experiencing night sweats.

  19. Regulation of energy expenditure by estradiol in premenopausal women.

    PubMed

    Melanson, Edward L; Gavin, Kathleen M; Shea, Karen L; Wolfe, Pamela; Wierman, Margaret E; Schwartz, Robert S; Kohrt, Wendy M

    2015-11-01

    Suppressing sex hormones in women for 1 wk reduces resting energy expenditure (REE). The effects of more chronic suppression on REE and other components of total energy expenditure (TEE), and whether the reduction in REE is specifically due to loss of estradiol (E2), are not known. We compared the effects of 5 mo of sex hormone suppression (gonadotropin releasing hormone agonist therapy, GnRHAG) with placebo (PL) or E2 add-back therapy on REE and the components of TEE. Premenopausal women received GnRHAG (leuprolide acetate 3.75 mg/mo) and were randomized to receive transdermal therapy that was either E2 (0.075 mg/d; n = 24; means ± SD, aged = 37 ± 8 yr, BMI = 27.3 ± 6.2 kg/m(2)) or placebo (n = 21; aged = 34 ± 9 yr, BMI = 26.8 ± 6.2 kg/m(2)). REE was measured by using a metabolic cart, and TEE, sleep EE (SEE), exercise EE (ExEE, 2 × 30 min bench stepping), non-Ex EE (NExEE), and the thermic effect of feeding (TEF) were measured by using whole room indirect calorimetry. REE decreased in GnRHAG+PL [mean (95% CI), -54 (-98, -15) kcal/d], but not GnRHAG+E2 [+6 (-33, +45) kcal/d] (difference in between-group changes, P < 0.05). TEE decreased in GnRHAG+PL [-128 (-214, -41) kcal/d] and GnRHAG+E2 [-96 (-159, -32) kcal/d], with no significant difference in between-group changes (P = 0.55). SEE decreased similarly in both GnRHAG+PL [-0.07 (-0.12, -0.03) kcal/min] and GnRHAG+E2 [-0.07 (-0.12, -0.02) kcal/min]. ExEE decreased in GnRHAG+PL [-0.46 (-0.79, -0.13) kcal/min], but not GnRHAG+E2 [-0.30 (-0.65, +0.06) kcal/min]. There were no changes in TEF or NExEE in either group. In summary, chronic pharmacologic suppression of sex hormones reduced REE and this was prevented by E2 therapy.

  20. Regulation of energy expenditure by estradiol in premenopausal women

    PubMed Central

    Gavin, Kathleen M.; Shea, Karen L.; Wolfe, Pamela; Wierman, Margaret E.; Schwartz, Robert S.; Kohrt, Wendy M.

    2015-01-01

    Suppressing sex hormones in women for 1 wk reduces resting energy expenditure (REE). The effects of more chronic suppression on REE and other components of total energy expenditure (TEE), and whether the reduction in REE is specifically due to loss of estradiol (E2), are not known. We compared the effects of 5 mo of sex hormone suppression (gonadotropin releasing hormone agonist therapy, GnRHAG) with placebo (PL) or E2 add-back therapy on REE and the components of TEE. Premenopausal women received GnRHAG (leuprolide acetate 3.75 mg/mo) and were randomized to receive transdermal therapy that was either E2 (0.075 mg/d; n = 24; means ± SD, aged = 37 ± 8 yr, BMI = 27.3 ± 6.2 kg/m2) or placebo (n = 21; aged = 34 ± 9 yr, BMI = 26.8 ± 6.2 kg/m2). REE was measured by using a metabolic cart, and TEE, sleep EE (SEE), exercise EE (ExEE, 2 × 30 min bench stepping), non-Ex EE (NExEE), and the thermic effect of feeding (TEF) were measured by using whole room indirect calorimetry. REE decreased in GnRHAG+PL [mean (95% CI), −54 (−98, −15) kcal/d], but not GnRHAG+E2 [+6 (−33, +45) kcal/d] (difference in between-group changes, P < 0.05). TEE decreased in GnRHAG+PL [−128 (−214, −41) kcal/d] and GnRHAG+E2 [−96 (−159, −32) kcal/d], with no significant difference in between-group changes (P = 0.55). SEE decreased similarly in both GnRHAG+PL [−0.07 (−0.12, −0.03) kcal/min] and GnRHAG+E2 [−0.07 (−0.12, −0.02) kcal/min]. ExEE decreased in GnRHAG+PL [−0.46 (−0.79, −0.13) kcal/min], but not GnRHAG+E2 [−0.30 (−0.65, +0.06) kcal/min]. There were no changes in TEF or NExEE in either group. In summary, chronic pharmacologic suppression of sex hormones reduced REE and this was prevented by E2 therapy. PMID:26338457

  1. Association of Uric Acid with Metabolic Syndrome in Men, Premenopausal Women and Postmenopausal Women

    PubMed Central

    Li, Yongqiang; Chen, Shanying; Shao, Xiaofei; Guo, Jia; Liu, Xinyu; Liu, Aiqun; Zhang, Ying; Wang, Honglei; Li, Bin; Deng, Kangping; Liu, Qin; Holthöfer, Harry; Zou, Hequn

    2014-01-01

    Objective: To explore the relationship between serum uric acid (SUA) and metabolic syndrome (MS) in men, premenopausal women and postmenopausal women. Methods: A cross-sectional study was conducted in 1,834 community-based Southern Chinese participants from June to October 2012. Sex-specific SUA quartiles were used as follows: <345, 345–<400, 400–<468, ≥468 µmol/L in males; and <248, 248–<288, 288–<328, ≥328 µmol/L in females. MS was defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) Criteria. The association between SUA and MS was then analyzed using the STATA software. Results: The odds ratio (OR) for having MS in the highest versus lowest quartiles of SUA levels was 2.46 (95% confidence interval [CI], 1.39 to 4.34, p = 0.002) in men after adjusting for age, sex, history of coronary heart disease, history of stroke, current current smoking, current alcohol use, physical inactivity, education status, and BMI. Further adjusting for above confounders, hypertension and diabetes, the OR for having MS in the highest versus lowest quartiles of SUA was 3.06 (95% CI, 1.64 to 5.70, p < 0.001). The OR for having MS in the highest versus lowest quartiles of SUA was 3.45 (95% CI, 1.38 to 8.64, p = 0.008) and 1.98 (95% CI, 1.16 to 3.37, p = 0.08) in premenopausal women and postmenopausal women after adjusting for age, sex, history of coronary heart disease, history of stroke, current smoking, current alcohol use, physical inactivity, education status, and BMI. Further adjusting for above confounders, hypertension and diabetes, the OR for having MS in the highest versus lowest quartiles of SUA was 3.42 (95% CI, 1.15 to 10.18, p = 0.03) and 1.87 (95% CI, 1.05 to 3.33, p = 0.03) in premenopausal women and postmenopausal women. Conclusions: Higher SUA levels are positively associated with the presence of MS in males and females. Higher SUA levels had a higher risk of having MS in premenopausal women than in postmenopausal

  2. Premenopausal Osteoporosis.

    PubMed

    Cohen, Adi

    2017-03-01

    Most premenopausal women with low trauma fracture(s) or low bone mineral density have a secondary cause of osteoporosis or bone loss. Where possible, treatment of the underlying cause should be the focus of management. Premenopausal women with an ongoing cause of bone loss and those who have had, or continue to have, low trauma fractures may require pharmacologic intervention. Clinical trials provide evidence of benefits of bisphosphonates and teriparatide for bone mineral density in several types of premenopausal osteoporosis, but studies are small and do not provide evidence regarding fracture risk reduction.

  3. Evaluation of body weight, insulin resistance, leptin and adiponectin levels in premenopausal women with hyperprolactinemia.

    PubMed

    Atmaca, Aysegul; Bilgici, Birsen; Ecemis, Gulcin Cengiz; Tuncel, Ozgur Korhan

    2013-12-01

    The effects of hyperprolactinemia on metabolic parameters are not clear and a few data evaluating adiponectin levels in prolactinoma and idiopathic hyperprolactinemia exist. The aim of this study was to evaluate the effects of hyperprolactinemia on body weight, insulin resistance, beta cell function, and leptin and adiponectin levels in premenopausal women with hyperprolactinemia. Forty premenopausal women with prolactinoma or idiopathic hyperprolactinemia were compared to 41 age-matched healthy premenopausal women with regard to body weight, body mass index, waist and hip circumferences, waist to hip ratio, fasting plasma glucose, insulin levels, insulin resistance measured by homeostasis model assessment (HOMA)-insulin resistance index, beta cell function measured by HOMA-β index, leptin and adiponectin levels. Plasma insulin levels and HOMA indexes (both insulin resistance and beta indexes) were significantly higher in hyperprolactinemic women. The other parameters were similar between both groups. There was a positive correlation between prolactin levels and fasting plasma glucose in hyperprolactinemic women. The results of this study showed that high prolactin levels may be associated with hyperinsulinemia and insulin resistance in premenopausal women. This effect seems to be independent of body weight, leptin and adiponectin levels. High prolactin levels may directly stimulate insulin secretion from pancreas and directly cause hepatic and whole-body insulin resistance.

  4. Korean women's attitudes toward physical activity.

    PubMed

    Im, Eun-Ok; Choe, Myoung-Ae

    2004-02-01

    In this study attitudes toward physical activity of three groups of Korean women were explored using a feminist qualitative research design. Seventeen healthy Korean women, 11 Korean women at risk of muscular atrophy, and 16 Korean immigrant women were recruited using a purposive sampling method. In-depth interviews using an interview guide were audiotaped and transcribed. Data were analyzed using thematic analysis. The findings indicate that the women viewed physical activity holistically, that death was viewed as the opposite of physical activity, that exercise was differentiated from physical activity, that exercise was connected to health, and that the women rarely participated in exercise because of their busy lives. The findings confirm the importance of considering the psychosocial contexts of attitudes toward health behavior.

  5. Obesity and endometrial hyperplasia and cancer in premenopausal women: A systematic review.

    PubMed

    Wise, Michelle R; Jordan, Vanessa; Lagas, Alice; Showell, Marian; Wong, Nicole; Lensen, Sarah; Farquhar, Cynthia M

    2016-06-01

    To systematically review the literature on the association between obesity and endometrial hyperplasia or cancer in premenopausal women. We searched the bibliographic databases MEDLINE, EMBASE, PubMed, and CINAHL (inception to May 5, 2015), and checked reference lists of included studies and systematic reviews. Studies of more than 50 women with endometrial pathology diagnosed during premenopause that reported on obesity as a risk factor were eligible. Study identification and data extraction were independently performed by 2 authors. Where possible, data were pooled in a generic inverse variance forest plot. Heterogeneity was reported using the I(2) statistic. Nine case-control studies of moderate quality were included. Quantitative analysis of 5 studies showed a dose-response relationship of body mass index and increased risk of endometrial cancer. For studies of women with body mass index of ≥25, the pooled odds ratio was 3.85 (95% confidence interval 2.53-5.84); body mass index of ≥30 was 5.25 (4.00-6.90); and body mass index of ≥40 was 19.79 (11.18-35.03). Body mass index is a consistent and leading risk factor for endometrial complex hyperplasia or cancer in premenopausal women. Body mass index should be considered when deciding to assess the endometrium in symptomatic premenopausal women. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Hormonal Modulation of Breast Cancer Gene Expression: Implications for Intrinsic Subtyping in Premenopausal Women

    PubMed Central

    Bernhardt, Sarah M.; Dasari, Pallave; Walsh, David; Townsend, Amanda R.; Price, Timothy J.; Ingman, Wendy V.

    2016-01-01

    Clinics are increasingly adopting gene-expression profiling to diagnose breast cancer subtype, providing an intrinsic, molecular portrait of the tumor. For example, the PAM50-based Prosigna test quantifies expression of 50 key genes to classify breast cancer subtype, and this method of classification has been demonstrated to be superior over traditional immunohistochemical methods that detect proteins, to predict risk of disease recurrence. However, these tests were largely developed and validated using breast cancer samples from postmenopausal women. Thus, the accuracy of such tests has not been explored in the context of the hormonal fluctuations in estrogen and progesterone that occur during the menstrual cycle in premenopausal women. Concordance between traditional methods of subtyping and the new tests in premenopausal women is likely to depend on the stage of the menstrual cycle at which the tissue sample is taken and the relative effect of hormones on expression of genes versus proteins. The lack of knowledge around the effect of fluctuating estrogen and progesterone on gene expression in breast cancer patients raises serious concerns for intrinsic subtyping in premenopausal women, which comprise about 25% of breast cancer diagnoses. Further research on the impact of the menstrual cycle on intrinsic breast cancer profiling is required if premenopausal women are to benefit from the new technology of intrinsic subtyping. PMID:27896218

  7. Association between Parity and Blood Pressure in Korean Women: Korean National Health and Nutrition Examination Survey, 2010-2012

    PubMed Central

    Jang, Miae; Choi, Jiho; Kim, Beomseok; Kang, Jayeon; Kim, Yongchae; Cho, Sewook

    2015-01-01

    Background Pregnancy considerably alters cardiovascular dynamics, and thereby affects the transition of blood pressure after delivery in women. We aimed to analyze the association between parity and blood pressure in Korean adult women. Methods We included 8,890 women who participated in Korean National Health and Nutrition Examination Survey between 2010 and 2012. We divided the population according to the menopause status and analyzed the association between parity and blood pressure by using multiple regression analysis, and on hypertension, by using logistic regression analysis. Results Systolic and diastolic blood pressures were significantly associated with parity in premenopausal women (β=-0.091 [P<0.001] and β=-0.069 [P<0.001], respectively). In the analysis that excluded women receiving antihypertensive medication, the systolic and diastolic blood pressure of postmenopausal women were significantly associated with parity (β=-0.059 [P=0.022] and β=-0.054 [P=0.044], respectively). Parity was found to prevent hypertension after adjustment for confounders in postmenopausal women (odds ratio, 0.55; 95% confidence interval, 0.310-0.985). Conclusion We found that parity prevented hypertension in Korean women. PMID:26634103

  8. Changes in Ovarian Stromal Function and Associated Symptoms in Premenopausal Women Undergoing Chemotherapy for Breast Cancer

    DTIC Science & Technology

    2007-08-01

    scars in benign breast biopsies. Breast Cancer Research and Treatment . Accepted for publication. 6 Dr Jeff Sloan and colleagues...premenopausal women at 4 time periods: baseline (before treatment ), mid- treatment , immediate post- treatment and 6 months later. Questionnaires include...study components. If a connection between low levels of androgens and symptoms is found, androgen replacement may be a viable treatment option for

  9. Endogenous subclinical hyperthyroidism may not lead to bone loss in premenopausal women

    PubMed Central

    Saler, T; Ahbab, S; Sağlam, ZA; Keşkek, ŞÖ; Kurnaz, S

    2014-01-01

    Background: Osteoporosis is defined as the decrease in bone mineral density. It is a serious health problem showing the predisposed person with increased bone fracture risk. Hyperthyroidism is one of the major causes of secondary osteoporosis. The aim of this study was to assess bone mineral density in premenopausal women with endogenous subclinical hyperthyroidism. Methods: A total of 168 subjects were included in this case-control study, of whom 86 and 82 participants were premenopausal women with subclinical hyperthyroidism and healthy premenopausal subjects, respectively. The patients with subclinical hyperthyroidism who were not receiving L-thyroxine treatment were included. The women in postmenopausal state or having chronic disease were excluded. The bone mineral densities of all subjects with dual energy X-ray absorptiometry were examined. Results: The Z scores (femur and L1-4) of the study group were -0.15 ± 1.15 and -0.23 ± 1.03, respectively. The Z scores of the control group were -0.39 ± 1.08 and -0.55 ± 0.98, respectively. The differences between the groups were not statistically significant (p=0.14, 0.34, respectively). Conclusion: Our data suggest that contrary to exogenous subclinical hyperthyroidism, endogenous subclinical hyperthyroidism may not decrease bone mineral density in premenopausal women and it may not a risk factor for osteopenia or osteoporosis. Hippokratia 2014; 18 (3): 240-244. PMID:25694759

  10. Significance of endoscopy in asymptomatic premenopausal women with iron deficiency anemia.

    PubMed

    Park, Dong Il; Ryu, Seung Ho; Oh, Suk Joong; Yoo, Tae Woo; Kim, Hong Ju; Cho, Yong Kyun; Sung, In Kyung; Sohn, Chong Il; Jeon, Woo Kyu; Kim, Byung Ik

    2006-12-01

    There is, currently, no consensus with regard to the role of endoscopy in the etiologic investigation of asymptomatic pemenopausal women suffering from iron deficiency anemia (IDA). We conducted a retrospective case-control study to evaluate the contribution of esophagogastroduodenoscopy (EGD) and colonoscopy to the etiologic diagnosis of a group of asymptomatic premenopausal women suffering from IDA. One hundred eight consecutive asymptomatic premenopausal women who fulfilled our entry criteria were included in our patient group between January 1998 and December 2004. One hundred thirty-five age-matched asymptomatic premenopausal women without anemia who had undergone EGD and colonoscopy for medical checkups were included in the control group. Clinically relevant lesions were detected in 7 of 108 (6.5%) of the patients and in 8 of 135 (5.9%) of the controls. There were no differences with regard to the frequency of clinically relevant lesions between the two groups (P > 0.05). Concomitant upper and lower GI lesions were not detected in any patients. In the upper GI tract, the only lesion found to be potentially causative of IDA anemia was a severe erosive gastritis, which was found in both the patient and the control groups. A source consistent with chronic bleeding was detected in the lower GI tract in 6 (5.6%) of the patients and 7 (5.2%) of the controls. Bleeding hemorrhoids represented the most frequently detected lesions in both the patient and control groups. Only one case of colon cancer was detected in the patient group. As IDA in the premenopausal women could not be attributed consistently to GI blood loss in this study, prospective studies should be conducted to validate our findings and to identify which subgroup of asymptomatic premenopausal women would benefit from a diagnostic endoscopic evaluation.

  11. Mammographic density and risk of breast cancer in Korean women.

    PubMed

    Kim, Bo-Kyoung; Choi, Yoon-Ho; Nguyen, Tuong L; Nam, Seok Jin; Lee, Jeong Eon; Hopper, John L; Sung, Joohon; Song, Yun-Mi

    2015-09-01

    We carried out this study to evaluate the association between mammographic density adjusted for age and BMI and early-onset breast cancer in Asian women. We recruited 213 Korean patients with breast cancer (45% diagnosed before the age of 50 years) and 630 controls matched for age, menopausal status, and examination date. The percentage and absolute size of dense areas on digital mammograms were measured using a computer-assisted thresholding technique (Cumulus). We carried out an analysis using the conditional logistic regression model with adjustment for covariates. An increase by 1 SD in age and BMI-adjusted absolute dense area and percentage dense area was associated with a 1.15-fold (95% confidence interval: 1.03, 1.29) and 1.20-fold (95% confidence interval: 1.06, 1.37) increased risk of breast cancer, respectively. These associations were stronger for premenopausal disease (P=0.07 and 0.01, respectively) and for disease diagnosed before age 50 (P=0.07 and 0.02, respectively) than for postmenopausal disease (P=0.16 and 0.23, respectively) or later onset disease (P=0.10 and 0.10, respectively). There was no difference in the associations with premenopausal versus postmenopausal and early-onset versus late-onset disease. After adjusting for age and BMI, both a greater absolute dense area and a greater percentage dense area were associated with an increased risk of breast cancer, particularly at a young age.

  12. Attitudes toward Women in Adolescent Korean Sample.

    ERIC Educational Resources Information Center

    Youn, Gahyun

    Since the 1960s Korean society has been influenced by a variety of Western cultures, resulting in considerable changes in the roles assumed by women, especially related to their increasing employment. However, less than 3% of all managers or administrators are women. The Attitudes Toward Women scale and questionnaires concerning other…

  13. Ethnic variation in hypertension among premenopausal and perimenopausal women: Study of Women's Health Across the Nation.

    PubMed

    Lloyd-Jones, Donald M; Sutton-Tyrrell, Kim; Patel, Ami S; Matthews, Karen A; Pasternak, Richard C; Everson-Rose, Susan A; Scuteri, Angelo; Chae, Claudia U

    2005-10-01

    Data are sparse regarding hypertension prevalence, treatment, and control among some ethnic groups of American women. Furthermore, the effects of ethnicity on hypertension, independent of other factors that vary with ethnicity, are poorly understood. We examined the prevalence of hypertension (defined as systolic > or =140 or diastolic > or =90 mm Hg or receiving treatment), treatment, and control (to <140/<90 mm Hg) in a multiethnic study of premenopausal and perimenopausal women. Stepwise multivariable logistic regression was used to select covariates associated with hypertension. Among 3292 women, 46.9% were white, 28.3% were black, 8.7% were Hispanic, 7.6% were Chinese, and 8.5% were Japanese. Among these 5 ethnic groups, respectively, there was substantial variation in prevalence of normal blood pressure levels (<120/<80 mm Hg; 59.9%, 35.4%, 16.8%, 67.2%, and 63.7%) and hypertension (14.5%, 38.1%, 27.6%, 12.8%, and 11.0%). After multivariable adjustment, hypertension prevalence was 2 to 3x higher among black and Hispanic women but similar among Chinese and Japanese women compared with white women. Among hypertensive participants, prevalence of antihypertensive treatment was highest among blacks (58.9%) and whites (55.2%) and lowest among Chinese (34.4%). Prevalence of control to goal blood pressure levels was highest among whites (43.0%) and Japanese (38.7%) and markedly lower among Hispanic women (11.4%). Compared with whites, black and Hispanic women have significantly higher prevalence of hypertension independent of other factors, whereas Chinese and Japanese women have similar prevalence. Treatment and control rates vary considerably across ethnicities. Greater efforts must be made to improve hypertension awareness, treatment, and control in all middle-aged women, particularly those in ethnic minority groups.

  14. Core body temperature is lower in postmenopausal women than premenopausal women: potential implications for energy metabolism and midlife weight gain.

    PubMed

    Neff, Lisa M; Hoffmann, Mindy E; Zeiss, Dinah M; Lowry, Katherine; Edwards, Monica; Rodriguez, Sarah M; Wachsberg, Kelley N; Kushner, Robert; Landsberg, Lewis

    2016-12-01

    Weight gain during the menopausal transition is common. Although studies have suggested that weight gain is more likely related to aging than menopause, there is a reduction in resting energy expenditure with surgical or natural menopause which is independent of age and changes in body composition. The underlying mechanisms could include a reduction in core body temperature. Data were obtained from two related studies. Sample size was 23 men and 25 women (12 premenopausal,13 postmenopausal). In the Clinical Research Unit, core temperature was measured every minute for 24 hours (CorTemp System,HQ Inc.). Mean 24-hour core body temperature was 0.25 ± 0.06 °C lower in postmenopausal than premenopausal women (p=0.001). Mean 24-hour core temperature was 0.34 ± 0.05 °C lower in men than in premenopausal women (p<0.001). Postmenopausal women, like men, had lower core body temperatures than premenopausal women. This may have implications for midlife weight gain.

  15. Strength training induced adaptations in neuromuscular function of premenopausal women with fibromyalgia: comparison with healthy women

    PubMed Central

    Hakkinen, A; Hakkinen, K; Hannonen, P; Alen, M

    2001-01-01

    OBJECTIVE—To investigate the effects of 21 weeks' progressive strength training on neuromuscular function and subjectively perceived symptoms in premenopausal women with fibromyalgia (FM).
METHODS—Twenty one women with FM were randomly assigned to experimental (FMT) or control (FMC) groups. Twelve healthy women served as training controls (HT). The FMT and HT groups carried out progressive strength training twice a week for 21 weeks. The major outcome measures were muscle strength and electromyographic (EMG) recordings. Secondary outcome measures were pain, sleep, fatigue, physical function capacity (Stanford Health Assessment Questionnaire), and mood (short version of Beck's depression index).
RESULTS—Female FMT subjects increased their maximal and explosive strength and EMG activity to the same extent as the HT group. Moreover, the progressive strength training showed immediate benefits on subjectively perceived fatigue, depression, and neck pain of training patients with FM.
CONCLUSIONS—The strength training data indicate comparable trainability of the neuromuscular system of women with FM and healthy women. Progressive strength training can safely be used in the treatment of FM to decrease the impact of the syndrome on the neuromuscular system, perceived symptoms, and functional capacity. These results confirm the opinion that FM syndrome has a central rather than a peripheral or muscular basis.

 PMID:11114277

  16. Optimal systemic therapy for premenopausal women with hormone receptor-positive breast cancer.

    PubMed

    Jankowitz, Rachel C; McGuire, Kandace P; Davidson, Nancy E

    2013-08-01

    Although systemic therapy is one of the cornerstones of therapy for premenopausal women with early stage breast cancer, there remain many unknowns regarding its optimal use. By accident of clinical trial design, much clinical investigation in premenopausal women has focused on chemotherapy. More recently the value of endocrine therapy (tamoxifen and ovarian suppression/ablation via surgery, LHRH agonists, or chemotherapy-induced menopause) has become apparent, and some form of endocrine therapy is viewed as standard for virtually all premenopausal women with early stage invasive breast cancer that expresses estrogen and/or progesterone receptor. Critical open questions include type and duration of endocrine therapy and the development of prognostic/predictive markers to help identify patients who are likely to benefit from chemotherapy in addition to endocrine therapy. For some years, five years of tamoxifen has been viewed as the standard endocrine therapy for premenopausal hormone-responsive breast cancer, although the ATLAS trial suggests that an additional five years of tamoxifen can be considered. The MA17 trial also suggests that an additional five years of an aromatase inhibitor can be considered for women who become postmenopausal during tamoxifen therapy. Information about the value of ovarian suppression continues to emerge, most recently with the demonstration of excellent outcome with goserelin plus tamoxifen in the ABCSG12 trial. The SOFT and TEXT trials, whose accrual is now complete, should help to define optimal endocrine therapy. In addition, use of the 21-gene recurrence score assay may help to delineate the additional value of chemotherapy for patients with node-negative breast cancer, and its utility in the setting of women with 1-3 positive lymph nodes is under study in the RxPONDER trial. Nonetheless, the need for other predictive biomarkers to select appropriate therapy remains real. Finally, attention to long term benefits and side effects

  17. The prognostic impact of obesity on molecular subtypes of breast cancer in premenopausal women.

    PubMed

    Turkoz, F P; Solak, M; Petekkaya, I; Keskin, O; Kertmen, N; Sarici, F; Arik, Z; Babacan, T; Ozisik, Y; Altundag, K

    2013-01-01

    The increasing incidence of obesity throughout the world will result in expansion of the number of women at risk for developing breast cancer. Obesity is associated with adverse outcomes in postmenopausal women with breast cancer. In premenopausal women, the association is less clear. We investigated the impact of obesity on tumor features, hormonal status, recurrence and mortality in premenopausal breast cancer patients, classified according to molecular subtypes. 818 premenopausal women with nonmetastatic breast cancer were analysed. Patients were classified into 3 groups according to body mass index (BMI): i) normal body weight (BMI: 18.5-24.9 kg/m(2)); ii) overweight (BMI: 25-29.9 kg/ m(2)); and iii) obese (BMI:>30 kg/ m(2)). Clinocopathologic characteristics and survival rates were analyzed for triple negative, HER-2 overexpressing and luminal subtypes. Obese patients compared with normal-weight women were older at diagnosis (p<0.001) and more often had high grade tumor (57.1 vs 42.3%; p=0.04) with lymphovascular invasion (79.5 vs 63.9%; p=0.03). The median follow-up period after diagnosis was 29 months. According to the molecular subtypes, overall survival (OS) and disease free survival (DFS) were significantly shorter in obese patients with triple negative breast cancer (TNBC) (p=0.001 and p=0.006, respectively). Obesity (HR 1.4; 95% CI 1.0-2.1; p=0.04) and lymphovascular invasion (HR 2.1; 95% CI 1.3- 3.3; p=0.02) were found to be independent prognostic factors for TNBC mortality. Obesity is associated with estrogen (ER) and progesterone receptor (PR) negative tumors and poor OS in premenopausal women with breast cancer.

  18. The affecting factors of breast anthropometry in Korean women.

    PubMed

    Kim, Sa Jin; Kim, Myungshin; Kim, Min-Jeong

    2014-03-01

    Breast anthropometric morphology affects various factors with diverse physiognomy, making accurate measurements very difficult. The aim of this study was to measure the female breast using anthropometry and to use this method on normal subjects to examine breast asymmetry and consider the influence of age, height, weight, body mass index (BMI), parity, delivery mode, and breastfeeding in premenopausal Korean women. In total, 17 parameters of breast were measured with participants in a standing position. Breast volume was also assessed. The mean values of the right and left breast volumes were calculated as 386.0±342.5 mL and 393.3±347.2 mL, respectively. With aging, the height of women decreased, but the weight, BMI, upper chest, middle chest, lower chest, waist, and hip widths, nipple-nipple length, and ptosis increased with statistical significance. No asymmetric differences were observed between each breast, except for nipple-inframammary fold length in 20-30-year-old women and upper arm length in 41-50-year-old women. In our study, the breast volume increased with age as a result of weight gain, but the delivery mode and breastfeeding did not affect anthropometric breast measurements. In conclusion, age, weight, and BMI are important factors in determining breast anthropometry in our study. The results of the present study will help in the comparison of the anthropometric breast values of Korean women with those of women in other countries and may also be useful in the understanding of breast physiologic change-related obstetrical factors and epidemiologic factors.

  19. Red Meat Consumption during Adolescence among Premenopausal Women and Risk of Breast Cancer

    PubMed Central

    Linos, Eleni; C.Willett, Walter; Cho, Eunyoung; Colditz, Graham; A.Frazier, Lindsay

    2015-01-01

    Background Adolescence may be a period of increased susceptibility to breast cancer due to regular division of undifferentiated cells that occurs between puberty and first birth. Red meat consumption during early adult life has been associated with breast cancer, but intake during adolescence has not been examined prospectively. We aimed to assess the relationship between various types of red meat intake during adolescence and premenopausal breast cancer. Methods: We examined the incidence of invasive pre-menopausal breast cancer prospectively within the Nurses’ Health Study II. A total of 39,268 premenopausal women who completed a validated 124-item food frequency questionnaire on their diet during high school, were followed for 7 years, from 1998 to 2005. Cox proportional hazards regression was used to estimate relative risks (RR) and 95% confidence intervals (95% CI). Results 455 cases of invasive premenopausal breast cancer were diagnosed between 1998 and 2005. Compared with women in the lowest quintile of red meat intake during high school, the multivariate-adjusted RR for the highest quintile of intake was 1.34 (95% CI, 0.94–1.89; Ptrend = 0.05). A significant linear association was observed with every additional 100 g of red meat consumed per day (RR, 1.20; 95% CI, 1.00–1.43; P = 0.05). This association was more pronounced in hormone receptor–positive tumors (RR, 1.36; 95% CI, 1.08–1.70; P = 0.008) and was not significant in hormone receptor negative tumors (RR, 0.99; 95% CI, 0.61–1.61, P = 0.97). Our conclusions: Higher red meat intake in adolescence may increase the risk of premenopausal breast cancer. PMID:18669582

  20. Associations between sex hormone binding globulin and metabolic syndrome parameters in premenopausal obese women.

    PubMed

    Akin, Fulya; Bastemir, Mehmet; Alkis, Esma; Kaptanoglu, Bunyamin

    2008-10-01

    The aim of this study was to determine sex hormone binding globulin (SHBG) concentrations in premenopausal obese women and to evaluate the relationships between sex hormones and features of the metabolic syndrome (MetS). Retrospective cross-sectional analysis was carried out on 350 obese patients aged 25 to 69 years referred to the Department of Endocrinology, Pamukkale University in 2002-2003. 125 premenopausal euthyroid patients were eligible for this study. Subjects were divided into two groups according to the body mass index (BMI): Group I, women with BMI 2 (n = 17) and Group II,, women with BMI > or = 30 kg/m 2 (n = 108). Median SHBG concentration of Group I was 50.1 nmol/L. Group II was divided into two subgroups according to the median SHBG concentration of Group I: subjects with high SHBG levels (SHBG concentration > or = median level of the control group, i.e > or = 50.1 nmol/L) and subjects with low SHBG levels ( No significant difference was found in mean age between the low and high SHBG groups. The low SHBG group was significantly heavier, and with higher waist circumference than the high SHBG group. In the low SHBG group, fasting glucose, postprandial glucose and gamma glutamyl transferase (GGT) and free androgen index (FAI) were significantly higher. Lipid profile, blood pressure, uric acid, insulin and HOMA were found similar between two groups. Linear regression analyses revealed that body mass index and FAI were significant, being independent predictors of SHBG concentrations in premenopausal women. (r = 0.365, r square = 0.134). It is concluded that low SHBG concentrations may indicate visceral obesity and glucose intolerance in premenopausal women.

  1. Effectiveness of a low-fat vegetarian diet in altering serum lipids in healthy premenopausal women.

    PubMed

    Barnard, N D; Scialli, A R; Bertron, P; Hurlock, D; Edmonds, K; Talev, L

    2000-04-15

    Few controlled trials have studied cholesterol-lowering diets in premenopausal women. None has examined the cholesterol-lowering effect of a low-fat vegetarian diet, which, in other population groups, leads to marked reductions in serum cholesterol concentrations and, in combination with other life-style changes, a regression of atherosclerosis. We tested the hypothesis that a low-fat, vegetarian diet significantly reduces serum total and low-density lipoprotein (LDL) cholesterol concentrations in premenopausal women. In a crossover design, 35 women, aged 22 to 48, followed a low-fat vegetarian diet deriving approximately 10% of energy from fat for 2 menstrual cycles. For 2 additional cycles, they followed their customary diet while also taking a "supplement" (placebo) pill. Serum lipid concentrations were assessed at baseline and during each intervention phase. Mean serum LDL, high-density lipoprotein (HDL), and total cholesterol concentrations decreased 16. 9%, 16.5%, and 13.2%, respectively, from baseline to the intervention diet phase (p<0.001), whereas mean serum triacylglycerol concentration increased 18.7% (p<0.01). LDL/HDL ratio remained unchanged. Thus, in healthy premenopausal women, a low-fat vegetarian diet led to rapid and sizable reductions in serum total, LDL, and HDL cholesterol concentrations.

  2. Among a sample of Iranian premenopausal and menopausal women differences in mood, sleep and health quality are small.

    PubMed

    Jahangard, Leila; Haghighi, Mohammad; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Brand, Serge

    2014-06-01

    Anecdotal evidence suggests that mood, sleep, and health quality change in women from premenopausal to menopausal period; however, data supporting these assumptions from non-Western countries are scarce. The aim of the present study was therefore to assess premenopausal and menopausal Iranian women with regard to mood, sleep, and general health. One hundred and twenty Iranian women took part in the study. Sixty were in a premenopausal state (mean age (M): = 46.9 years) and 60 in a menopausal state (M = 53.8 years). They completed a series of self-rating questionnaires related to sleep, mood, and health quality. Compared to premenopausal women, menopausal women reported more difficulties such as falling asleep, and less general physical activities and vitality. No statistically significant differences were found for sleep quality, sleep schedules, difficulties in social life, general mood state, or general physical and mental health. Menopausal women reported to be more irritable, and to have more energy. Data suggest that among a sample of Iranian premenopausal and menopausal women, differences in mood, sleep, and general health are small. Data, therefore, do not support "beliefs" and hearsay that mood, sleep, and general health do decrease from premenopausal to menopausal state.

  3. Genome-wide association study of serum iron phenotypes in premenopausal women of European descent.

    PubMed

    Koller, Daniel L; Imel, Erik A; Lai, Dongbing; Padgett, Leah R; Acton, Dena; Gray, Amie; Peacock, Munro; Econs, Michael J; Foroud, Tatiana

    2016-03-01

    A genome-wide association study was performed on 1130 premenopausal women to detect common variants associated with three serum iron-related phenotypes. Total iron binding capacity was strongly associated (p=10(-14)) with variants in and near the TF gene (transferrin), the serum iron transporting protein, and with variants in HFE (p=4×10(-7)), which encodes the human hemochromatosis gene. Association was also detected between percent iron saturation (p=10(-8)) and variants in the chromosome 6 region containing both HFE and SLC17A2, which encodes a phosphate transport protein. No significant associations were detected with serum iron, but variants in HFE were suggestive (p=10(-6)). Our results corroborate prior studies in older subjects and demonstrate that the association of these genetic variants with iron phenotypes can be detected in premenopausal women. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Iron nutrition and premenopausal women: effects of poor iron status on physical and neuropsychological performance.

    PubMed

    McClung, James P; Murray-Kolb, Laura E

    2013-01-01

    Iron is a nutritionally essential trace element that functions through incorporation into proteins and enzymes, many of which contribute to physical and neuropsychological performance. Poor iron status, including iron deficiency (ID; diminished iron stores) and iron deficiency anemia (IDA; poor iron stores and diminished hemoglobin), affects billions of people worldwide. This review focuses on physical and neuropsychological outcomes associated with ID and IDA in premenopausal women, as the prevalence of ID and IDA is often greater in premenopausal women than other population demographics. Recent studies addressing the physiological effects of poor iron status on physical performance, including work productivity, voluntary activity, and athletic performance, are addressed. Similarly, the effects of iron status on neurological performance, including cognition, affect, and behavior, are summarized. Nutritional countermeasures for the prevention of poor iron status and the restoration of decrements in performance outcomes are described.

  5. Evaluation of Feasibility for a Case-Control Study of Pituitary-Ovarian Function in Premenopausal Women With Breast Cancer

    DTIC Science & Technology

    2006-07-01

    case-control study that uses gonadotropin releasing hormone (GnRH) agonist stimulation tests to compare pituitary -ovarian function in premenopausal women...in responsiveness of ovarian hormones to gonadotropin releasing hormone (GnRH) stimulation in healthy premenopausal women. GnRH stimulation was...determine the safety and feasibility of conducting a case-control study that uses gonadotropin releasing hormone (GnRH) stimulation tests to evaluate

  6. Restrained eating and self-esteem in premenopausal and postmenopausal women.

    PubMed

    Drobnjak, Suzana; Atsiz, Semra; Ditzen, Beate; Tuschen-Caffier, Brunna; Ehlert, Ulrike

    2014-01-01

    There has been limited research about disordered eating in middle-aged women, and to date, few data exist about restrained eating behavior in postmenopausal women. Therefore, the aim of this study was to examine eating behavior with a specific focus on menopause as an associated factor in restrained eating. Beyond this, we were interested in how postmenopausal status and self-esteem would interact to determine eating patterns in women in middle age. We conducted an online survey in women aged between 40 and 66. Eating behavior was assessed with the Eating Disorder Examination-Questionnaire (EDE-Q) in premenopausal (N = 318) and postmenopausal women (N = 250). All participants rated their self-esteem using the Rosenberg Self-Esteem Scale (RSE) and reported their weight, height, waist circumference, and hip circumference. 15.7% of all participants showed clinically meaningful scores on restrained eating. Postmenopausal women showed significantly higher scores on the EDE-Q subscale of restrained eating as compared to premenopausal women, but when controlling for body mass index, however, this finding was no longer significant. Further exploratory analyses suggest that particularly low or high self-esteem levels are associated with restrained eating. Self-esteem might serve as a mediator between menopausal status and restrained eating, however results of these additional analyses were inconsistent. Restrained eating may appear in middle-aged women. Particularly in postmenopausal women, restrained eating might be associated with lower and higher self-esteem.

  7. Body image and genital self-image in pre-menopausal women with dyspareunia.

    PubMed

    Pazmany, Els; Bergeron, Sophie; Van Oudenhove, Lukas; Verhaeghe, Johan; Enzlin, Paul

    2013-08-01

    With a prevalence of 15-21%, dyspareunia is one of the most commonly reported sexual dysfunctions in pre-menopausal women under the age of 40. Studies to date have focused primarily on clinical samples, showing that women with dyspareunia report overall sexual impairment, anxiety, and feelings of sexual inadequacy. However, little is known about their body image and genital self-image and few studies have sampled women exclusively from the general population. The aim of the present, controlled study was to investigate body image and genital self-image in a community sample of pre-menopausal women with self-reported dyspareunia. In total, 330 women completed an online survey, of which 192 (58%) had dyspareunia and 138 (42%) were pain-free control women. In comparison to pain-free control women, women with dyspareunia reported significantly more distress about their body image and a more negative genital self-image. Moreover, findings from a logistic regression, in which trait anxiety was controlled for, showed that a more negative genital self-image was strongly and independently associated with an increased likelihood of reporting dyspareunia. These results suggest that, in women with dyspareunia, body image and genital self-image are significantly poorer and would benefit from more attention from both clinicians and researchers.

  8. Soy and Tamoxifen for Breast Cancer Prevention in High Risk Pre-Menopausal Women

    DTIC Science & Technology

    2005-10-01

    endpoints including changes in mammographic breast density and blood serum biomarkers (IGF-1/IGF-BP 3, hormone levels). 5 Body Consumption...Pollak MN, Hankinson SE. Insulin-like growth factor-I, its binding proteins (IGFBP-1 and IGFBP-3), and growth hormone and breast cancer risk in...binding protein-3 in a 2-year soya intervention among premenopausal women. Br J Nutr. Sep 2005;94(3):362-367. 40. Nagata C, Shimizu H, Takami R, Hayashi M

  9. NSAIDS and the Osteogenic Response to Mechanical Stress in Premenopausal Women

    DTIC Science & Technology

    2005-10-01

    training Participants take either ibuprofen (400mg) or placebo capsules before and after each exercise session. Women are randomized to three treatment...of ibuprofen , a non-steroidal anti-inflammatory drug (NSAID), on the osteogenic response to 9 months of exercise training in healthy, premenopausal...physical activity. 15. SUBJECT TERMS Exercise, stress fracture, ibuprofen , prostaglandins, bone mineral density, estrogen 16. SECURITY CLASSIFICATION

  10. Prevalence and severity of menopause symptoms and associated factors across menopause status in Korean women.

    PubMed

    Yim, Gyeyoon; Ahn, Younjhin; Chang, Yoosoo; Ryu, Seungho; Lim, Joong-Yeon; Kang, Danbee; Choi, Eun-Kyung; Ahn, Jiin; Choi, Yuni; Cho, Juhee; Park, Hyun-Young

    2015-10-01

    The present study investigated the prevalence and severity of menopause symptoms experienced by Korean women aged 44 to 56 years and their associated factors. A cross-sectional study was performed on 2,201 women aged 44 to 56 years in health checkup centers between November 2012 and March 2013. The 29-item Menopause-Specific Quality of Life Questionnaire was used to assess vasomotor, psychosocial, physical, and sexual symptoms related to menopause. The guidelines for the classification of reproductive aging stages proposed at the Stages of Reproductive Aging Workshop were used. Multivariable linear regression analyses were performed to identify factors associated with severity of menopause symptoms. Among participants, 42.6% were premenopausal, 36.7% were perimenopausal, and 20.7% were postmenopausal. Although physical symptoms were the most severe menopause symptoms experienced by premenopausal and perimenopausal women, postmenopausal women reported sexual symptoms as the most bothersome. The mean scores for each domain increased from the premenopausal period through the postmenopausal period (P for trend < 0.001). The regression model revealed that age (for vasomotor and sexual symptoms) and obesity (for vasomotor and physical symptoms) were significantly associated with severity of menopause symptoms (P < 0.05). Physically active women had fewer severe physical symptoms related to menopause than inactive women. Postmenopausal women experience the most severe symptoms. Obesity and physical activity are the main modifiable factors associated with symptom severity. Further studies are needed to examine the effects of physical activity promotion and weight control interventions on preventing menopause symptoms in Korean women.

  11. The Modern Landscape of Endocrine Therapy for Premenopausal Women with Breast Cancer.

    PubMed

    Rossi, Lorenzo; Pagani, Olivia

    2015-10-01

    The optimal endocrine therapy for premenopausal women with early and advanced breast cancer still remains an important and controversial issue. For over 30 years, tamoxifen has been the gold standard in the adjuvant setting. New therapeutic options, such as the addition of ovarian function suppression to oral endocrine therapy (either tamoxifen or aromatase inhibitors), can improve outcomes over tamoxifen alone in well-selected patients. Treatment duration has also been revisited, and extended therapy is becoming a new standard of care, especially in high-risk patients. Endocrine therapy for advanced disease still represents a challenge and a research priority. New drugs and combinations able to overcome endocrine resistance are at the horizon, and their role in premenopausal women should be better elucidated. Side effects and quality of life (including family planning considerations) play an important role in treatment selection and in the patients' treatment adherence and should always be discussed before start of treatment. The paper will specifically focus on how to integrate all new treatment options in the current armamentarium of endocrine therapy of premenopausal women, with the aim of best fine-tuning treatment selections according to the individual risk/benefit evaluation.

  12. The Meaning of Korean Women's Career-Leaving Experience

    ERIC Educational Resources Information Center

    Lee, Yu-Jin

    2010-01-01

    What is the meaning of Korean women's career-leaving experience? To answer this question, this study adopted a hermeneutic phenomenology approach. My intention was to search for the deeper meaning of Korean women's career-leaving experience from their perspective. Ten Korean women who had left their careers due to their domestic roles in their…

  13. The Meaning of Korean Women's Career-Leaving Experience

    ERIC Educational Resources Information Center

    Lee, Yu-Jin

    2010-01-01

    What is the meaning of Korean women's career-leaving experience? To answer this question, this study adopted a hermeneutic phenomenology approach. My intention was to search for the deeper meaning of Korean women's career-leaving experience from their perspective. Ten Korean women who had left their careers due to their domestic roles in their…

  14. Prevalence of fibromyalgia in premenopausal and postmenopausal women and its relation to climacteric symptoms

    PubMed Central

    Hernandez, Idun Berenice Villalobos

    2014-01-01

    Aim of the study To compare fibromyalgia prevalence in premenopausal and postmenopausal women and its relation to the climacteric symptoms. Material and methods Two hundred and nine women were studied, who attended the gynecology consultation at the hospital. They were divided in two groups: group I (premenopausal, n = 113) and group II (postmenopausal, n = 96). In all of them, climacteric symptoms and fibromyalgia diagnostic criteria were investigated; for the latter, the evaluations were done according to the 1990 and 2010 criteria of the American College of Rheumatology. Results When groups I and II were compared, no differences were found in somatometry, medicament consumption and associated diseases. When analyzing the general group, the fibromyalgia prevalence was greater in the postmenopausal women. However, when comparing the groups according to climacteric symptoms, in group I, 29% of symptomatic women had fibromyalgia, while only 4% of asymptomatic ones (p < 0.002). In group II, 15.7% of symptomatic women, and 2.5% of asymptomatic ones had fibromyalgia (p < 0.02). In group I, the more common painful points were the lower back (45.5%), neck (35.7%), and upper back (32.1%). The more frequent symptoms were non-restful sleep (49%), followed by fatigue and cognitive symptoms (42% for each one). In group II, the more common painful points were the lower back (42%), neck (40%) and upper back (38.5%). The more frequent symptoms were fatigue (69.6%), cognitive symptoms (59.3%) and non-restful sleep (57%). Conclusions In premenopausal women, fibromyalgia was related to the presence of climacteric symptoms and in postmenopausal women – to their absence. PMID:26327850

  15. Phalangeal quantitative ultrasound and metabolic control in pre-menopausal women with type 1 diabetes mellitus.

    PubMed

    Catalano, A; Morabito, N; Di Vieste, G; Pintaudi, B; Cucinotta, D; Lasco, A; Di Benedetto, A

    2013-05-01

    Several studies have reported increased fracture risk in Type 1 diabetes mellitus (T1DM). Quantitative Ultrasound (QUS) provides information on the structure and elastic properties of bone, which are important determinants of fracture risk, along with bone mineral density. To study phalangeal sites by QUS, examine bone turnover markers and analyze association between these factors with metabolic control in a population of pre-menopausal women with T1DM. Thirty-five T1DM pre-menopausal women (mean age 34.5 ± 6.8 yr) attending the Diabetic Outpatients Clinic in the Department of Internal Medicine, University of Messina, were consecutively enrolled and divided into two groups, taking into account the mean value of glycated hemoglobin in the last three years. Twenty healthy age-matched women served as controls. Phalangeal ultrasound measurements [Amplitude Dependent Speed of Sound (AD-SoS), Ultrasound Bone Profile Index (UBPI), TScore, Z-Score] were performed using a DBM Sonic Bone Profiler. Osteocalcin and deoxypyridinoline served as markers of bone formation and bone resorption, respectively. T1DM women with poor metabolic control showed lower phalangeal QUS values compared to healthy controls (p<0.01) and T1DM women with good metabolic control (p<0.05). No significant differences in QUS measurements were detected between T1DM women with good metabolic control and healthy controls. Lower bone formation and increased bone resorption, although not statistically significant, were observed in patients with poor metabolic control in comparison to patients with good metabolic control. Poor metabolic control may worsen the quality of bone in T1DM. Phalangeal QUS could be considered as a tool to screen T1DM women for osteoporosis in pre-menopausal age.

  16. Early onset vulvar Lichen Sclerosus in premenopausal women and oral contraceptives.

    PubMed

    Günthert, Andreas R; Faber, Melanie; Knappe, Gabriele; Hellriegel, Simin; Emons, Günter

    2008-03-01

    For vulvar Lichen sclerosus (LS) immunological factors, genetic predisposition, and decreased 5 alpha-reductase activity have been discussed as aetiological factors. During the last decade an increase of LS in young women has been suspected. Aim of this study was to evaluate data of premenopausal women with early onset LS to find potential risk factors focussing on the use of oral contraceptives. We retrospectively analyzed the data of 40 premenopausal patients with early onset LS regarding use of oral contraceptives (OCPs), and first occurrence of LS. To compare these data in a case-control study we analyzed a matched control group of 110 healthy women. All our LS patients were using OCPs compared to 73 women (66.4%) in the control group. OCPs with anti-androgenic activity (chlormadinone acetate, cyproterone acetate, dienogest, and drospirenone) were used by 28 (70%) of the LS patients and by 35 (47.9%) of the 73 women using OCPs in the control group. Thus, the odds ratio for early onset LS for women using anti-androgenic OCPs was 2.53 (95% CI: 1.12-5.75). Our data suggest that disturbance of the androgen dependent growth of the vulvar skin by OCPs and especially by OCPs with anti-androgenic properties might trigger the early onset of LS in a subgroup of susceptible young women.

  17. Risk factors and prevalence of osteoporosis in premenopausal women from poor economic backgrounds in Colombia

    PubMed Central

    Londono, John; Valencia, Paula; Santos, Ana María; Gutiérrez, Luisa F; Baquero, Roberto; Valle-Oñate, Rafael

    2013-01-01

    Introduction The prevalence of osteoporosis in premenopausal women along with associated risk factors has not been well elucidated. Recent studies have shown that poverty is a risk factor for osteoporosis. Objective To determine the prevalence of osteoporosis and its risk factors in a group of premenopausal women of poor economic background in Colombia. Materials and methods The study comprised 1483 women between 35 and 53 years of age with at least one risk factor for osteoporosis. Demographic characteristics, reproductive factors, comorbidities, and risk factors for osteoporosis were evaluated. Lumbar vertebrae (L2–L4) and the femur neck were assessed using dual-energy X-ray absorptiometry. Results Of the 1483 patients, 1443 (97.3%) had at least one risk factor for osteoporosis and 40 (2.7%) had no risk factors. Patients with one risk factor were referred to have a dual-energy X-ray absorptiometry scan, which 795 women completed. Osteopenia was found in 30.5% and osteoporosis in 4.8% of these women. The majority of these women were homemakers, and 18.5% of the patients with osteoporosis were also illiterate (P < 0.001). The risk factors identified in this population were: hypothyroidism (odds ratio [OR] = 5.19, 95% confience interval [CI]:1.6–16), age over 45 years old (OR = 1.13, 95% CI: 1.0–1.2), a history of malnutrition or low birth weight (OR = 2.35, 95% CI: 1.0–5.2), or early-onset menopause (OR = 3.4, 95% CI: 1.6–7.2). Conclusion Premenopausal Colombian women from impoverished areas showed increased rates of osteopenia and osteoporosis compared with the data described in the current literature. Hypothyroidism was an outstanding risk factor in Colombian premenopausal women with osteoporosis. This shows the influence of poverty and other risk factors on the onset of osteoporosis in women aged 35–53 years. PMID:23901298

  18. Evaluation and management of abnormal uterine bleeding in premenopausal women.

    PubMed

    Sweet, Mary Gayle; Schmidt-Dalton, Tarin A; Weiss, Patrice M; Madsen, Keith P

    2012-01-01

    Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, and increased risk of endometrial cancer. Causes include polycystic ovary syndrome, uncontrolled diabetes mellitus, thyroid dysfunction, hyperprolactinemia, and use of antipsychotics or antiepileptics. Women 35 years or older with recurrent anovulation, women younger than 35 years with risk factors for endometrial cancer, and women with excessive bleeding unresponsive to medical therapy should undergo endometrial biopsy. Treatment with combination oral contraceptives or progestins may regulate menstrual cycles. Histologic findings of hyperplasia without atypia may be treated with cyclic or continuous progestin. Women who have hyperplasia with atypia or adenocarcinoma should be referred to a gynecologist or gynecologic oncologist, respectively. Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia. The levonorgestrel-releasing intrauterine system is an effective treatment for menorrhagia. Oral progesterone for 21 days per month and nonsteroidal anti-inflammatory drugs are also effective. Tranexamic acid is approved by the U.S. Food and Drug Administration for the treatment of ovulatory bleeding, but is expensive. When clear structural causes are identified or medical management is ineffective, polypectomy, fibroidectomy, uterine artery embolization, and endometrial ablation may be considered. Hysterectomy is the most definitive treatment.

  19. Premenopausal Hysterectomy and Risk of Ovarian Cancer in African-American Women.

    PubMed

    Peres, Lauren C; Alberg, Anthony J; Bandera, Elisa V; Barnholtz-Sloan, Jill; Bondy, Melissa; Cote, Michele L; Funkhouser, Ellen; Moorman, Patricia G; Peters, Edward S; Schwartz, Ann G; Terry, Paul D; Abbott, Sarah E; Camacho, Fabian; Wang, Frances; Schildkraut, Joellen M

    2017-07-01

    Although the inverse association between hysterectomy and epithelial ovarian cancer (EOC) was considered well established, investigators in recent studies including women diagnosed after 2000 have observed modest increases in risk. Most studies have been conducted in white women with little representation of African-American women. We examined the relationship between premenopausal hysterectomy and EOC in African-American women and explored whether hormone therapy (HT) modified this association in 614 cases and 743 controls enrolled in the African American Cancer Epidemiology Study (2010-2015). Premenopausal hysterectomy was inversely associated with the odds of EOC (odds ratio (OR) = 0.75, 95% confidence interval (CI): 0.56, 1.01). Qualitative interaction by estrogen-only HT was present; among never users of estrogen-only HT, premenopausal hysterectomy was associated with a significantly decreased odds of EOC (OR = 0.65, 95% CI: 0.46, 0.92), whereas among users of estrogen-only HT, a positive association was observed (OR = 1.71, 95% CI: 0.76, 3.84). In a population of African-American women diagnosed after 2000, our overall results are consistent with the inverse association observed in the era before 2000, yet the effect modification by HT suggests that HT use among women who have had hysterectomies may negate the protective effects of hysterectomy on EOC, creating the appearance of a null or slightly increased risk. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Cyclic endogenous estrogen and progesterone vary by mammographic density phenotypes in premenopausal women

    PubMed Central

    Iversen, Anita; Furberg, Anne-Sofie; Flote, Vidar G.; Finstad, Sissi Espetvedt; McTiernan, Anne; Ursin, Giske; Wilsgaard, Tom; Ellison, Peter T.; Jasienska, Grazyna; Thune, Inger

    2016-01-01

    Estrogen and progesterone are key factors in the development of breast cancer, but it remains unclear whether these hormones are associated with mammographic density phenotypes in premenopausal women. We measured percent mammographic density, nondense area, and absolute mammographic density using computer-assisted breast density readings (Madena) from digitized mammograms taken on a scheduled day of the menstrual cycle (day 7–12) among 202 healthy, premenopausal women (Energy Balance and Breast cancer Aspects Study-I). Daily salivary concentrations of 17β-estradiol and progesterone throughout an entire menstrual cycle and fasting morning serum concentrations of hormones on 3 specific days of the menstrual cycle were assessed. Salivary and serum 17β-estradiol and progesterone were positively associated with percent mammographic density, we observed by 1 SD increase in overall salivary estradiol (β-value equal to 2.07, P=0.044), luteal salivary progesterone (β-value equal to 2.40, P=0.020). Women with above-median percent mammographic density had a 20% higher mean salivary 17β-estradiol level throughout the menstrual cycle. The odds ratio for having above-median percent mammographic density (>28.5%) per 1 SD increase in overall salivary 17β-estradiol was 1.66 (95% confidence interval 1.13–2.45). Women in the top tertile of the overall average daily 17β-estradiol concentrations had an odds ratio of 2.54 (confidence interval 1.05–6.16) of above-median percent mammographic density compared with women in the bottom tertile. Our finding of a relationship between estrogen, progesterone, and percent mammographic density and not with other mammographic density phenotypes in premenopausal women is biologically plausible, but needs to be replicated in larger studies. PMID:25714648

  1. Comparison of depression, anxiety, quality of life, vitality and mental health between premenopausal and postmenopausal women.

    PubMed

    Jafari, F; Hadizadeh, M H; Zabihi, R; Ganji, K

    2014-12-01

    The purpose of this research was to investigate and compare the rates of depression, anxiety, quality of life, vitality and mental health between premenopausal and postmenopausal women. The sample included 218 women selected randomly from the cultural center of Tehran in November and December 2013 and was divided into two groups. The first group included 110 postmenopausal women (45-55 years old). One year had passed since their last monthly period and they had not used any hormones. The second group included 108 premenopausal women (35-45 years old) who had not yet experienced menopause. In order to assess data, three tests were used: the Zung Anxiety Self-Report scale, the Beck Depression Inventory and the Quality of Life questionnaire (SF-36). The gathered data were analyzed with the T-test for independent groups. The results indicated that all five hypotheses were confirmed. There were significant differences between the scores of anxiety, depression, quality of life, vitality and mental health between the two groups. Since menopausal women spend almost one-third of their long life in this situation, it can be useful to recognize the causes of these disorders in women and their influences on their families. We can also increase their motivation and self-efficacy in order to improve their quality of life.

  2. Hypoactive sexual desire disorder in premenopausal women: case studies.

    PubMed

    Miner, Martin; Sadovsky, Richard; Buster, John E

    2012-01-01

    Hypoactive sexual desire disorder (HSDD) is the most common female sexual dysfunction (FSD) and is thus frequently encountered in the primary care provider and OB/GYN practices. Causes of low sexual desire may be hormonal, neurologic, vascular, psychologic, or a result of illness/surgery or medications. The condition is often left untreated because both women and clinicians feel embarrassed to bring up the topic and believe that there is no available treatment. The use of short, validated questionnaires, such as the Decreased Sexual Desire Screener, to be completed in the waiting room, can open up discussion between provider and patient. In addition, 2 other algorithms are designed for clinicians who are not specifically trained in FSD and can help in diagnosing and managing a broad range of conditions related to FSD. Treatment for low desire consists primarily of patient education and counseling, as well as treatment of underlying comorbid conditions, such as diabetes, obesity, or cancer. While testosterone products are approved in Europe for use in surgically postmenopausal women with HSDD, in the United States, no pharmacologic treatments are approved for the treatment of HSDD or any FSD. Testosterone products are being used off-label, but questions remain about their efficacy and safety in pre- and postmenopausal women. This article gives an overview of HSDD in clinical practice and provides 3 case descriptions to illustrate the treatment of low sexual desire in women with diverse histories.

  3. Serum fibroblast growth factor 23, serum iron and bone mineral density in premenopausal women

    PubMed Central

    Imel, Erik A.; Liu, Ziyue; McQueen, Amie K.; Acton, Dena; Acton, Anthony; Padgett, Leah R.; Peacock, Munro; Econs, Michael J.

    2016-01-01

    Fibroblast growth factor 23 (FGF23) circulates as active protein and inactive fragments. Low iron status increases FGF23 gene expression, and iron deficiency is common. We hypothesized that in healthy premenopausal women, serum iron influences C-terminal and intact FGF23 concentrations, and that iron and FGF23 associate with bone mineral density (BMD). Serum iron, iron binding capacity, percent iron saturation, phosphorus, and other biochemistries were measured in stored fasting samples from healthy premenopausal white (n=1898) and black women (n= 994), age 20–55 years. Serum C-terminal and intact FGF23 were measured in a subset (1631 white and 296 black women). BMD was measured at the lumbar spine and femur neck. Serum phosphorus, calcium, alkaline phosphatase and creatinine were lower in white women than black women (p<0.001). Serum iron (p<0.0001) and intact FGF23 (p< 0.01) were higher in white women. C-terminal FGF23 did not differ between races. Phosphorus correlated with intact FGF23 (white women, r=0.120, p<0.0001; black women r=0.163, p<0.01). However, phosphorus correlated with C-terminal FGF23 only in black women (r=0.157, p<0.01). Intact FGF23 did not correlate with iron. C-terminal FGF23 correlated inversely with iron (white women r=−0.134, p<0.0001; black women r=−0.188, p<0.01), having a steeper slope at iron <50 mcg/dl than >50 mcg/dl. Longitudinal changes in iron predicted changes in C-terminal FGF23. Spine BMD correlated with iron negatively (r=−0.076, p<0.01) in white women; femur neck BMD correlated with iron negatively (r=−0.119, p<0.0001) in black women. Both relationships were eliminated in weight-adjusted models. BMD did not correlate with FGF23. Serum iron did not relate to intact FGF23, but was inversely related to C-terminal FGF23. Intact FGF23 correlated with serum phosphorus. In weight-adjusted models, BMD was not related to intact FGF23, C-terminal FGF23 or iron. The influence of iron on FGF23 gene expression is not important

  4. Serum fibroblast growth factor 23, serum iron and bone mineral density in premenopausal women.

    PubMed

    Imel, Erik A; Liu, Ziyue; McQueen, Amie K; Acton, Dena; Acton, Anthony; Padgett, Leah R; Peacock, Munro; Econs, Michael J

    2016-05-01

    Fibroblast growth factor 23 (FGF23) circulates as active protein and inactive fragments. Low iron status increases FGF23 gene expression, and iron deficiency is common. We hypothesized that in healthy premenopausal women, serum iron influences C-terminal and intact FGF23 concentrations, and that iron and FGF23 associate with bone mineral density (BMD). Serum iron, iron binding capacity, percent iron saturation, phosphorus, and other biochemistries were measured in stored fasting samples from healthy premenopausal white (n=1898) and black women (n=994), age 20-55years. Serum C-terminal and intact FGF23 were measured in a subset (1631 white and 296 black women). BMD was measured at the lumbar spine and femur neck. Serum phosphorus, calcium, alkaline phosphatase and creatinine were lower in white women than black women (p<0.001). Serum iron (p<0.0001) and intact FGF23 (p<0.01) were higher in white women. C-terminal FGF23 did not differ between races. Phosphorus correlated with intact FGF23 (white women, r=0.120, p<0.0001; black women r=0.163, p<0.01). However, phosphorus correlated with C-terminal FGF23 only in black women (r=0.157, p<0.01). Intact FGF23 did not correlate with iron. C-terminal FGF23 correlated inversely with iron (white women r=-0.134, p<0.0001; black women r=-0.188, p<0.01), having a steeper slope at iron <50mcg/dl than ≥50mcg/dl. Longitudinal changes in iron predicted changes in C-terminal FGF23. Spine BMD correlated with iron negatively (r=-0.076, p<0.01) in white women; femur neck BMD correlated with iron negatively (r=-0.119, p<0.0001) in black women. Both relationships were eliminated in weight-adjusted models. BMD did not correlate with FGF23. Serum iron did not relate to intact FGF23, but was inversely related to C-terminal FGF23. Intact FGF23 correlated with serum phosphorus. In weight-adjusted models, BMD was not related to intact FGF23, C-terminal FGF23 or iron. The influence of iron on FGF23 gene expression is not important in

  5. Breast Cancer Screening Beliefs among Older Korean American Women

    PubMed Central

    Eun, Young; Lee, Eunice E.; Kim, Mi Ja; Fogg, Louis

    2011-01-01

    Korean American women’s breast cancer screening rates are low, and the rates among older Korean American women are even lower. This article describes health beliefs related to older Korean American women’s screening behaviors, comparing them to beliefs of younger Korean American women. The 73 women age 65 and older had significantly different health beliefs than the 114 women between ages 40 and 64. Further, older women’s perceptions of the seriousness of the disease and benefits of and barriers to taking action to prevent the disease predated their screening behaviors. Interventions to change the health beliefs of older Korean American women are suggested. PMID:19715259

  6. Patterns of nonmasslike enhancement at screening breast MR imaging of high-risk premenopausal women.

    PubMed

    Giess, Catherine S; Raza, Sughra; Birdwell, Robyn L

    2013-01-01

    Current U.S. recommendations for breast cancer screening of women with at least a 20%-25% lifetime risk of developing breast cancer include contrast material-enhanced magnetic resonance (MR) imaging of the breasts. The cancer detection rate in high-risk women undergoing screening MR imaging is approximately 10 times higher than that in normal-risk women undergoing screening mammography. Many of these high-risk women commence MR imaging screening while they are premenopausal, when the breasts are most influenced by cyclical hormonal changes. Healthy premenopausal breast tissue enhances in a cyclical and variable manner. This enhancement is described as background enhancement. Typically, enhancement of normal breast tissue occurs in a symmetric and diffuse pattern, and there is little diagnostic difficulty in classifying it as normal background parenchymal enhancement. However, sometimes the pattern is more focal, asymmetric, or regional. It may then be described as nonmasslike enhancement, an observation associated with both benign and malignant breast pathologic conditions. A review of the morphologic features and internal enhancement patterns in normal but nondiffuse background enhancement and abnormal nonmasslike enhancement in high-risk premenopausal women can help improve interpretive specificity and decrease false-positive interpretations. MR imaging pitfalls and interpretation strategies for localized background enhancement and pathologic nonmasslike enhancement in this high-risk population are highlighted. In evaluating nonmasslike enhancement, the use of the Breast Imaging Reporting and Data System (BI-RADS) lexicon to perform careful analysis of morphologic features, along with an understanding of the role and limitations of kinetic information, will help balance early breast cancer detection against false-positive interpretation.

  7. Effect of Dietary Fiber Intake on Lipoprotein Cholesterol Levels Independent of Estradiol in Healthy Premenopausal Women

    PubMed Central

    Mumford, Sunni L.; Schisterman, Enrique F.; Siega-Riz, Anna Maria; Gaskins, Audrey J.; Wactawski-Wende, Jean; VanderWeele, Tyler J.

    2011-01-01

    High-fiber diets are associated with improved lipid profiles. However, pre- and postmenopausal women respond differently to fiber intake, suggesting that endogenous estradiol mediates the effect. The authors' objective was to determine the direct effect of fiber intake on lipoprotein cholesterol levels independent of estradiol among premenopausal women. The BioCycle Study, a prospective cohort study conducted at the State University of New York at Buffalo from 2005 to 2007, followed 259 healthy women for up to 2 complete menstrual cycles. Serum lipoprotein and hormone levels were measured at 16 visits timed using fertility monitors. Fiber intake was assessed by 8 24-hour recalls. Marginal structural models with inverse probability weights for both lipoprotein and estradiol levels were used to estimate controlled direct effects of the highest category of fiber intake (≥22 g/day vs. <22 g/day) while accounting for age, body mass index, total energy, vitamin E intake, physical activity, luteinizing hormone, follicle-stimulating hormone, and progesterone. Reductions were observed in total and low density lipoprotein cholesterol in women with higher fiber intakes. Direct effects were greater than total effects. These analyses suggested that estradiol mediates at least part of the association between fiber and cholesterol among premenopausal women. More research is needed to elucidate the biologic mechanisms driving these associations. PMID:21148240

  8. Abnormal uterine bleeding in pre-menopausal women.

    PubMed

    Singh, Sukhbir; Best, Carolyn; Dunn, Sheila; Leyland, Nicholas; Wolfman, Wendy Lynn

    2013-05-01

    Abnormal uterine bleeding is the direct cause of a significant health care burden for women, their families, and society as a whole. Up to 30% of women will seek medical assistance for this problem during their reproductive years. This guideline replaces previous clinical guidelines on the topic and is aimed to enable health care providers with the tools to provide the latest evidence-based care in the diagnosis and the medical and surgical management of this common problem. To provide current evidence-based guidelines for the diagnosis and management of abnormal uterine bleeding (AUB) among women of reproductive age. Outcomes evaluated include the impact of AUB on quality of life and the results of interventions including medical and surgical management of AUB. Members of the guideline committee were selected on the basis of individual expertise to represent a range of practical and academic experience in terms of location in Canada, type of practice, subspecialty expertise, and general gynaecology background. The committee reviewed relevant evidence in the English medical literature including published guidelines. Recommendations were established as consensus statements. The final document was reviewed and approved by the Executive and Council of the SOGC. This document provides a summary of up-to-date evidence regarding diagnosis, investigations, and medical and surgical management of AUB. The resulting recommendations may be adapted by individual health care workers when serving women with this condition. Abnormal uterine bleeding is a common and sometimes debilitating condition in women of reproductive age. Standardization of related terminology, a systematic approach to diagnosis and investigation, and a step-wise approach to intervention is necessary. Treatment commencing with medical therapeutic modalities followed by the least invasive surgical modalities achieving results satisfactory to the patient is the ultimate goal of all therapeutic interventions

  9. Anthropometry, CT, and DXA as predictors of GH deficiency in premenopausal women: ROC curve analysis

    PubMed Central

    Bredella, Miriam A.; Utz, Andrea L.; Torriani, Martin; Thomas, Bijoy; Schoenfeld, David A.; Miller, Karen K.

    2009-01-01

    Visceral adiposity is a strong determinant of growth hormone (GH) secretion, and states of GH deficiency are associated with increased visceral adiposity and decreased lean body mass. The purpose of our study was to determine the sensitivity and specificity of different methods of assessing body composition [anthropometry, dual-energy X-ray absorptiometry (DXA), and computed tomography (CT)] to predict GH deficiency in premenopausal women and threshold values for each technique to predict GH deficiency, using receiver operator characteristic (ROC) curve analysis. We studied a group of 45 healthy lean, overweight, and obese premenopausal women who underwent anthropometric measurements (body mass index, waist and hip circumferences, skin fold thickness), DXA, CT, and a GH-releasing hormone-arginine stimulation test. ROC curve analysis was used to determine cutoff values for each method to identify GH deficiency. Visceral adiposity measured by CT showed the highest sensitivity and specificity for identifying subjects with GH deficiency with a cutoff of >9,962 mm2 [area under the curve (AUC), 0.95; sensitivity, 100%; specificity, 77.8%; P = 0.0001]. Largest waist circumference showed high sensitivity and specificity with a cutoff of >101.7 cm (AUC, 0.89; sensitivity, 88.9%; specificity, 75%; P = 0.0001). When the ROC curves of visceral fat measured by CT and largest waist circumference were compared, the difference between the two methods was not statistically significant (P = 0.36). Our study showed that the largest waist circumference predicts the presence of GH deficiency in healthy premenopausal women with high sensitivity and specificity and nearly as well as CT measurement of visceral adiposity. It can be used to identify women in whom GH deficiency is likely and therefore in whom formal GH stimulation testing might be indicated. PMID:19095751

  10. Serum resistin is inversely related to breast cancer risk in premenopausal women.

    PubMed

    Georgiou, Georgia P; Provatopoulou, Xeni; Kalogera, Eleni; Siasos, Gerasimos; Menenakos, Evangelos; Zografos, George C; Gounaris, Antonia

    2016-10-01

    Adipokines have been suggested as potential mediators linking obesity and breast cancer. Resistin is the least-studied adipokine with diverse findings regarding its association with disease development and progression. The present study aimed to determine resistin serum levels in breast cancer in relation to the histological type of disease and to investigate their association with breast cancer risk. The study included 216 women, of which 163 were diagnosed with breast cancer (58 with IDC, 52 with DCIS and 53 with LN) and 53 were healthy. Serum levels of resistin, leptin and adiponectin were quantitatively determined in duplicates by ELISA. Differences in resistin levels among patient groups were evaluated with Kruskal-Wallis and Mann-Whitney tests. The association of resistin with breast cancer risk was evaluated by multiple logistic regression analysis. Resistin levels varied between histological types of breast cancer (p = 0.044). Significant differences in serum resistin were observed in IDC patients compared to those with DCIS and to controls (p < 0.014 and p < 0.03, respectively). Decreased levels of resistin, adiponectin and leptin were observed in premenopausal patients. Resistin was associated with a reduced risk for ductal carcinoma only in premenopausal women (OR: 0.364, 95% CI: 0.154-0.862, p < 0.022). Our findings indicate that resistin levels were inversely related to breast cancer risk in premenopausal women, supporting a protective role of resistin for these patients. Further advances in adipokine research may lead to tangible benefits for overweight/obese women at an increased risk for breast cancer. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Caffeine, coffee, and tea intake and urinary estrogens and estrogen metabolites in premenopausal women.

    PubMed

    Sisti, Julia S; Hankinson, Susan E; Caporaso, Neil E; Gu, Fangyi; Tamimi, Rulla M; Rosner, Bernard; Xu, Xia; Ziegler, Regina; Eliassen, A Heather

    2015-08-01

    Prior studies have found weak inverse associations between breast cancer and caffeine and coffee intake, possibly mediated through their effects on sex hormones. High-performance liquid chromatography/tandem mass spectrometry was used to quantify levels of 15 individual estrogens and estrogen metabolites (EM) among 587 premenopausal women in the Nurses' Health Study II with mid-luteal phase urine samples and caffeine, coffee, and/or tea intakes from self-reported food frequency questionnaires. Multivariate linear mixed models were used to estimate geometric means of individual EM, pathways, and ratios by intake categories, and P values for tests of linear trend. Compared with women in the lowest quartile of caffeine consumption, those in the top quartile had higher urinary concentrations of 16α-hydroxyestrone (28% difference; Ptrend = 0.01) and 16-epiestriol (13% difference; Ptrend = 0.04), and a decreased parent estrogens/2-, 4-, 16-pathway ratio (Ptrend = 0.03). Coffee intake was associated with higher 2-catechols, including 2-hydroxyestradiol (57% difference, ≥4 cups/day vs. ≤6 cups/week; Ptrend = 0.001) and 2-hydroxyestrone (52% difference; Ptrend = 0.001), and several ratio measures. Decaffeinated coffee was not associated with 2-pathway metabolism, but women in the highest (vs. lowest) category of intake (≥2 cups/day vs. ≤1-3 cups/month) had significantly lower levels of two 16-pathway metabolites, estriol (25% difference; Ptrend = 0.01) and 17-epiestriol (48% difference; Ptrend = 0.0004). Tea intake was positively associated with 17-epiestriol (52% difference; Ptrend = 0.01). Caffeine and coffee intake were both associated with profiles of estrogen metabolism in premenopausal women. Consumption of caffeine and coffee may alter patterns of premenopausal estrogen metabolism. ©2015 American Association for Cancer Research.

  12. Caffeine, coffee and tea intake and urinary estrogens and estrogen metabolites in premenopausal women

    PubMed Central

    Sisti, Julia S.; Hankinson, Susan E.; Caporaso, Neil E.; Gu, Fangyi; Tamimi, Rulla M.; Rosner, Bernard; Xu, Xia; Ziegler, Regina; Eliassen, A. Heather

    2015-01-01

    Background Prior studies have found weak inverse associations between breast cancer and caffeine and coffee intake, possibly mediated through their effects on sex hormones. Methods High-performance liquid chromatography/tandem mass spectrometry was used to quantify levels of 15 individual estrogens and estrogen metabolites (EM) among 587 premenopausal women in the Nurses’ Health Study II with mid-luteal phase urine samples and caffeine, coffee and/or tea intakes from self-reported food frequency questionnaires. Multivariate linear mixed models were used to estimate geometric means of individual EM, pathways and ratios by intake categories, and P-values for tests of linear trend. Results Compared to women in the lowest quartile of caffeine consumption, those in the top quartile had higher urinary concentrations of 16α-hydroxyestrone (28% difference; P-trend=0.01) and 16-epiestriol (13% difference; P-trend=0.04), and a decreased parent estrogens/2-, 4-, 16-pathway ratio (P-trend=0.03). Coffee intake was associated with higher 2-catechols, including 2-hydroxyestradiol (57% difference, ≥4 cups/day vs. ≤6 cups/week; P-trend=0.001) and 2-hydroxyestrone (52% difference; P-trend=0.001), and several ratio measures. Decaffeinated coffee was not associated with 2-pathway metabolism, but women in the highest (vs. lowest) category of intake (≥2 cups/day vs. ≤1–3 cups/month) had significantly lower levels of two 16-pathway metabolites, estriol (25% difference; P-trend=0.01) and 17-epiestriol (48% difference; Ptrend=0.0004). Tea intake was positively associated with 17-epiestriol (52% difference; Ptrend=0.01). Conclusion Caffeine and coffee intake were both associated with profiles of estrogen metabolism in premenopausal women. Impact Consumption of caffeine and coffee may alter patterns of premenopausal estrogen metabolism. PMID:26063478

  13. Immigration patterns, social support, and adaptation among Korean immigrant women and Korean American women.

    PubMed

    Kim, Y; Grant, D

    1997-01-01

    There are little empirical data available on the mental health and social functioning of Korean American Women (both native U.S. born and foreign Korean-born U.S. residents, inclusive). State-of-the-art research used to inform social work practice is exploratory descriptive. With the goal of contributing to the social work knowledge base regarding this understudied population, this article uses an emic understanding and approach to examine immigration patterns, social support networks, and issues around adaptation experienced by Korean American women. Issues examined include gender role disruption, limited use of social services, and evidence of depressive symptoms in Korean American women and subsequent risk of substance abuse, suicide, battering, loss of employment, deficits in parenting, and mental health problems. Focus on these areas of functioning suggests the need for development of culturally competent community, family, individual, and organizational-level intervention strategies.

  14. Adolescent diet in relation to breast cancer risk among premenopausal women.

    PubMed

    Linos, Eleni; Willett, Walter C; Cho, Eunyoung; Frazier, Lindsay

    2010-03-01

    Although the association between adult diet and breast cancer has been investigated extensively, large prospective studies have generally not shown a direct link between intakes of carbohydrate, fat, fiber, and other nutrients and risk of breast cancer. Adolescence may be a period of increased susceptibility to risk factors that predispose to breast cancer. Dietary risk factors could therefore be more important during early life than later in adulthood. This is a prospective observational study of 39,268 premenopausal women in the Nurses' Health Study II who completed a 124-item food frequency questionnaire on their diet during high school (HS-FFQ) in 1998, at which time participants were 34 to 53 years of age. Cox proportional hazards regression was used to estimate relative risks and 95% CIs. Four hundred fifty-five incident cases of invasive breast cancer were diagnosed between 1998 and 2005. Compared with women in the lowest quintile of intake, the relative risk of breast cancer in the highest quintile of adolescent total fat consumption was 1.35 (95% confidence interval, 1.00-1.81). Adolescent consumption of saturated, monounsaturated, polyunsaturated, and trans fats was not significantly associated with breast cancer risk. Total dairy, milk, carbohydrate intake, glycemic index, glycemic load, and fiber consumed during adolescence were not significantly related to breast cancer incidence. Dietary fat consumed during adolescence may be associated with an elevated risk of breast cancer. Further studies to assess this relationship among postmenopausal women, and confirm these results in premenopausal women, are needed.

  15. Increased vitamin D and calcium intake associated with reduced mammographic breast density among premenopausal women.

    PubMed

    Fair, Alecia Malin; Lewis, Toni J; Sanderson, Maureen; Dupont, William D; Fletcher, Sarah; Egan, Kathleen M; Disher, Anthony C

    2015-10-01

    Vitamin D has been identified as a weak protective factor for postmenopausal breast cancer (relative risk, ~0.9), whereas high breast density has been identified as a strong risk factor (relative risk, ~4-6). To test the hypothesis that there is an association between vitamin D intake, but not circulating vitamin D levels, and mammographic breast density among women in our study, we conducted a cross-sectional study of 165 screening mammography patients at Nashville General Hospital's Breast Health Center, a public facility serving medically indigent and underserved women. Dietary and total (dietary plus supplements) vitamin D and calcium intakes were estimated by the Harvard African American Food Frequency Questionnaire, and blood samples were analyzed for 25-hydroxyvitamin D. Average percent breast density for the left and right breasts combined was estimated from digitized films using an interactive thresholding method available through Cumulus software. After statistical adjustment for age, race, and body mass index, the results revealed that there were significant trends of decreasing breast density with increasing vitamin D and calcium intake among premenopausal but not among postmenopausal women. There was no association between serum vitamin D and breast density in premenopausal or postmenopausal women. Confirmation of our findings in larger studies may assist in clarifying the role of vitamin D in breast density.

  16. Premenopausal and postmenopausal differences in bone microstructure and mechanical competence in Chinese-American and white women.

    PubMed

    Walker, Marcella D; Liu, X Sherry; Zhou, Bin; Agarwal, Shivani; Liu, George; McMahon, Donald J; Bilezikian, John P; Guo, X Edward

    2013-06-01

    Compared to white women, premenopausal Chinese-American women have more plate-like trabecular (Tb) bone. It is unclear whether these findings are relevant to postmenopausal women and if there are racial differences in the deterioration of bone microarchitecture with aging. We applied individual trabecula segmentation and finite element analysis to high-resolution peripheral quantitative computed tomography images in premenopausal and postmenopausal Chinese-American and white women to quantify within-race age-related differences in Tb plate-versus-rod microarchitecture and bone stiffness. Race-menopause status interactions were assessed. Comparisons between races within menopause status were adjusted for age, height and weight. Comparisons between premenopausal and postmenopausal women were adjusted for height and weight. Adjusted analyses at the radius indicated that premenopausal Chinese-Americans had a higher plate bone volume fraction (pBV/TV), Tb plate-to-rod ratio (P-R ratio), and greater plate-plate junction densities (P-P Junc.D) versus white women (all p < 0.01), resulting in 27% higher Tb stiffness (p < 0.05). Greater cortical thickness and density (Ct.Th and Dcort) and more Tb plates led to 19% greater whole bone stiffness (p < 0.05). Postmenopausal Chinese-Americans had similar pBV/TV and P-P Junc.D, yet a higher P-R ratio versus white women. Postmenopausal Chinese-American versus white women had greater Ct.Th, Dcort, and relatively intact Tb plates, resulting in similar Tb stiffness but 12% greater whole bone stiffness (p < 0.05). In both races, Ct.Th and Dcort were lower in postmenopausal versus premenopausal women and there were no differences between races. Tb plate parameters were also lower in postmenopausal versus premenopausal women, but age-related differences in pBV/TV, P-R ratio, and P-P Junc D were greater (p < 0.05) in Chinese-Americans versus white women. There are advantages in cortical and Tb bone in premenopausal

  17. The Effects of Weight Loss on Relative Bone Mineral Density in Premenopausal Women

    PubMed Central

    Hamilton, Kara C.; Fisher, Gordon; Roy, Jane L.; Gower, Barbara A.; Hunter, Gary R.

    2012-01-01

    Heavier individuals have higher bone mineral density (BMD) than individuals of lower body weight, but it is unclear whether BMD changes in proportion to body weight during weight loss. This study compared BMD relative to body weight following a ~6 months weight loss program and a one year weight maintenance phase in premenopausal women and determined whether African American (AA) and European-American (EA) women’s BMD respond similarly during weight loss. Premenopausal women (n=115, 34 ± 5 yrs.) were evaluated in an overweight state (BMI between 27–30 kg/m2), following an 800 kcal/day diet/exercise program designed to reduce BMI <25 kg/m2, and one year following weight loss. Results indicated that BMD relative to body weight (Z-scores) increased after weight loss, but decreased during the one year weight maintenance phase. All one year follow up BMD Z-scores were increased (except L1) compared to baseline measurements (P < 0.05). These sites included the hip neck (+0.088, P=0.014), total hip (+0.099, P=0.001), L2 (+0.127, P=0.013), L3 (+0.135, P=0.014), and L4 (+0.199, P=0.002). AAs had significantly higher absolute BMD at all sites (P<0.05) compared to EAs, but no time by race interactions were evident during weight loss (except in L3). These results may indicate that weight loss is safe with regard to bone health for overweight premenopausal women. PMID:23404937

  18. Comparison of saline infusion sonohysterography and hysteroscopy in diagnosis of premenopausal women with abnormal uterine bleeding.

    PubMed

    Soguktas, Suna; Cogendez, Ebru; Kayatas, Semra Eser; Asoglu, Mehmet Resit; Selcuk, Selcuk; Ertekin, Aktug

    2012-03-01

    The aim of this study was to compare the diagnostic effectiveness of transvaginal sonography (TVS), saline infusion sonohysterography (SIS), and diagnostic hysteroscopy (HS), with the pathologic specimen as a gold standard diagnostic method, in detecting endometrial pathology in premenopausal women with abnormal uterine bleeding. This prospective cohort study was conducted at Zeynep Kamil Education and Training Hospital, Istanbul, Turkey, and included 89 premenopausal women. All participants were examined first by TVS, further investigated with SIS and HS, and finally dilatation and curettage was performed when needed. The results obtained from these three methods were compared with the pathologic diagnoses. The positive and negative likelihood ratios (LR+ and LR-) of TVS, SIS and HS were calculated by comparison with the final pathological diagnosis. In addition, area under the curve (AUC) values were also calculated. Polypoid lesion was the most common abnormal pathology. LR+ and LR- of TVS, SIS, and HS were 3.13 and 0.15, 9.83 and 0.07, 13.7 and 0.02 respectively in detection of any abnormal pathology, and the AUCs of TVS, SIS, and HS were 0.804, 0.920, and 0.954 respectively. When the three procedures were compared with each other separately, HS had the best diagnostic accuracy, and the diagnostic accuracy of HS and SIS was superior to TVS (p(1)=0.000, p(2)=0.000). For the detection of polypoid lesions, HS was the most accurate diagnostic procedure (AUC=0.947), followed by SIS (AUC=0.894) and TVS (AUC=0.778). HS provides the most accurate diagnosis and allows treatment in the same session in premenopausal women with abnormal uterine bleeding. Published by Elsevier Ireland Ltd.

  19. Exercise and Bone Mineral Density in Premenopausal Women: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Kelley, George A.; Kelley, Kristi S.; Kohrt, Wendy M.

    2013-01-01

    Objective. Examine the effects of exercise on femoral neck (FN) and lumbar spine (LS) bone mineral density (BMD) in premenopausal women. Methods. Meta-analysis of randomized controlled exercise trials ≥24 weeks in premenopausal women. Standardized effect sizes (g) were calculated for each result and pooled using random-effects models, Z score alpha values, 95% confidence intervals (CIs), and number needed to treat (NNT). Heterogeneity was examined using Q and I 2. Moderator and predictor analyses using mixed-effects ANOVA and simple metaregression were conducted. Statistical significance was set at P ≤ 0.05. Results. Statistically significant improvements were found for both FN (7g's, 466 participants, g = 0.342, 95%  CI = 0.132, 0.553, P = 0.001, Q = 10.8, P = 0.22, I 2 = 25.7%, NNT = 5) and LS (6g's, 402 participants, g = 0.201, 95%  CI = 0.009, 0.394, P = 0.04, Q = 3.3, P = 0.65, I 2 = 0%, NNT = 9) BMD. A trend for greater benefits in FN BMD was observed for studies published in countries other than the United States and for those who participated in home versus facility-based exercise. Statistically significant, or a trend for statistically significant, associations were observed for 7 different moderators and predictors, 6 for FN BMD and 1 for LS BMD. Conclusions. Exercise benefits FN and LS BMD in premenopausal women. The observed moderators and predictors deserve further investigation in well-designed randomized controlled trials. PMID:23401684

  20. Vitamin D Decreases Risk of Breast Cancer in Premenopausal Women of Normal Weight in Subtropical Taiwan

    PubMed Central

    Lee, Meei-Shyuan; Huang, Yi-Chen; Wahlqvist, Mark L; Wu, Tsai-Yi; Chou, Yu-Ching; Wu, Mei-Hsuan; Yu, Jyh-Cherng; Sun, Chien-An

    2011-01-01

    Background Evidence for an association between vitamin D status and breast cancer is now more convincing, but is uncertain in subtropical areas like Taiwan. This hospital-based case-control study examined the relationship of breast cancer with vitamin D intake and sunlight exposure. Methods A total of 200 incident breast cancer cases in a Taipei hospital were matched with 200 controls by date of interview and menopausal status. Information on risk factors for breast cancer was collected in face-to-face interviews and assessed with reference to vitamin D intake (foods and nutrients) and sunlight exposure. Vitamin D intake was divided into quartiles, and threshold effect was evaluated by comparing Q2–Q4 with Q1. Results After controlling for age, education, parity, hormone replacement therapy, body mass index (BMI), energy intake, menopausal status, and daily sunlight exposure, the risk of breast cancer in participants with a dietary vitamin D intake greater than 5 µg per day was significantly lower (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.24–0.97) than that of participants with an intake less than 2 µg per day. In analysis stratified by menopausal status and BMI, both dietary vitamin D and total vitamin D intakes were associated with a protective effect among premenopausal women. There was a significant linear trend for breast cancer risk and dietary vitamin D intake in premenopausal women (P = 0.02). In participants with a BMI lower than 24 kg/m2 (ie, normal weight), dietary vitamin D intake was inversely related to breast cancer risk (P for trend = 0.002), and a threshold effect was apparent (Q2–Q4 vs Q1: OR, 0.46; 95% CI, 0.23–0.90). Conclusions Vitamin D had a protective effect against breast cancer in premenopausal women of normal weight in subtropical Taiwan, especially an intake greater than 5 µg per day. PMID:21160130

  1. Vitamin D decreases risk of breast cancer in premenopausal women of normal weight in subtropical taiwan.

    PubMed

    Lee, Meei-Shyuan; Huang, Yi-Chen; Wahlqvist, Mark L; Wu, Tsai-Yi; Chou, Yu-Ching; Wu, Mei-Hsuan; Yu, Jyh-Cherng; Sun, Chien-An

    2011-01-01

    Evidence for an association between vitamin D status and breast cancer is now more convincing, but is uncertain in subtropical areas like Taiwan. This hospital-based case-control study examined the relationship of breast cancer with vitamin D intake and sunlight exposure. A total of 200 incident breast cancer cases in a Taipei hospital were matched with 200 controls by date of interview and menopausal status. Information on risk factors for breast cancer was collected in face-to-face interviews and assessed with reference to vitamin D intake (foods and nutrients) and sunlight exposure. Vitamin D intake was divided into quartiles, and threshold effect was evaluated by comparing Q2-Q4 with Q1. After controlling for age, education, parity, hormone replacement therapy, body mass index (BMI), energy intake, menopausal status, and daily sunlight exposure, the risk of breast cancer in participants with a dietary vitamin D intake greater than 5 µg per day was significantly lower (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.24-0.97) than that of participants with an intake less than 2 µg per day. In analysis stratified by menopausal status and BMI, both dietary vitamin D and total vitamin D intakes were associated with a protective effect among premenopausal women. There was a significant linear trend for breast cancer risk and dietary vitamin D intake in premenopausal women (P = 0.02). In participants with a BMI lower than 24 kg/m(2) (ie, normal weight), dietary vitamin D intake was inversely related to breast cancer risk (P for trend = 0.002), and a threshold effect was apparent (Q2-Q4 vs Q1: OR, 0.46; 95% CI, 0.23-0.90). Vitamin D had a protective effect against breast cancer in premenopausal women of normal weight in subtropical Taiwan, especially an intake greater than 5 µg per day.

  2. Association between uterine leiomyoma and metabolic syndrome in parous premenopausal women

    PubMed Central

    Tak, Young Jin; Lee, Sang Yeoup; Park, Sun Ki; Kim, Yun Jin; Lee, Jeong Gyu; Jeong, Dong Wook; Kim, Seung Chul; Kim, In Joo; Yi, Yu Hyun

    2016-01-01

    Abstract Previous studies have reported that uterine leiomyoma (UL) may share pathogenic features with obesity and hypertension, which are components of metabolic syndrome (MetS). We examined the association between UL and MetS in premenopausal parous women. This 1:1 case–control study was conducted on 615 asymptomatic women with UL and 615 women without UL that were matched for age, reproductive history, and hormonal use, who underwent a comprehensive health examination. UL was diagnosed by a gynecologist based on transvaginal ultrasonography findings. Blood pressure (BP), body composition, fasting plasma glucose, lipid profiles, insulin, and HOMA-IR were checked. Median age of the 1230 study subjects was 44 (40–47) years and 7% had MetS. Women with UL had significantly higher waist circumferences and body fat, BP, and low-density lipoprotein cholesterol (LDL-C) than women without UL. Although nonsignificant, the prevalence of MetS was higher in the UL group than in the non-UL group (9.3% vs 5.7%). In addition, the prevalence of UL increased as the number of abnormal metabolic components increased and was higher than in women without UL. Conditional logistic regression analysis, after adjustment for confounding factors, showed that hyperglycemia was significantly associated with an increased risk of UL (odds ratio = 1.45; 95% confidence interval, 1.10–1.89). Prevalence of abnormal metabolic component was higher in premenopausal women with UL than in normal controls, regardless of age or reproductive history. Furthermore, the study suggests that UL may share pathogenic features with the components of MetS and that women with UL be considered eligible for the early screening of metabolic abnormalities. PMID:27861360

  3. Do Premenopausal Women with Major Depression Have Low Bone Mineral Density? A 36-Month Prospective Study

    PubMed Central

    Cizza, Giovanni; Mistry, Sima; Nguyen, Vi T.; Eskandari, Farideh; Martinez, Pedro; Torvik, Sara; Reynolds, James C.; Gold, Philip W.; Sinai, Ninet; Csako, Gyorgy

    2012-01-01

    Background An inverse relationship between major depressive disorder (MDD) and bone mineral density (BMD) has been suggested, but prospective evaluation in premenopausal women is lacking. Methods Participants of this prospective study were 21 to 45 year-old premenopausal women with MDD (n = 92) and healthy controls (n = 44). We measured BMD at the anteroposterior lumbar spine, femoral neck, total hip, mid-distal radius, trochanter, and Ward's triangle, as well as serum intact parathyroid hormone (iPTH), ionized calcium, plasma adrenocorticotropic hormone (ACTH), serum cortisol, and 24-hour urinary-free cortisol levels at 0, 6, 12, 24, and 36 months. 25-hydroxyvitamin D was measured at baseline. Results At baseline, BMD tended to be lower in women with MDD compared to controls and BMD remained stable over time in both groups. At baseline, 6, 12, and 24 months intact PTH levels were significantly higher in women with MDD vs. controls. At baseline, ionized calcium and 25-hydroxyvitamin D levels were significantly lower in women with MDD compared to controls. At baseline and 12 months, bone-specific alkaline phosphatase, a marker of bone formation, was significantly higher in women with MDD vs. controls. Plasma ACTH was also higher in women with MDD at baseline and 6 months. Serum osteocalcin, urinary N-telopeptide, serum cortisol, and urinary free cortisol levels were not different between the two groups throughout the study. Conclusion Women with MDD tended to have lower BMD than controls over time. Larger and longer studies are necessary to extend these observations with the possibility of prophylactic therapy for osteoporosis. Trial Registration ClinicalTrials.gov NCT 00006180 PMID:22848407

  4. Comparison of dienogest versus triptorelin acetate in premenopausal women with adenomyosis: a prospective clinical trial.

    PubMed

    Fawzy, Muhammad; Mesbah, Yasser

    2015-12-01

    To compare the efficacy of the oral dienogest versus triptorelin acetate injection for treatment of premenopausal menorrhagia and pelvic pains in women with uterine adenomyosis. A total of 41 patients with adenomyosis suffering from pelvic pains and menorrhagia were recruited. First group was managed with oral dienogest (2 mg/day, orally) while the second group received triptorelin acetate (3.75 mg/4 weeks, subcutaneous injection) for 16 weeks. Outpatient follow-up was undertaken after 8 weeks but mean values were calculated at baseline and after 16 weeks (end of treatment). A total of 41 women were allocated to treatment with dienogest (n = 22) or triptorelin acetate (n = 19); 19 (86.4 %) and 18 (94.7 %) % of the respective groups completed the trial. Significant reductions in pelvic pains after 16 weeks treatment were obtained in both groups demonstrating the equivalence of dienogest relative to triptorelin acetate. Triptorelin acetate was more effective in controlling of menorrhagia and reduction of uterine volume. Dienogest may be a valuable alternative to depot triptorelin acetate for treatment of premenopausal pelvic pains in women with uterine adenomyosis.

  5. Nutrients involved in one-carbon metabolism and risk of breast cancer among premenopausal women.

    PubMed

    Cho, Eunyoung; Holmes, Michelle; Hankinson, Susan E; Willett, Walter C

    2007-12-01

    Folate, vitamin B6, vitamin B12, methionine, choline, and betaine are nutrients involved in one-carbon metabolism and have been hypothesized to reduce the risk of breast cancer. However, previous epidemiologic studies on most of these nutrients and breast cancer risk have been inconclusive and have included primarily postmenopausal women. No study has examined choline and betaine in relation to breast cancer risk. Therefore, we examined the intake of these nutrients in relation to breast cancer risk among 90,663 premenopausal women ages 26 to 46 years in 1991 in the Nurses' Health Study II. Nutrient intake was assessed with a validated food frequency questionnaire in 1991, 1995, and 1999. During 12 years of follow-up from 1991 to 2003, we documented 1,032 incident cases of invasive breast cancer. Overall, none of the nutrients was associated with risk of breast cancer. The results were similar by levels of alcohol intake and folate intake and for estrogen receptor-negative breast cancer. In conclusion, we found no evidence that higher intakes of nutrients involved in one-carbon metabolism reduce risk of breast cancer among premenopausal women.

  6. Expression of aquaporin water channels in the vagina in premenopausal women.

    PubMed

    Kim, Sun-Ouck; Oh, Kyung Jin; Lee, Hyun Suk; Ahn, Kyuyoun; Kim, Soo Wan; Park, Kwangsung

    2011-07-01

    Aquaporins (AQPs) are membrane proteins that facilitate water movement across biological membranes. This study builds on a previous report on the distinct localization of AQPs in the rat vagina. The purposes of this study were to investigate the localization and expression of the AQPs in the vaginal tissue of premenopausal women. Anterior vaginal tissue was collected during transvaginal uterine myomectomy or hysterectomy from 10 premenopausal women (mean age, 40 years) for Western blot and immunohistochemistry. The expression and cellular localization of AQP1-9 were determined in the human vagina by Western blot and immunohistochemistry. Immunolabeling showed that AQP1 was mainly expressed in the capillaries and venules of the vagina, AQP2 was expressed in the cytoplasm of the epithelium, AQP3 was mainly associated with the plasma membrane of the vaginal epithelium, and both AQP5 and AQP6 were expressed in the cytoplasm throughout all vaginal epithelium. Western blot analysis revealed bands at 28 kDa for AQP1, 2, 3, 5, and 6 proteins. However, AQP4, 7, 8, and 9 were not detected. The distinct localization of AQPs in the human vagina suggests that AQP1, 2, 3, 5, and 6 may play an important role in vaginal lubrication in women. © 2011 International Society for Sexual Medicine.

  7. Adherence to Mediterranean diet and risk of breast cancer in premenopausal and postmenopausal women.

    PubMed

    Farsinejad-Marj, Maryam; Talebi, Shokufeh; Ghiyasvand, Reza; Miraghajani, Maryam

    2015-11-01

    Mediterranean diet (MD) has long been suspected to impact on health promotion. Epidemiologic studies reveal the protective role of adherence to this dietary pattern on cancer incidence. However, its association with breast cancer risk remains unclear. Therefore, we aimed to investigate whether adherence to Mediterranean dietary pattern influence on breast cancer risk in postmenopausal and premenopausal women. We performed an electronic search of published studies earlier than Apr 2015 using Pubmed, Google scholar, Cochrane and Scopus databases. The search terms included: breast neoplasm, breast tumors, mammary carcinoma, mammary neoplasm, breast cancer, and Mediterranean diet. Study inclusion criteria were: 1) written in English; 2) with a study arm of MD intervention or MD style assessment; 3) reported the BC risk in premenopausal and postmenopausal women. We summarized the findings of 8 studies in this review, including five cohorts and three case-control studies. Although, cohort studies reported controversial results in this field, case-control studies resulted inverse relation between this Mediterranean dietary pattern and breast cancer risk in pre or/and postmenopausal women. It seems that there is no sufficient data to reach a conclusion about the effect of MD on breast cancer risk in pre and postmenopausal, but there are some evidences suggesting the protective association. More cohort studies in different parts of the world are needed to confirm these results.

  8. Effects of mifepristone on uterine leiomyoma in premenopausal women: a meta-analysis.

    PubMed

    Shen, Qi; Hua, Ying; Jiang, Wenxiao; Zhang, Wenwen; Chen, Miaomiao; Zhu, Xueqiong

    2013-12-01

    To conduct a meta-analysis of the studies assessing the effects of mifepristone on the uterus, uterine leiomyoma, and leiomyoma-related symptoms in premenopausal women. Meta-analysis. Centers for reproductive care. Premenopausal women who suffered from leiomyoma. We identified all of the studies published before December 2012 that compared the status of patients with leiomyoma before and after treatment with mifepristone. Leiomyoma-related symptoms, uterine or leiomyoma volume, changes in endometrial thickness. A meta-analytic technique was used to study 11 randomized controlled trials involving 780 women with symptomatic uterine leiomyomas. The subjects received 2.5-25 mg/d of mifepristone for 3-6 months. Mifepristone could effectively reduce uterine and leiomyoma volume and alleviate leiomyoma symptoms, including hypermenorrhea, the mean menstrual blood loss, pelvic pain, pelvic pressure, anemia, and dysmenorrhea. There was no significant difference in the rate of atypical endometrial hyperplasia between the mifepristone treatment group and the placebo group. Mifepristone significantly reduced uterine and leiomyoma volume and alleviated leiomyoma-related symptoms. We recommend 2.5 mg of mifepristone administered daily for 3 or 6 months as the optimum clinical treatment for leiomyoma. There is insufficient evidence that mifepristone treatment led to atypical endometrial hyperplasia. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Abnormal phosphorylation of Tie2/Akt/eNOS signaling pathway and decreased number or function of circulating endothelial progenitor cells in prehypertensive premenopausal women with diabetes mellitus.

    PubMed

    Zeng, Haitao; Jiang, Yanping; Tang, Hailin; Ren, Zi; Zeng, Gaofeng; Yang, Zhen

    2016-03-02

    The number and activity of circulating endothelial progenitor cells (EPCs) in prehypertension is preserved in premenopausal women. However, whether this favorable effect still exists in prehypertensive premenopausal women with diabetes is not clear. This study compared the number and functional activity of circulating EPCs in normotensive or prehypertensive premenopausal women without diabetes mellitus and normotensive or prehypertensive premenopausal women with diabetes mellitus, evaluated the vascular endothelial function in each groups, and investigated the possible underlying mechanism. We found that compared with normotensive premenopausal women, the number and function of circulating EPCs, as well as endothelial function evaluated by flow-mediated dilatation (FMD) in prehypertensive premenopausal women were preserved. In parallel, the Tie2/Akt/eNOS signaling pathway and the plasma NO level or NO secretion of circulating EPCs in prehypertensive premenopausal women was also retained. However, in presence of normotension or prehypertension with diabetes mellitus, the number or function of circulating EPCs and FMD in premenopausal women decreased. Similarly, the phosphorylation of Tie2/Akt/eNOS signaling pathway and the plasma NO level or NO secretion of circulating EPCs was reduced in prehypertension premenopausal with diabetes mellitus. The present findings firstly demonstrate that the unfavorable effects of diabetes mellitus on number and activity of circulating EPCs in prehypertension premenopausal women, which is at least partially related to the abnormal phosphorylation of Tie2/Akt/eNOS signaling pathway and subsequently reduced nitric oxide bioavailability. The Tie2/Akt/eNOS signaling pathway may be a potential target of vascular protection in prehypertensive premenopausal women with diabetes mellitus.

  10. Sex Hormone Binding Globulin and Sex Steroids Among Premenopausal Women in the Diabetes Prevention Program

    PubMed Central

    Pi-Sunyer, Xavier; Barrett-Connor, Elizabeth; Stentz, Frankie B.; Murphy, Mary Beth; Kong, Shengchun; Nan, Bin; Kitabchi, Abbas E.

    2013-01-01

    Context: It is unknown whether intensive lifestyle modification (ILS) or metformin changes sex steroids among premenopausal women without a history of polycystic ovarian syndrome (PCOS). Objectives: We examined 1-year intervention impact on sex steroids (estradiol, testosterone, dehydroepiandrosterone, and androstenedione [A4]) and SHBG and differences by race/ethnicity. Participants: A subgroup of Diabetes Prevention Program participants who were premenopausal, not using estrogen, without a history of PCOS or irregular menses, and who reported non-Hispanic white (NHW), Hispanic, or African-American race/ethnicity (n = 301). Interventions: Randomization arms were 1) ILS with the goals of weight reduction of 7% of initial weight and 150 minutes per week of moderate intensity exercise, 2) metformin 850 mg twice a day, or 3) placebo. Results: Neither intervention changed sex steroids compared to placebo. ILS, but not metformin, increased median SHBG by 3.1 nmol/L (∼11%) compared to decreases of 1.1 nmol/L in the placebo arm (P < .05). This comparison remained significant after adjustment for changes in covariates including waist circumference. However, associations with glucose were not significant. Median baseline A4 was lower in Hispanics compared to NHWs (5.7 nmol/L vs 6.5 nmol/L, P < .05) and increases in A4 were greater in Hispanics compared to NHWs (3.0 nmol/ vs 1.2 nmol/L, P < .05), and these differences did not differ significantly by intervention arm. No other racial/ethnic differences were significant. Conclusions: Among premenopausal glucose-intolerant women, no intervention changed sex steroids. ILS increased SHBG, although associations with glucose were not significant. SHBG and sex steroids were similar by race/ethnicity, with the possible exception of lower baseline A4 levels in Hispanics compared to NHWs. PMID:23709655

  11. The Effects of Aerobic Exercise on Estrogen Metabolism in Healthy Premenopausal Women

    PubMed Central

    Smith, Alma J.; Phipps, William R.; Thomas, William; Schmitz, Kathryn H.; Kurzer, Mindy S.

    2013-01-01

    Background It is well accepted that exercise can decrease breast cancer risk. Limited clinical evidence suggests that this risk could be mediated through changes in estrogen metabolism in premenopausal women. Our objective was to investigate the effects of exercise on premenopausal estrogen metabolism pertinent to breast cancer risk. Methods Sedentary, healthy, young eumenorrheic women were randomized into an intervention of 30 minutes of moderate-to-vigorous aerobic exercise 5 times a week for approximately 16 weeks (n = 212), or into a usual-lifestyle sedentary control group (n = 179). Urinary levels of estrogens (estrone [E1], estradiol, and estriol) and nine estrogen metabolites were measured at baseline and at study end by liquid chromatography/tandem mass spectrometry. The ratios of 2-hydroxyestrone to 16α-hydroxyestrone (2-OHE1/16α-OHE1) and 2-OHE1 to 4-hydroxyestrone (2- OHE1/4-OHE1) were also calculated. Results The exercise intervention resulted in significant increases in aerobic fitness and lean body mass, and a significant decrease in percent body fat. For exercisers who completed the study (n = 165), 2-OHE1/16α-OHE1 increased significantly (P = 0.043), while E1 decreased significantly (P = 0.030) in control participants (n = 153). The change from baseline in 2-OHE1/16α-OHE1 was significantly different between groups (P = 0.045), even after adjustment for baseline values. Conclusions The exercise intervention resulted in a significant increase in the 2-OHE1/16α-OHE1 ratio, but no differences in other estrogen metabolites or ratios. Impact Our results suggest that changes in premenopausal estrogen metabolism may be a mechanism by which increased physical activity lowers breast cancer risk. PMID:23652373

  12. PRESENTING SYMPTOMS AMONG PREMENOPAUSAL AND POSTMENOPUSAL WOMEN WITH VULVODYNIA: A CASE SERIES

    PubMed Central

    Phillips, Nancy A; Brown, Candace; Foster, David; Bachour, Candi; Rawlinson, Leslie; Wan, Jim; Bachmann, Gloria

    2015-01-01

    OBJECTIVE To determine whether there are differences in the clinical presentation of symptoms and vulvar pain ratings in postmenopausal women compared to premenopausal women with provoked vestibulodynia (PVD) enrolled in a clinical trial, after correcting for estrogen deficiency. METHODS Questionnaire data was collected from seventy-six pre-menopausal and twenty post-menopausal women enrolled in a clinical trial for PVD. The questionnaire obtained information about the presence or absence of vulvar pain, the characteristics of this pain, and information about the women's demographic characteristics and reproductive health history. Participants were clinically confirmed to have PVD by a positive cotton swab test on pelvic exam and either absence of, or corrected vulvovaginal atrophy based on Ratkoff staining with <10% parabasal cells. Women completed a standardized questionnaire describing their vulvar symptoms and rated daily pain on a visual analogue scale (0 = no pain to 10 = worse pain imaginable) from sexual intercourse, tampon insertion (as a surrogate measure of intercourse) and 24-hour vulvar pain for 2 weeks during the screening period. Pre-treatment data were analyzed prior to pharmacologic intervention. Chi-Square was used to determine differences between pre- and postmenopausal women in demographic characteristics and clinical presentation, and independent t-tests were used to analyze pain ratings by (0-10) numeric rating scale (NRS). RESULTS The average ages of premenopausal and postmenopausal women were (30.6 ± 8.6 years) and (54.4 ± 6.5 years), respectively. The groups significantly differed with regard to relationship status (p =.002) and race (p = 0.03), but did not differ in years of education (p = 0.49), income level (p = 0.29) or duration of symptoms (p = 0.09) Post-menopausal women reported significantly more vulvar burning (70.00% vs. 43.42%, p =0. 03), but there were no differences in vulvar itching (20.00% vs. 22.37%, p =0.82), vulvar

  13. Sarcopenia in premenopausal and postmenopausal women with osteopenia, osteoporosis and normal bone mineral density.

    PubMed

    Walsh, Marianne C; Hunter, Gary R; Livingstone, Margaret Barbara

    2006-01-01

    Sarcopenia, the decline of muscle mass with age, causes impaired gait, disability and falls. It may therefore increase the risk of fracture for osteoporotic women. The aims of this study were to determine the prevalence of sarcopenia in osteopenic and osteoporotic women, and to determine if hormone replacement therapy (HRT), diet, or physical activity (PA) has a role in the prevention of sarcopenia. One hundred and thirty-one premenopausal and 82 postmenopausal (54 taking HRT) healthy women (17-77 years) volunteered for the study. Body composition was measured by dual X-ray absorptiometry (DXA). Sarcopenia was defined as a relative skeletal muscle index (RSMI) (appendicular skeletal muscle mass divided by height) below 5.45 kg/m2. Osteopenia was defined by a densitometric t-score for bone mineral density (BMD) (g/cm2) below -1.0 and osteoporosis by a t-score below -2.5. Nutrient intake was assessed using 3-day food records and physical activity (PA) was measured using the Baecke Physical Activity Questionnaire. Pearson chi-squared, independent t-tests, simple correlation and multiple regression were used to analyze the data. In premenopausal osteopenic women the prevalence of sarcopenia was 12.5%. In postmenopausal women it was 25% for those with osteopenia, and 50% for those with osteoporosis. PA was independently related to RSMI (beta=0.222, p=0.0001), but diet and HRT were not. After adjusting for PA, RSMI was not significantly related to BMD. These data suggest that the relationship between RSMI, BMD and risk of osteoporosis may largely be mediated through participation in PA. Sarcopenia screening simultaneous to BMD examinations by DXA, may be of value in identifying osteoporotic women with sarcopenia, a group that may be most in need of exercise interventions to increase muscle and BMD.

  14. Postmenopausal Women Have Higher HDL and Decreased Incidence of Low HDL than Premenopausal Women with Metabolic Syndrome

    PubMed Central

    Fernandez, Maria Luz; Murillo, Ana Gabriela

    2016-01-01

    It is well known that plasma lipids, waist circumference (WC) and blood pressure (BP) increase following menopause. In addition, there is a perceived notion that plasma high-density lipoprotein-cholesterol (HDL-C) concentrations also decrease in postmenopausal women. In this cross-sectional study, we evaluated plasma lipids, fasting glucose, anthropometrics and BP in 88 post and 100 pre-menopausal women diagnosed with metabolic syndrome. No differences were observed in plasma low-density lipoprotein-cholesterol cholesterol, triglycerides, fasting glucose or systolic and diastolic BP between groups. However, plasma HDL-C was higher (p < 0.01) in postmenopausal women and the percentage of women who had low HDL (<50 mg/dL) was higher (p < 0.01) among premenopausal women. In addition, negative correlations were found between WC and HDL-C (r = −0.148, p < 0.05) and BMI and HDL-C (r = −0.258, p < 0.01) for all subjects indicating that increases in weight and abdominal fat have a deleterious effect on plasma HDL-C. Interestingly, there was a positive correlation between age and plasma HDL-C (r = 0.237 p < 0.01). The results from this study suggest that although HDL is decreased by visceral fat and overall weight, low HDL is not a main characteristic of metabolic syndrome in postmenopausal women. Further, HDL appears to increase, not decrease, with age. PMID:27417608

  15. Postmenopausal Women Have Higher HDL and Decreased Incidence of Low HDL than Premenopausal Women with Metabolic Syndrome.

    PubMed

    Fernandez, Maria Luz; Murillo, Ana Gabriela

    2016-03-16

    It is well known that plasma lipids, waist circumference (WC) and blood pressure (BP) increase following menopause. In addition, there is a perceived notion that plasma high-density lipoprotein-cholesterol (HDL-C) concentrations also decrease in postmenopausal women. In this cross-sectional study, we evaluated plasma lipids, fasting glucose, anthropometrics and BP in 88 post and 100 pre-menopausal women diagnosed with metabolic syndrome. No differences were observed in plasma low-density lipoprotein-cholesterol cholesterol, triglycerides, fasting glucose or systolic and diastolic BP between groups. However, plasma HDL-C was higher (p < 0.01) in postmenopausal women and the percentage of women who had low HDL (<50 mg/dL) was higher (p < 0.01) among premenopausal women. In addition, negative correlations were found between WC and HDL-C (r = -0.148, p < 0.05) and BMI and HDL-C (r = -0.258, p < 0.01) for all subjects indicating that increases in weight and abdominal fat have a deleterious effect on plasma HDL-C. Interestingly, there was a positive correlation between age and plasma HDL-C (r = 0.237 p < 0.01). The results from this study suggest that although HDL is decreased by visceral fat and overall weight, low HDL is not a main characteristic of metabolic syndrome in postmenopausal women. Further, HDL appears to increase, not decrease, with age.

  16. Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer

    PubMed Central

    Bakkum-Gamez, Jamie N.; Laughlin, Shannon K.; Jensen, Jani R.; Akogyeram, Clement O.; Pruthi, Sandhya

    2011-01-01

    Premenopausal women with a new diagnosis of breast cancer are faced with many challenges. Providing health care for issues such as gynecologic comorbidities, reproductive health concerns, and vasomotor symptom control can be complicated because of the risks of hormone treatments and the adverse effects of adjuvant therapies. It is paramount that health care professionals understand and be knowledgeable about hormonal and nonhormonal treatments and their pharmacological parameters so they can offer appropriate care to women who have breast cancer, with the goal of improving quality of life. Articles for this review were identified by searching the PubMed database with no date limitations. The following search terms were used: abnormal uterine bleeding, physiologic sex steroids, endometrial ablation, hysteroscopic sterilization, fertility preservation in endometrial cancer, tranexamic acid and breast cancer, menorrhagia treatment and breast cancer, abnormal uterine bleeding and premenopausal breast cancer, levonorgestrel IUD and breast cancer, tamoxifen and gynecologic abnormalities, tamoxifen metabolism, hormones and breast cancer risk, contraception and breast cancer, pregnancy and breast cancer, and breast cancer and infertility treatment. PMID:21307388

  17. Relationship between BMI and skinfold thicknesses to risk factors in premenopausal and postmenopausal women.

    PubMed

    Pavlica, Tatjana; Mikalacki, Milena; Matić, Radenko; Korovljev, Darinka; Cokorilo, Nebojsa; Vujkov, Sandra; Srdić, Biljana; Sakac, Dejan

    2013-05-01

    Studies conducted on children and adults have pointed to the correlation of BMI (kg/m2) with risk factors for certain diseases. Other studies have stressed a more intense correlation between the risk factors and indicators of subcutaneous fat obtained in other ways. The aim Of the study was to compare the intensity of correlation between the risk factors and triceps and subscapular skinfold thickness in relation to BMI. The study included 53 postmenopausal and 107 premenopausal women, the risk factors were assessed upon systolic and diastolic blood pressure, glucose concentration, triglyceride and cholesterol levels. Statistically significant differences were established in almost all variables referring to premenopausal and postmenopausal women, except in body height, subscapular skinfold thickness and tryglyceride concentration. Significant correlation with the risk factors was detected in BMI and both skinfold thicknesses, while the subscapular thickness correlates more intensively with the risk factors than it is the case with the triceps thickness. The results indicate that BMI equally correlates with risk factors as well as skinfold thickness.

  18. Levonorgestrel-releasing intrauterine system use in premenopausal women with symptomatic uterine leiomyoma: a systematic review.

    PubMed

    Jiang, Wenxiao; Shen, Qi; Chen, Miaomiao; Wang, Ying; Zhou, Qingfeng; Zhu, Xuejie; Zhu, Xueqiong

    2014-08-01

    A systematic review is done to determine the efficacy and safety of levonorgestrel-releasing intrauterine systems as a treatment using in premenopausal women with symptomatic uterine leiomyoma. We searched the Medline, Central and ICTRP databases for all articles published from inception through July 2013 that examined the following outcomes: uterine volume, uterine leiomyoma volume, endometrial thickness, then menstrual blood loss, blood haemoglobin, ferritin and hematocrit levels, treatment failure rate, device expulsion rate, hysterectomy rate and side effects. From 645 studies, a total of 11 studies met our inclusion criteria with sample sizes ranging from 10 to 104. Evidence suggested that levonorgestrel-releasing intrauterine systems could decrease uterine volume and endometrial thickness, significantly reduce menstrual blood loss, and increase blood haemoglobin, ferritin and hematocrit levels. There was no evidence for decreasing uterine leiomyoma volume. There were no adverse effects on the ovarian function except for ovarian cysts. Device expulsion rates were low, which associated with leiomyoma size (larger than 3cm) but not with leiomyoma location. Irregular bleeding/spotting was observed at the beginning of the follow-up period and then decreased progressively. Results of this systematic review indicate that levonorgestrel-releasing intrauterine systems may be effective and safe treatment for symptomatic uterine leiomyoma in premenopausal women. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Dietary Fat, Fiber, and Carbohydrate Intake and Endogenous Hormone Levels in Premenopausal Women

    PubMed Central

    Cui, Xiaohui; Rosner, Bernard; Willett, Walter C; Hankinson, Susan E

    2011-01-01

    The authors conducted a cross-sectional study to investigate the associations of fat, fiber and carbohydrate intake with endogenous estrogen, androgen, and insulin-like growth factor (IGF) levels among 595 premenopausal women. Overall, no significant associations were found between dietary intake of these macronutrients and plasma sex steroid hormone levels. Dietary fat intake was inversely associated with IGF-I and IGF-binding protein 3 (IGFBP-3) levels. When substituting 5% of energy from total fat for the equivalent amount of energy from carbohydrate or protein intake, the plasma levels of IGF-I and IGFBP-3 were 2.8% (95% confidence interval [CI] 0.3, 5.3) and 1.6% (95% CI 0.4, 2.8) lower, respectively. Animal fat, saturated fat and monounsaturated fat intakes also were inversely associated with IGFBP-3 levels (P < 0.05). Carbohydrates were positively associated with plasma IGF-I level. When substituting 5% of energy from carbohydrates for the equivalent amount of energy from fat or protein intake, the plasma IGF-I level was 2.0% (95% CI 0.1, 3.9%) higher. No independent associations between fiber intake and hormone levels were observed. The results suggest that a low-fat/high-fiber or carbohydrate diet is not associated with endogenous levels of sex steroid hormones, but it may modestly increase IGF-I and IGFBP-3 levels among premenopausal women. PMID:21761370

  20. Exercise lowers estrogen and progesterone levels in premenopausal women at high risk of breast cancer.

    PubMed

    Kossman, D A; Williams, N I; Domchek, S M; Kurzer, M S; Stopfer, J E; Schmitz, K H

    2011-12-01

    Experimental and clinical data support a role for estrogens in the development and growth of breast cancer, and lowered estrogen exposure reduces breast cancer recurrence and new diagnoses in high-risk women. There is varied evidence that increased physical activity is associated with breast cancer risk reduction in both pre- and postmenopausal women, perhaps via lowered estrogen levels. The purpose of this study was to assess whether exercise intervention in premenopausal women at increased breast cancer risk reduces estrogen or progesterone levels. Seven healthy premenopausal women at high risk for breast cancer completed a seven-menstrual-cycle study. The study began with two preintervention cycles of baseline measurement of hormone levels via daily first-morning urine collection, allowing calculation of average area under the curve (AUC) hormone exposure across the menstrual cycle. Participants then began five cycles of exercise training to a maintenance level of 300 min per week at 80-85% of maximal aerobic capacity. During the last two exercise cycles, urinary estradiol and progesterone levels were again measured daily. Total estrogen exposure declined by 18.9% and total progesterone exposure by 23.7%. The declines were mostly due to decreased luteal phase levels, although menstrual cycle and luteal phase lengths were unchanged. The study demonstrated the feasibility of daily urine samples and AUC measurement to assess hormone exposure in experimental studies of the impact of interventions on ovarian hormones. The results suggest value in exercise interventions to reduce hormone levels in high-risk women with few side effects and the potential for incremental benefits to surgical or pharmacologic interventions.

  1. Biomarkers of vascular function in premenopausal and recent postmenopausal women of similar age: effect of exercise training.

    PubMed

    Nyberg, Michael; Seidelin, Kaare; Andersen, Thomas Rostgaard; Overby, Nickie Neumann; Hellsten, Ylva; Bangsbo, Jens

    2014-04-01

    Menopause is associated with an accelerated decline in vascular function; however, whether this is an effect of age and/or menopause and how exercise training may affect this decline remains unclear. We examined a range of molecular measures related to vascular function in matched premenopausal and postmenopausal women before and after 12 wk of exercise training. Thirteen premenopausal and 10 recently postmenopausal [1.6 ± 0.3 (means ± SE) years after final menstrual period] women only separated by 3 yr (48 ± 1 vs. 51 ± 1 yr) were included. Before training, diastolic blood pressure, soluble intercellular adhesion molecule-1 (sICAM-1), and skeletal muscle expression of thromboxane A synthase were higher in the postmenopausal women compared with the premenopausal women, all indicative of impaired vascular function. In both groups, exercise training lowered diastolic blood pressure, the levels of sICAM-1, soluble vascular adhesion molecule-1 (sVCAM-1), as well as plasma and skeletal muscle endothelin-1. The vasodilator prostacyclin tended (P = 0.061) to be higher in plasma with training in the postmenopausal women only. These findings demonstrate that already within the first years after menopause, several biomarkers of vascular function are adversely altered, indicating that these biomarker changes are more related to hormonal changes than aging. Exercise training appears to have a positive impact on vascular function, as indicated by a marked improvement in the biomarker profile, in both premenopausal and postmenopausal women.

  2. Sex hormones and breast cancer risk in premenopausal women: collaborative reanalysis of seven prospective studies

    PubMed Central

    2014-01-01

    Background The relationships of circulating concentrations of oestrogens, progesterone and androgens with breast cancer and related risk factors in premenopausal women are not well understood. Methods Individual data on prediagnostic sex hormone and sex hormone binding globulin (SHBG) concentrations were contributed by 7 prospective studies. Analyses were restricted to women who were premenopausal and under age 50 at blood collection, and to breast cancer cases diagnosed before age 50. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for breast cancer associated with hormone concentrations were estimated by conditional logistic regression in up to 767 cases and 1699 controls matched for age, date of blood collection, and day of cycle, with stratification by study and further adjustment for cycle phase. The associations of hormones with risk factors for breast cancer in control women were examined by comparing geometric mean hormone concentrations in categories of these risk factors, adjusted for study, age, phase of menstrual cycle and body mass index (BMI). All statistical tests were two-sided. Findings ORs for breast cancer associated with a doubling in hormone concentration were 1.19 (95% CI 1.06–1.35) for oestradiol, 1.17 (1.03–1.33) for calculated free oestradiol, 1.27 (1.05–1.54) for oestrone, 1.30 (1.10–1.55) for androstenedione, 1.17 (1.04–1.32) for dehydroepiandrosterone sulphate, 1.18 (1.03–1.35) for testosterone and 1.08 (0.97–1.21) for calculated free testosterone. Breast cancer risk was not associated with luteal phase progesterone (for a doubling in concentration OR=1.00 (0.92–1.09)), and adjustment for other factors had little effect on any of these ORs. The cross-sectional analyses in control women showed several associations of sex hormones with breast cancer risk factors. Interpretation Circulating oestrogens and androgens are positively associated with the risk for breast cancer in premenopausal women. PMID:23890780

  3. Sexual desire, distress, and associated factors in premenopausal women: preliminary findings from the hypoactive sexual desire disorder registry for women.

    PubMed

    Connor, Megan K; Maserejian, Nancy N; De Rogatis, Leonard; Meston, Cindy M; Gerstenberger, Eric P; Rosen, Raymond C

    2011-01-01

    This article presents data from a validation sample of 390 premenopausal women clinically diagnosed with hypoactive sexual desire disorder (HSDD) enrolled in the HSDD Registry for Women. Participants completed validated measures of sexual distress (e.g., Female Sexual Distress Scale Revised, Question 13) and sexual function including desire (e.g., Female Sexual Function Index). Results showed that lower levels of desire in these women were associated with diminished sexual satisfaction, increased sexually related distress, and fatigue or stress in the women's lives. In addition, the level of distress related to sexual desire decreased with age. The authors conclude that even among women with clinically diagnosed HSDD, the level of sexually related distress varies with situational factors, such as stress and fatigue.

  4. Vocal Symptoms and Acoustic Findings in Menopausal Women in Comparison to Pre-menopause Women with Body Mass Index as a Confounding Variable.

    PubMed

    Hamdan, Abdul-Latif; Ziade, Georges; Tabet, Georges; Btaiche, Rachel; Fakhri, Ghina; Yatim, Firas; Sarieddine, Doja; Seoud, Muhieddine

    2017-08-01

    To compare the prevalence of phonatory symptoms in menopausal women compared to pre-menopause women with body mass index (BMI) as a confounding variable. A total of 69 women, 34 menopausal and 35 pre-menopausal were invited to participate in this study. Demographic variables included age, smoking, and BMI. All subjects were asked about the presence hoarseness, loss of high or low frequencies, pitch breaks, throat clearing, dryness in the throat and vocal fatigue. Acoustic analysis was performed and the Voice Handicap Index (VHI)-10 was filled by all the subjects. There was a significantly higher prevalence of throat clearing and dryness in the menopausal group compared to the pre-menopause group with a P value of 0.035 and 0.032 respectively. When BMI was taken into account, there was no statistically significant difference in the prevalence of any of the phonatory symptoms in menopausal women with high BMI and pre-menopause. There was no statistically significant difference in the means of any of the acoustic parameters between the menopausal group and pre-menopausal group. There was no significant difference in the mean VHI-10 between the menopause group and the pre-menopause (P = 0.652). The results of this investigation substantiate the importance of fat as an alternative source of estrogen which can mask some of the phonatory symptoms.

  5. Ovarian failure and cancer treatment: Incidence and interventions for premenopausal women

    SciTech Connect

    Feldman, J.E.

    1989-09-01

    Ovarian failure may be a long-term consequence of cancer treatment for premenopausal women. Caused by several treatments, including radiation therapy and the alkylating agents, it produces signs and symptoms associated with menopause: hot flashes, amenorrhea, dyspareunia, loss of libido, and irritability. Critical factors that determine ovarian functioning after treatment for cancer are the patient's age at the time of therapy, the amount of radiation that the ovaries received, and the dose of the antineoplastic agent(s). Medical interventions, such as hormonal therapy and surgical repositioning of the ovaries, may maintain ovarian function for some women. Nursing intervention includes assessment, education, and counseling. Counseling focuses on how the prematurely menopausal patient feels about herself as indicated by self-esteem, body image, and sexuality.

  6. Association of hair dye use with circulating levels of sex hormones in premenopausal Japanese women.

    PubMed

    Nagata, Chisato; Wada, Keiko; Tsuji, Michiko; Hayashi, Makoto; Takeda, Noriyuki; Yasuda, Keigo

    2015-10-01

    Substances identified as animal carcinogens are no longer used as ingredients of hair dyes. However, hair dyes are diverse groups of chemicals, and certain compounds may affect endogenous sex hormone levels. We examined the association between hair dye use and sex hormone levels among premenopausal women. Study subjects were 431 premenopausal Japanese women who had regular menstrual cycles less than 40 days long. Information on the use of hair dyes or hair bleach, the type of hair coloring used, the duration of use and the frequency of application was collected using a self-administered questionnaire. Fasting plasma samples were obtained to measure estradiol, testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin, follicle-stimulating hormone and luteinizing hormone. After controlling for covariates, the mean plasma total testosterone level was about 14% higher in women who had used hair dyes for 10 or more years than that among women who had never used them (P for trend = 0.02). A similar association was observed when the type of hair dye was restricted to permanent hair dyes. A higher frequency of applying non-permanent hair dyes was marginally significantly associated with higher total and free estradiol levels. Data suggest that long-term use of hair dyes may be associated with an increase in circulating testosterone levels. As this is, to our knowledge, the first study examining the association between hair dye use and sex hormone levels, replication of the results is required. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  7. Alcohol Consumption and Urinary Estrogens and Estrogen Metabolites in Premenopausal Women

    PubMed Central

    Sisti, Julia S.; Hankinson, Susan E.; Xu, Xia; Eliassen, A. Heather; Ziegler, Regina

    2016-01-01

    In a cross-sectional analysis, we evaluated the associations of usual total alcohol and wine intake with a comprehensive profile of mid-luteal phase urinary estrogens and estrogen metabolites (referred to jointly as EM) in a sample of 603 premenopausal women participating in the Nurses' Health Study II (NHSII). A total of 15 individual EM (pmol/mg creatinine) were measured by a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method with high accuracy and reproducibility. We used linear mixed models to calculate the adjusted geometric means of individual EM, EM grouped by metabolic pathways, and pathway ratios by category of alcohol intake with non-drinkers of alcohol as the referent. Total alcohol intake was not associated with total EM but was positively associated with estradiol (26 % higher among women consuming >15 g/day vs. non-drinkers; P trend=0.03). Wine consumption was positively associated with a number of EM measures including estradiol (22 % higher among women consuming ≥5 drinks/week vs. non-drinkers, P trend < 0.0001). In conclusion, the total alcohol intake was positively and significantly associated with urinary estradiol levels. Some differences in urinary estrogen metabolites were observed with wine drinking, when compared with non-drinkers. This study strengthens the evidence that alcohol consumption might play a role in breast cancer and other estrogen-related conditions. Additional studies of premenopausal women are needed to further explore the association of alcohol, particularly the specific types of alcohol, on patterns of estrogen metabolism in blood, urine, and tissue. PMID:26728472

  8. Alcohol Consumption and Urinary Estrogens and Estrogen Metabolites in Premenopausal Women.

    PubMed

    Hartman, Terryl J; Sisti, Julia S; Hankinson, Susan E; Xu, Xia; Eliassen, A Heather; Ziegler, Regina

    2016-02-01

    In a cross-sectional analysis, we evaluated the associations of usual total alcohol and wine intake with a comprehensive profile of mid-luteal phase urinary estrogens and estrogen metabolites (referred to jointly as EM) in a sample of 603 premenopausal women participating in the Nurses' Health Study II (NHSII). A total of 15 individual EM (pmol/mg creatinine) were measured by a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method with high accuracy and reproducibility. We used linear mixed models to calculate the adjusted geometric means of individual EM, EM grouped by metabolic pathways, and pathway ratios by category of alcohol intake with non-drinkers of alcohol as the referent. Total alcohol intake was not associated with total EM but was positively associated with estradiol (26% higher among women consuming >15 g/day vs. non-drinkers; P trend = 0.03). Wine consumption was positively associated with a number of EM measures including estradiol (22% higher among women consuming ≥ 5 drinks/week vs. non-drinkers, P trend < 0.0001). In conclusion, the total alcohol intake was positively and significantly associated with urinary estradiol levels. Some differences in urinary estrogen metabolites were observed with wine drinking, when compared with non-drinkers. This study strengthens the evidence that alcohol consumption might play a role in breast cancer and other estrogen-related conditions. Additional studies of premenopausal women are needed to further explore the association of alcohol, particularly the specific types of alcohol, on patterns of estrogen metabolism in blood, urine, and tissue.

  9. Polycystic ovary syndrome and increased polyp numbers as risk factors for malignant transformation of endometrial polyps in premenopausal women.

    PubMed

    Kilicdag, Esra B; Haydardedeoglu, Bulent; Cok, Tayfun; Parlakgumus, Ayse H; Simsek, Erhan; Bolat, Filiz A

    2011-03-01

    To determine the pre-malignant and malignant potential of endometrial polyps and to assess whether different clinical parameters are associated with malignancy in the polyps of premenopausal women. The clinical records of operative office hysteroscopic and resectoscopic procedures for endometrial polyps in 417 premenopausal women who attended Baskent University were examined over a retrospective period of 30 months. Only premenopausal patients were included in the study. In 97.8% of women, histology showed benign endometrial pathology. In 2.2% of women, pre-malignant or malignant conditions were found in the polyp. Polycystic ovary syndrome (PCOS) and the presence of 2 or more polyps were associated with significant pre-malignant or malignant changes. The presence of irregular vaginal bleeding was not a predictor of malignancy in the polyp. Premenopausal women with PCOS and those with 2 or more polyps had an increased prevalence of polyp malignancy. These groups of patients, whether symptomatic or not, should be evaluated by hysteroscopic resection of the polyps. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Challenges in Treating Premenopausal Women with Endocrine-Sensitive Breast Cancer.

    PubMed

    Azim, Hatem A; Davidson, Nancy E; Ruddy, Kathryn J

    2016-01-01

    For the hundreds of thousands of premenopausal women who are diagnosed annually with endocrine-sensitive breast cancer, treatment strategies are complex. For many, chemotherapy may not be necessary, and endocrine therapy decision making is paramount. Options for adjuvant endocrine regimens include tamoxifen for 5 years, tamoxifen for 10 years, ovarian function suppression (OFS) plus tamoxifen for 5 years, and OFS plus an aromatase inhibitor for 5 years. There are modest differences in efficacy between these regimens, with a benefit from OFS most obvious among patients with higher-risk disease; therefore, choosing which should be used for a given patient requires consideration of expected toxicities and patient preferences. An aromatase inhibitor cannot be safely prescribed without OFS in this setting. Additional research is needed to determine whether genomic tests such as Prosigna and Endopredict can help with decision making about optimal duration of endocrine therapy for premenopausal patients. Endocrine therapy side effects can include hot flashes, sexual dysfunction, osteoporosis, and infertility, all of which may impair quality of life and can encourage nonadherence with treatment. Ovarian function suppression worsens menopausal side effects. Hot flashes tend to be worse with tamoxifen/OFS, whereas sexual dysfunction and osteoporosis tend to be worse with aromatase inhibitors/OFS. Pregnancy is safe after endocrine therapy, and some survivors can conceive naturally. Still, embryo or oocyte cryopreservation should be considered at the time of diagnosis for patients with endocrine-sensitive disease who desire future childbearing, particularly if they will undergo chemotherapy.

  11. The risk of osteopenia in premenopausal women with various sellar tumors.

    PubMed

    Zhao, Yongbo; Gan, Xiaoqiang; Luo, Peng; He, Qiang; Guo, Qindong; Zhang, Lei; Zhang, Xiaorui; Zhang, Xiang; Fei, Zhou

    2012-12-01

    Patients with prolactinoma seem to be at high risk for osteopenia. However, whether patients with various pathological sellar tumors have risk for osteopenia remains unclear. The aim of the present study is to assess the bone mass alteration in patients with various sellar tumors and further to investigate the risk factors of bone mass alteration. 65 premenopausal female patients with diverse sellar tumors and 325 normal controls were enrolled in this study. Bone mineral density (BMD) of lumbar spine and comprehensive endocrinological evaluations were undergone. Compared to the matched controls, BMD of patients with prolactinoma or craniopharyngioma significantly decreased. Patients with sellar meningioma and nonfunctioning adenoma are with a decreasing tendency and patients with growth hormone-secreting adenoma are with an increasing tendency compared to controls. Univariate and multivariate regression analysis indicated that the bone loss in prolactinomas was significantly correlated to disease duration and hypogonadism. In the premenopausal women, patients with prolactinoma or craniopharyngioma are often accompanied with osteopenia or osteoporosis, and disease duration and hypogonadism are the risk factors of bone loss in prolactinoma. Continuous surveillance of BMD is recommended in patients with meningioma or nonfunctioning adenoma.

  12. Long-term Effectiveness of Adjuvant Goserelin in Premenopausal Women With Early Breast Cancer

    PubMed Central

    Baum, Michael; Fornander, Tommy; Nordenskjold, Bo; Nicolucci, Antonio; Monson, Kathryn; Forsyth, Sharon; Reczko, Krystyna; Johansson, Ulla; Fohlin, Helena; Valentini, Miriam; Sainsbury, Richard

    2009-01-01

    Background Systematic reviews have found that luteinizing hormone–releasing hormone (LHRH) agonists are effective in treating premenopausal women with early breast cancer. Methods We conducted long-term follow-up (median 12 years) of 2706 women in the Zoladex In Premenopausal Patients (ZIPP), which evaluated the LHRH agonist goserelin (3.6 mg injection every 4 weeks) and tamoxifen (20 or 40 mg daily), given for 2 years. Women were randomly assigned to receive each therapy alone, both, or neither, after primary therapy (surgery with or without radiotherapy/chemotherapy). Hazard ratios and absolute risk differences were used to assess the effect of goserelin treatment on event-free survival (breast cancer recurrence, new tumor or death), overall survival, risk of recurrence of breast cancer, and risk of dying from breast cancer, in the presence or absence of tamoxifen. Results Fifteen years after the initiation of treatment, for every 100 women not given tamoxifen, there were 13.9 (95% confidence interval [CI] = 17.5 to 19.4) fewer events among those who were treated with goserelin compared with those who were not treated with goserelin. However, among women who did take tamoxifen, there were 2.8 fewer events (95% CI = 7.7 fewer to 2.0 more) per 100 women treated with goserelin compared with those not treated with goserelin. The risk of dying from breast cancer was also reduced at 15 years: For every 100 women given goserelin, the number of breast cancer deaths was lower by 2.6 (95% CI = 6.6 fewer to 2.1 more) and 8.5 (95% CI = 2.2 to 13.7) in those who did and did not take tamoxifen, respectively, although in the former group the difference was not statistically significant. Conclusions Two years of goserelin treatment was as effective as 2 years of tamoxifen treatment 15 years after starting therapy. In women who did not take tamoxifen, there was a large benefit of goserelin treatment on survival and recurrence, and in women who did take tamoxifen, there was a

  13. A-FABP Concentration Is More Strongly Associated with Cardiometabolic Risk Factors and the Occurrence of Metabolic Syndrome in Premenopausal Than in Postmenopausal Middle-Aged Women

    PubMed Central

    Ponikowska, Irena; Sypniewska, Grazyna

    2014-01-01

    We aimed at the evaluation of the relationship between adipocyte fatty acid binding protein (A-FABP) and cardiometabolic risk factors in premenopausal and postmenopausal women. Additionally, we compared A-FABP with adipokines related to metabolic syndrome (MetS) such as leptin and adiponectin. 94 premenopausal and 90 early postmenopausal middle-aged Caucasian women were subject to examinations. Postmenopausal women had higher A-FABP than premenopausal; this difference became insignificant after controlling for age. We found significantly higher correlation coefficients between A-FABP and TC/HDL-C ratio and number of MetS components in premenopausal women, compared to postmenopausal. Each 1 ng/dL increase in A-FABP concentration significantly increased the probability of occurrence of atherogenic lipid profile in premenopausal women, even after multivariate adjustment. All odds ratios became insignificant after controlling for BMI in postmenopausal women. A-FABP was more strongly associated with MetS than leptin and adiponectin in premenopausal women. Adiponectin concentration was a better biomarker for MetS after menopause. Our results suggest that the A-FABP is more strongly associated with some cardiometabolic risk factors in premenopausal than in postmenopausal women. Higher values of A-FABP after menopause are mainly explained by the fact that postmenopausal women are older. Because of the limitation of study, these results should be interpreted with caution. PMID:24971341

  14. Use of accelerometry to classify activity beneficial to bone in premenopausal women.

    PubMed

    Stiles, Victoria H; Griew, Pippa J; Rowlands, Alex V

    2013-12-01

    The aims of this study were to quantify the relation between ground reaction force (GRF) and peak acceleration from hip- and wrist-worn accelerometers and determine peak acceleration cut-points associated with a loading rate previously demonstrated as beneficial to bone (43 body weights (BW)·s⁻¹) in premenopausal women. Forty-seven premenopausal women (age, 39.2 ± 5.6 yr; mass, 65.9 ± 11.0 kg; height, 1.67 ± 0.06 m) performed walking (slow, fast, and with bag), floor sweeping, running (slow and fast), jumping (low, <5 cm; high, >5 cm), and box drop (20 cm) trials. Peak accelerations were sampled at 100 Hz by GENEActiv and ActiGraph GT3X+ accelerometers (ActiGraph LLC, Pensacola, FL) worn at the hip (vertical and resultant) and the wrist (resultant). A force plate (960 Hz, AMTI) was used to assess peak vertical GRF and peak loading rate for eight steps per activity. Receiver operating characteristic curves were used to determine the optimal peak acceleration cut-points associated with a loading rate of 43 BW·s⁻¹ in 37 participants, and these cut-points were cross-validated in the remaining 10 participants. For all activities combined, peak accelerations were positively and significantly (P < 0.001) correlated with peak vertical GRF (hip r > 0.8, wrist r > 0.7) and peak loading rate (hip r > 0.7, wrist r > 0.57). Irrespective of monitor type and wear site, peak acceleration discriminated between loading rates above and below 43 BW·s⁻¹ with high levels of accuracy (area under the curve >0.92, P < 0.001). Overall classification agreement was >85% for both monitors worn at either the wrist or hip in the cross-validation sample. GENEActiv and ActiGraph GT3X+ accelerometers worn at the wrist or hip can be used as an unobtrusive tool to identify the occurrence of loading rates likely beneficial to bone in premenopausal women during their daily activity.

  15. Peripheral Blood Lymphocyte Subset Counts in Pre-menopausal Women with Iron-Deficiency Anaemia.

    PubMed

    Reza Keramati, Mohammad; Sadeghian, Mohammad Hadi; Ayatollahi, Hossein; Mahmoudi, Mahmoud; Khajedaluea, Mohammad; Tavasolian, Houman; Borzouei, Anahita

    2011-01-01

    Iron-deficiency anaemia (IDA) is a major worldwide public health problem. Children and women of reproductive age are especially vulnerable to IDA, and it has been reported that these patients are more prone to infection. This study was done to evaluate alteration of lymphocyte subgroups in IDA. In this prospective study, we investigated lymphocyte subsets in pre-menopausal women with iron-deficiency anaemia; 50 normal subjects and 50 IDA (hypochromic microcytic) cases were enrolled. Experimental and control anticoagulated blood samples were evaluated using flow cytometry to determine the absolute and relative numbers of various lymphocyte subgroups. Finally, the results of the patient and control groups were compared. Mean (SD) absolute counts of lymphocytes, CD3+ cells, CD3+/CD4+ subsets (T helper) and CD3+/CD8+ subsets (T cytotoxic) in the patient group were 2.08 (0.65) x 109/L, 1.53 (0.53) x 10(9)/L, 0.87 (0.28) x 109/L, and 0.51 (0.24) x 10(9)/L, respectively. The results showed significant differences between case and control groups in mean absolute counts of lymphocytes (P = 0.014), T lymphocytes (P = 0.009), helper T cells (P = 0.004), and cytotoxic T cells (P = 0.043). This study showed that absolute counts of peripheral blood T lymphocytes as a marker of cell-mediated immunity may be decreased in pre-menopausal women with iron-deficiency anaemia, and that these patients may be more prone to infection.

  16. Red versus white wine as a nutritional aromatase inhibitor in premenopausal women: a pilot study.

    PubMed

    Shufelt, Chrisandra; Merz, C Noel Bairey; Yang, YuChing; Kirschner, Joan; Polk, Donna; Stanczyk, Frank; Paul-Labrador, Maura; Braunstein, Glenn D

    2012-03-01

    An increased risk of breast cancer is associated with alcohol consumption; however, it is controversial whether red wine increases this risk. Aromatase inhibitors (AIs) prevent the conversion of androgens to estrogen and occur naturally in grapes, grape juice, and red, but not white wine. We tested whether red wine is a nutritional AI in premenopausal women. In a cross-over design, 36 women (mean age [SD], 36 [8] years) were assigned to 8 ounces (237 mL) of red wine daily then white wine for 1 month each, or the reverse. Blood was collected twice during the menstrual cycle for measurement of estradiol (E2), estrone (E1), androstenedione (A), total and free testosterone (T), sex hormone binding globulin (SHBG), luteinizing hormone (LH), and follicle stimulating hormone (FSH). Red wine demonstrated higher free T vs. white wine (mean difference 0.64 pg/mL [0.2 SE], p=0.009) and lower SHBG (mean difference -5.0 nmol/L [1.9 SE], p=0.007). E2 levels were lower in red vs. white wine but not statistically significant. LH was significantly higher in red vs. white wine (mean difference 2.3 mIU/mL [1.3 SE], p=0.027); however, FSH was not. Red wine is associated with significantly higher free T and lower SHBG levels, as well as a significant higher LH level vs. white wine in healthy premenopausal women. These data suggest that red wine is a nutritional AI and may explain the observation that red wine does not appear to increase breast cancer risk.

  17. Effects of an 8-month yoga intervention on arterial compliance and muscle strength in premenopausal women.

    PubMed

    Kim, Sojung; Bemben, Michael G; Bemben, Debra A

    2012-01-01

    Previous studies have indicated that Yoga exercise has a positive effect on reducing blood pressure and heart rate. However, no randomized controlled studies to date have investigated its effects on arterial compliance. The purpose of this study was to investigate the effects of an 8-month Yoga intervention on arterial compliance and muscle strength in normal premenopausal women 35-50 years of age. Thirty-four women were randomly assigned either to a Yoga exercise group (YE, n = 16) or a control group (CON, n = 18). Participants in YE group performed 60 minutes of an Ashtanga Yoga series 2 times/week with one day between sessions for 8 months. Each Yoga session consisted of 15 minutes of warm-up exercises, 35 minutes of Ashtanga Yoga postures and 10 minutes of cool-down with relaxation; and the session intensity was progressively increased during the 8 months. Participants in CON were encouraged to maintain their normal daily lifestyles monitored by the bone-specific physical activity questionnaire at 2 month intervals for 8 months. Arterial compliance (pulse contour analysis) and muscle strength (1 Repetition Maximum) were assessed at baseline and after the intervention. Arterial compliance of the large and small arteries was not affected by the 8 month Yoga training (p > 0.05). Also, there were no significant (p > 0.05) group, time, or group × time interaction effects for cardiovascular variables. YE group significantly (p < 0.01) improved leg press muscle strength compared to CON (11.4% vs. -6.5%). Eight months of Ashtanga Yoga training was beneficial for improving leg press strength, but not arterial compliance in premenopausal women. Key pointsThe 8 month Yoga training did not affect arterial compliance of the large and small arteries.None of the cardiovascular variables were changed by the Yoga intervention.Isotonic muscle strength was not altered by the Yoga intervention, with the exception of leg press.

  18. Adherence to a Mediterranean diet and plasma concentrations of lipid peroxidation in premenopausal women123

    PubMed Central

    Gaskins, Audrey J; Rovner, Alisha J; Mumford, Sunni L; Yeung, Edwina; Browne, Richard W; Trevisan, Maurizio; Perkins, Neil J; Wactawski-Wende, Jean; Schisterman, Enrique F

    2010-01-01

    Background: A Mediterranean diet has been associated with a reduced risk of cardiovascular disease and mortality. A possible mechanism is through a decrease in lipid peroxidation (LPO); however, evidence linking the Mediterranean diet with lower LPO in premenopausal women is sparse. Objective: We investigated whether adherence to a Mediterranean diet was associated with lower LPO concentrations in premenopausal women. Design: Two hundred fifty-nine healthy women aged 18–44 y were followed for ≤2 menstrual cycles. Plasma concentrations of F2-isoprostane (8-iso-PGF2α), 9-hydroxyoctadecadieneoic acid (9-HODE), and thiobarbituric acid reactive substances (TBARS) were measured ≤8 times per cycle at visits scheduled by using fertility monitors. Diet was assessed ≤4 times per cycle by using 24-h dietary recalls. The alternate Mediterranean Diet Score (aMED) (range: 0–9) was calculated on the basis of intake of vegetables, legumes, fruit, nuts, whole grains, red and processed meat, fish, and alcohol and the ratio of monounsaturated to saturated fat. Results: A 1-unit increase in aMED was associated with a 4.50% decrease in 8-iso-PGF2α concentrations (95% CI: −6.32%, −2.65%) and a 14.01% decrease in 9-HODE concentrations (95% CI: −17.88%, −9.96%) after adjustment for energy intake, age, race, body mass index, plasma ascorbic acid, and serum cholesterol. No significant association was observed between aMED and TBARS. A 1-unit increase in aMED was associated with a 1.39% increase (95% CI: 0.07%, 2.72%) in plasma ascorbic acid concentrations. Conclusions: Adherence to a Mediterranean diet is associated with lower LPO and higher ascorbic acid concentrations. These results confirm that decreased LPO is a plausible mechanism linking a Mediterranean diet to reduced cardiovascular disease risk. PMID:20943796

  19. Effects of an 8-Month Yoga Intervention on Arterial Compliance and Muscle Strength In Premenopausal Women

    PubMed Central

    Kim, SoJung; Bemben, Michael G.; Bemben, Debra A.

    2012-01-01

    Previous studies have indicated that Yoga exercise has a positive effect on reducing blood pressure and heart rate. However, no randomized controlled studies to date have investigated its effects on arterial compliance. The purpose of this study was to investigate the effects of an 8-month Yoga intervention on arterial compliance and muscle strength in normal premenopausal women 35-50 years of age. Thirty-four women were randomly assigned either to a Yoga exercise group (YE, n = 16) or a control group (CON, n = 18). Participants in YE group performed 60 minutes of an Ashtanga Yoga series 2 times/week with one day between sessions for 8 months. Each Yoga session consisted of 15 minutes of warm-up exercises, 35 minutes of Ashtanga Yoga postures and 10 minutes of cool-down with relaxation; and the session intensity was progressively increased during the 8 months. Participants in CON were encouraged to maintain their normal daily lifestyles monitored by the bone-specific physical activity questionnaire at 2 month intervals for 8 months. Arterial compliance (pulse contour analysis) and muscle strength (1 Repetition Maximum) were assessed at baseline and after the intervention. Arterial compliance of the large and small arteries was not affected by the 8 month Yoga training (p > 0.05). Also, there were no significant (p > 0.05) group, time, or group × time interaction effects for cardiovascular variables. YE group significantly (p < 0.01) improved leg press muscle strength compared to CON (11.4% vs. -6.5%). Eight months of Ashtanga Yoga training was beneficial for improving leg press strength, but not arterial compliance in premenopausal women. Key pointsThe 8 month Yoga training did not affect arterial compliance of the large and small arteries.None of the cardiovascular variables were changed by the Yoga intervention.Isotonic muscle strength was not altered by the Yoga intervention, with the exception of leg press. PMID:24149206

  20. Chronic dietary fiber supplementation with wheat dextrin does not inhibit calcium and magnesium absorption in premenopausal and postmenopausal women

    USDA-ARS?s Scientific Manuscript database

    This placebo-controlled, randomized, crossover clinical study examined the effect of chronic wheat dextrin intake on calcium and magnesium absorption. Forty premenopausal and post menopausal women (mean +/- SD age 49.9 +/- 9.8 years)consumed wheat dextrin or placebo (15 g/day) for 2 weeks prior to 4...

  1. Effectiveness of Self Instructional Module on Coping Strategies of Tri-Dimensional Problems of Premenopausal Women - A Community Based Study.

    PubMed

    Bhattacharya, Prasanta Kumar; Boro, Enu; Jamil, M D; Roy, Aakash

    2016-11-01

    Pre-menopause in women presents with diverse symptoms, encompassing the tri-dimensional spheres of physical, social and psychological domains, which requires development of appropriate coping strategies to overcome these problems. To assess level of knowledge about tri-dimensional problems in pre-menopausal women and evaluate effectiveness of self instruction module on coping strategies of these problems by pre-test and post-test analysis. In a cross-sectional, community based study, in pre-menopausal women aged 40-49years baseline knowledge of tridimensional problems was assessed in 300 pre-menopausal women, selected by convenient sampling after satisfying selection criteria, by a pre-formed questionnaire. This was followed by administration of a pre-tested, Self-Instructional Module (SIM). The SIM dealt with imparting knowledge about coping strategies regarding pre-menopausal problems and the participants were required to read and retain the SIM. Post-test was conducted using same questionnaire after seven days. Chi-square test/ Paired t-test was used for comparing ratios. A 'p-value' <0.05 was considered statistically significant. Baseline knowledge of tridimensional problems was adequate in 10%, moderate in 73% and inadequate in 17% women with a pre-test mean knowledge score of 8.66±2.45. The post-test mean knowledge score was higher (19.11±3.38) compared to the pre-test score. The post-test mean knowledge difference from pre-test was -10.45 with a highly significant paired t-value of -47.45 indicating that the self-instructional module was effective in increasing the knowledge score of pre- menopausal women under study. Administration of self instructional module was shown to significantly increase the knowledge scores in all areas of pre-menopausal tri-dimensional problems. Such self-instructional module can be used as an effective educational tool in increasing the knowledge of tri-dimensional problems in premenopausal women.

  2. [The process of remodeling of left chambers of the heart and dysfunction of endothelium of peripheral vessels in hypertensive premenopausal women].

    PubMed

    Khabibulina, M M; Serebrennikov, R V; Iordanidi, Ia S; Grishina, I F

    2009-01-01

    Results of ultrasound study of 230 premenopausal women with I-II stage essential hypertension (EH) in relation to functional state of endothelium of peripheral arteries are presented. Endothelial dysfunction in hypertensive premenopausal women can be one of factors contributing to remodeling of left cardiac chamber. Women with EH and endothelial dysfunction compared with those with conserved vascular endothelial function more often had hypertrophic variants of left ventricular myocardial remodeling (mostly of concentric type). Premenopausal women with EH had diastolic dysfunction of the left ventricle with impairment of both its rigidity and active relaxation, more pronounced in the presence of dysfunction of endothelium of peripheral vessels.

  3. Relationship between dietary copper intake and indices of copper status in men, premenopausal and postmenopausal women

    SciTech Connect

    Panda, P.; Reiser, S.; Canary, J. )

    1989-02-09

    Dietary copper (Cu) intake, red blood cell superoxide dismutase (SOD), ceruloplasmin (Cp) and plasma Cu were determined in 18 men, 18 premenopausal (PRE) and 18 postmenopausal (POST) women. Follicle stimulating hormone and leutinizing hormone were measured to verify menopausal status in women. SOD levels were significantly different in men, PRE and POST women and were used to divide subjects into adequate (350-700 U/mI) and inadequate (<350 U/ml) Cu status. Dietary Cu intake including supplements was highest for men (2.53 mg/day) as compared to PRE (1.35 mg/day) and POST (1.86 mg/day) women. There was an inverse correlation between dietary Cu intake and SOD levels. Plasma Cu levels were significantly higher in women (102.8 {mu}g/dl PRE, 108.95 POST {mu}g/dl) compared to men (88.34 {mu}g/dl). Cp levels showed a positive correlation with plasma Cu but did not show a sex effect. The present Cu intake levels were calculated from diet records using a food Cu data base. These results are in the process of being verified by direct analysis of Cu level in a 3 day food composite. The results indicate that Cu intake alone is not a good predictor of Cu status as determine by SOD levels.

  4. The Risk of Being Obese According to Short Sleep Duration Is Modulated after Menopause in Korean Women

    PubMed Central

    Doo, Miae; Kim, Yangha

    2017-01-01

    We previously reported that women with short sleep duration consumed more dietary carbohydrate and showed an increased risk for obesity compared to those who slept adequately, but not for men. Using a cross-sectional study of 17,841 Korean women, we investigated the influence of sleep duration on obesity-related variables and consumption of dietary carbohydrate-rich foods in relation to menopausal status. Premenopausal women with short sleep duration had significantly greater body weight (p = 0.007), body mass index (p = 0.003), systolic and diastolic blood pressures (p = 0.028 and p = 0.024, respectively), prevalence of obesity (p < 0.016), and consumption of more carbohydrate-rich foods such as staple foods (p = 0.026) and simple sugar-rich foods (p = 0.044) than those with adequate sleep duration after adjustment for covariates. Premenopausal women with short sleep duration were more obese by 1.171 times compared to subjects adequate sleep duration (95% confidence interval = 1.030–1.330). However, obesity-related variables, dietary consumption, and odds of being obese did not differ according to sleep duration for postmenopausal women. The findings suggest that the increased risk for obesity and consumption of dietary carbohydrate-rich foods with short sleep duration appeared to disappear after menopause in Korean women. PMID:28264442

  5. The Risk of Being Obese According to Short Sleep Duration Is Modulated after Menopause in Korean Women.

    PubMed

    Doo, Miae; Kim, Yangha

    2017-02-27

    We previously reported that women with short sleep duration consumed more dietary carbohydrate and showed an increased risk for obesity compared to those who slept adequately, but not for men. Using a cross-sectional study of 17,841 Korean women, we investigated the influence of sleep duration on obesity-related variables and consumption of dietary carbohydrate-rich foods in relation to menopausal status. Premenopausal women with short sleep duration had significantly greater body weight (p = 0.007), body mass index (p = 0.003), systolic and diastolic blood pressures (p = 0.028 and p = 0.024, respectively), prevalence of obesity (p < 0.016), and consumption of more carbohydrate-rich foods such as staple foods (p = 0.026) and simple sugar-rich foods (p = 0.044) than those with adequate sleep duration after adjustment for covariates. Premenopausal women with short sleep duration were more obese by 1.171 times compared to subjects adequate sleep duration (95% confidence interval = 1.030-1.330). However, obesity-related variables, dietary consumption, and odds of being obese did not differ according to sleep duration for postmenopausal women. The findings suggest that the increased risk for obesity and consumption of dietary carbohydrate-rich foods with short sleep duration appeared to disappear after menopause in Korean women.

  6. Prevalence, etiology and risk factors of pelvic organ prolapse in premenopausal primiparous women.

    PubMed

    Durnea, C M; Khashan, A S; Kenny, L C; Durnea, U A; Smyth, M M; O'Reilly, B A

    2014-11-01

    The natural history of pelvic organ prolapse (POP) is poorly understood. We investigated the prevalence and risk factors of postnatal POP in premenopausal primiparous women and the associated effect of mode of delivery. We conducted a prospective cohort study in a tertiary teaching hospital attending 9,000 deliveries annually. Collagen-diseases history and clinical assessment was performed in 202 primiparae at ≥ 1 year postnatally. Assessment included Pelvic Organ Prolapse Quantification (POP-Q) system, Beighton mobility score, 2/3D-transperineal ultrasound (US) and quantification of collagen type III levels. Association with POP was assessed using various statistical tests, including logistic regression, where results with p < 0.1 in univariate analysis were included in multivariate analysis. POP had a high prevalence: uterine prolapse 89 %, cystocele 90 %, rectocele 70 % and up to 65 % having grade two on POP-Q staging. The majority had multicompartment involvement, and 80 % were asymptomatic. POP was significantly associated with joint hypermobility, vertebral hernia, varicose veins, asthma and high collagen type III levels (p < 0.05). In multivariate logistic regression, only levator ani muscle (LAM) avulsion was significant in selected cases (p < 0.05). Caesarean section (CS) was significantly protective against cystocele and rectocele but not for uterine prolapse. Mild to moderate POP has a very high prevalence in premenopausal primiparous women. There is a significant association between POP, collagen levels, history of collagen disease and childbirth-related pelvic floor trauma. These findings support a congenital contribution to POP etiology, especially for uterine prolapse; however, pelvic trauma seems to play paramount role. CS is significantly protective against some types of prolapse only.

  7. Oxidative stress in relation to diet and physical activity among premenopausal women

    PubMed Central

    Anderson, Chelsea; Milne, Ginger L.; Sandler, Dale P.; Nichols, Hazel B.

    2017-01-01

    Higher levels of oxidative stress, as measured by F2-isoprostanes, have been associated with chronic diseases such as CVD and some cancers. Improvements in diet and physical activity may help reduce oxidative stress; however, previous studies regarding associations between lifestyle factors and F2-isoprostane concentrations have been inconsistent. The aim of this cross-sectional study was to investigate whether physical activity and intakes of fruits/vegetables, antioxidant nutrients, dietary fat subgroups and alcohol are associated with concentrations of F2-isoprostane and the major F2-isoprostane metabolite. Urinary F2-isoprostane and its metabolite were measured in urine samples collected at enrolment from 912 premenopausal women (aged 35–54 years) participating in the Sister Study. Physical activity, alcohol consumption and dietary intakes were self-reported via questionnaires. With adjustment for potential confounders, the geometric means of F2-isoprostane and its metabolite were calculated according to quartiles of dietary intakes, alcohol consumption and physical activity, and linear regression models were used to evaluate trends. Significant inverse associations were found between F2-isoprostane and/or its metabolite and physical activity, vegetables, fruits, vitamin C, α-carotene, vitamin E, β-carotene, vitamin A, Se, lutein + zeaxanthin and long-chain n-3 fatty acids. Although trans fats were positively associated with both F2-isoprostane and its metabolite, other dietary fat subgroups including SFA, n-6 fatty acids, n-3 fatty acids, MUFA, PUFA, short-chain n-3 fatty acids, long-chain n-3 fatty acids and total fat were not associated with either F2-isoprostane or its metabolite. Our findings suggest that lower intake of antioxidant nutrients and higher intake of trans fats may be associated with greater oxidative stress among premenopausal women. PMID:27725001

  8. Determinants of insulin-stimulated glucose disposal in middle-aged, premenopausal women.

    PubMed

    Toth, M J; Sites, C K; Cefalu, W T; Matthews, D E; Poehlman, E T

    2001-07-01

    Controversy exists regarding the relative importance of adiposity, physical fitness, and physical activity in the regulation of insulin-stimulated glucose disposal. To address this issue, we measured insulin-stimulated glucose disposal [mg. kg fat-free mass (FFM)(-1). min(-1); oxidative and nonoxidative components] in 45 nondiabetic, nonobese, premenopausal women (mean +/- SD; 47 +/- 3 yr) by use of hyperinsulinemic euglycemic clamp (40 mU. m(-2). min(-1)) and [6,6-2H2]glucose dilution techniques. We also measured body composition, abdominal fat distribution, thigh muscle fat content, maximal oxygen consumption (VO2 max), and physical activity energy expenditure ((2)H(2)(18)O kinetics) as possible correlates of glucose disposal. VO2 max was the strongest correlate of glucose disposal (r = 0.63, P < 0.01), whereas whole body and abdominal adiposity showed modest associations (range of r values from -0.32 to -0.46, P < 0.05 to P < 0.01). A similar pattern of correlations was observed for nonoxidative glucose disposal. None of the variables measured correlated with oxidative glucose disposal. The relationship of VO2 max to glucose disposal persisted after statistical control for FFM, percent body fat, and intra-abdominal fat (r = 0.40, P < 0.01). In contrast, correlations of total and regional adiposity measures to insulin sensitivity were no longer significant after statistical adjustment for VO2 max. VO2 max was the only variable to enter stepwise regression models as a significant predictor of total and nonoxidative glucose disposal. Our results highlight the importance of VO2 max as a determinant of glucose disposal and suggest that it may be a stronger determinant of variation in glucose disposal than total and regional adiposity in nonobese, nondiabetic, premenopausal women.

  9. Endocrine Consequences of Continuous Antiestrogen Therapy with Tamoxifen in Premenopausal Women

    PubMed Central

    Sherman, Barry M.; Chapler, Frederick K.; Crickard, Kent; Wycoff, Dorothy

    1979-01-01

    Daily administration of estrogen antagonists to premenopausal women has been incorporated into the adjuvant treatment of breast cancer. We have studied the changes in reproductive hormones, pituitary responses to hypothalamic-releasing hormones, and endometrial histology during treatment with the antiestrogen tamoxifen in five healthy, premenopausal women. These studies were carried out during one menstrual cycle before and during two cycles of antiestrogen treatment. All subjects continued to have regular menses with biphasic basal body temperature records. During treatment, estradiol (E2) levels were increased but followed the usual pattern reflecting follicular maturation and corpus luteum formation. The mean E2 concentration at the midcycle peak and during the luteal phase was twice that observed during the non-treatment cycle. By contrast, the concentrations and secretory patterns of luteinizing hormone and follicle-stimulating hormone were not greatly changed, and the gonadotropin responses to gonadotropin-releasing hormone were not suppressed. Endometrial biopsies obtained during the follicular phase of control and tamoxifen treatment cycles showed no differences whereas biopsies obtained during the luteal phase of tamoxifen cycles uniformly showed a lack of changes attributed to progesterone action with no progression of histologic changes beyond those expected on day 7-8 of the luteal phase. These observations are consistent with maturation of multiple ovarian follicles, a surprising finding considering the normal gonadotropin concentrations. The retarded development of the endometrium in the presence of supranormal serum E2 and progesterone concentrations is a morphologic demonstration of the antiprogestational effect of antiestrogens. The lack of gonadotropin suppression in the presence of hyperestrogenemia suggests a major antiestrogen action on the hypothalmus and pituitary gland. PMID:110834

  10. Association between Physical Activity and Urinary Estrogens and Estrogen Metabolites in Premenopausal Women

    PubMed Central

    Fortner, Renee T.; Xu, Xia; Hankinson, Susan E.; Eliassen, A. Heather; Ziegler, Regina G.

    2012-01-01

    Objective: The objective of the study was to evaluate in premenopausal women the relationships of physically active and sedentary behaviors reported for adulthood and adolescence with a comprehensive profile of estrogen metabolism. Methodology: Fifteen estrogens and estrogen metabolites (jointly termed EM) were measured using liquid chromatography-tandem mass spectrometry in luteal phase urines from 603 premenopausal women in the Nurses' Health Study II. Geometric means of individual EM, metabolic pathway groups, and pathway ratios were examined by level of exposure after adjustment for age, body mass index, alcohol intake, menstrual cycle length, and sample collection timing. Results: High overall physical activity in adulthood (42+ metabolic equivalent h/wk vs. <3 metabolic equivalent h/wk) was associated with a 15% lower level of urinary estradiol (Ptrend = 0.03) and 15% lower level of 16-hydroxylation pathway EM (Ptrend = 0.03). Levels of 2- and 4-hydroxylation pathway EM did not differ significantly by physical activity. High overall activity was also positively associated with four ratios: 2-pathway EM to parent estrogens (Ptrend = 0.05), 2-pathway catechols to parent estrogens (Ptrend = 0.03), 2-pathway catechols to methylated 2-pathway catechols (Ptrend < 0.01), and 2-hydroxyestrone to 16α-hydroxyestrone (Ptrend = 0.01). Similar patterns of association were noted for walking and vigorous physical activity, but there was little evidence of associations with sedentary behaviors or activity during adolescence. Conclusions: High levels of physical activity were associated with lower levels of parent estrogens and 16-hydroxylation pathway EM and preferential metabolism to 2-pathway catechols. The results of our analysis, the largest, most comprehensive examination of physical activity and estrogen metabolism to date, may be useful in future studies investigating the etiology of diseases linked to both physical activity and endogenous estrogen. PMID:22855335

  11. 25-hydroxyvitamin D is associated with metabolic syndrome among premenopausal women with systemic lupus erythematosus in China.

    PubMed

    Wang, L-M; Zheng, Z-H; Li, T-F; Han, L-S; He, Y-J; Zhang, Y-L; Zeng, H-L; Liu, S-Y

    2017-04-01

    Objectives This study aimed to investigate the status of 25-hydroxyvitamin D (25(OH)D) and its association with metabolic syndrome (MS) and different MS components among premenopausal women with systemic lupus erythematosus (SLE) in China. Patients and methods Altogether 113 premenopausal women with SLE and the age-matched healthy cohorts were recruited in this cross-sectional study. Clinical manifestations and laboratory data including serum 25(OH)D concentration were collected. A multivariable analysis was performed to analyze the association of 25(OH)D with MS and its components. Results The prevalence of 25(OH)D deficiency (25(OH)D < 20 ng/ml) and MS were common (24.8% and 30.1%, respectively) in premenopausal patients with SLE in China. Analysis of the association between 25(OH)D, MS and its components demonstrated that the lower level of 25(OH)D was associated with increased MS prevalence (OR = 0.920, p = 0.012), a decreased level of high-density lipoprotein (OR = 1.059, p = 0.033) and a higher level of fasting glucose (OR = 0.810, p = 0.004). These associations were still detectible after adjustment for age, body mass index and SLE-related variables. Conclusion The level of 25(OH)D is associated with MS and its components in premenopausal women with SLE.

  12. Korean and Japanese Women: An Analytic Bibliographical Guide.

    ERIC Educational Resources Information Center

    Koh, Hesung Chun, Ed.

    This book is a selective bibliography and index of materials on Korean and Japanese women, their history, social and cultural patterns, sex roles, family and kinship patterns, and other characteristics. Designed to assist researchers in the systematic selection of information for descriptive or comparative research on Korean and Japanese women,…

  13. Reduced progesterone levels explain the reduced risk of breast cancer in obese premenopausal women: a new hypothesis.

    PubMed

    Dowsett, Mitch; Folkerd, Elizabeth

    2015-01-01

    Understanding the complex relationship between obesity and breast cancer is fundamental to our knowledge of the etiology of this malignancy; changes in the composition of the hormonal milieu are implicit in this process. Estrogens are synthesized from androgens by aromatase in the gonads and in peripheral tissues, principally, adipose tissue. Obesity in women, regardless of their age, leads to more aromatase and more extra-glandular estrogen production. In postmenopausal women, in whom ovarian estrogen production is absent, the increased incidence of breast cancer in women with high body mass index has been attributed to the relatively high plasma levels of estradiol from subcutaneous fat. In contrast, obesity in premenopausal women is associated with a previously unexplained reduced incidence of breast cancer. In obese premenopausal women, the cumulative effect of higher levels of estrogens synthesized in the peripheral tissues, together with ovarian estrogen production, results in a negative feedback on the hypothalamic pituitary controlled release of gonadotrophins and a resultant diminution in ovarian steroid production. As a consequence, the normal balance of estrogen and progesterone levels is disrupted: while estrogen levels are normalized, progesterone production is markedly decreased. Progesterone is a promoter of proliferation in the breast. The low levels of progesterone in obese premenopausal women are consistent with, and we propose, are responsible for, the reduction in breast cancer incidence in these women.

  14. Diet composition and physical activity in overweight and obese premenopausal women with or without polycystic ovary syndrome.

    PubMed

    Álvarez-Blasco, Francisco; Luque-Ramírez, Manuel; Escobar-Morreale, Héctor F

    2011-12-01

    The polycystic ovary syndrome (PCOS) is a complex polygenic disorder in which environmental factors play an important modifying role. We aimed to find differences in diet and life-style that might contribute to the development of PCOS among overweight or obese premenopausal women. We compared diet composition and self-reported physical activity among 22 patients with PCOS and 59 women without androgen excess recruited from a total of 113 consecutive premenopausal women reporting for management of weight excess. After correcting for a difference in age between women with PCOS and controls, there were no overall statistical significant differences between them in the total caloric intake, in the intake of macro- and micro-nutrients, caffeine, fiber and alcohol, in the proportion of women exercising regularly, or in the number of hours of exercise per week. The proportion of fat in the diets of the overweight and obese women irrespective of PCOS was well-above current recommendations, yet this excessive fat intake occurred at the expense of monounsaturated fatty acids mostly. In conclusion, diet composition and physical activity were apparently not decisive for the development of PCOS among overweight and obese premenopausal women.

  15. Kidney biomarkers associated with blood lead, mercury, and cadmium in premenopausal women: a prospective cohort study.

    PubMed

    Pollack, Anna Z; Mumford, Sunni L; Mendola, Pauline; Perkins, Neil J; Rotman, Yaron; Wactawski-Wende, Jean; Schisterman, Enrique F

    2015-01-01

    Certain metals are harmful to the kidney and liver at high levels, but associations with functional biomarkers at low exposure levels among premenopausal women apparently has not been evaluated. Healthy, regularly menstruating women (n = 259) were followed for up to 2 menstrual cycles with up to 16 visits. Renal and liver biomarkers were measured in serum at each clinic visit. Cadmium (Cd), lead (Pb), and mercury (Hg) were measured in whole blood at baseline. Linear mixed models were adjusted for age, body mass index (BMI), race, average calories, alcohol intake, smoking, and cycle day. Median levels of Cd, Pb, and Hg were 0.31 μg/L, 0.88 μg/dl, and 1.1 μg/L, respectively. One-third of women had diminished glomerular filtration rate (eGFR) (<90 ml/min/1.73 m(2)). Each twofold increase in Cd was associated with a negative 4.9% change in blood urea nitrogen (BUN) and bilirubin. Each twofold rise in Pb was associated with decreased eGFR and increased creatinine. A twofold elevation in Hg was associated with higher protein and reduced alkaline phosphatase. In healthy, predominantly nonsmoking women, low levels of Cd, Pb, and Hg were associated with changes in select biomarkers of kidney and liver function.

  16. Increased vitamin D and calcium intake associated with reduced mammographic breast density among premenopausal women

    PubMed Central

    Fair, Alecia Malin; Lewis, Toni J.; Sanderson, Maureen; Dupont, William D.; Fletcher, Sarah; Egan, Kathleen M.; Disher, Anthony C.

    2015-01-01

    Vitamin D has been identified as a weak protective factor for postmenopausal breast cancer (relative risk [RR]~0.9), while high breast density has been identified as a strong risk factor (RR~4–6). To test the hypothesis that there is an association between vitamin D intake, but not circulating vitamin D levels, and mammographic breast density among women in our study we conducted a cross-sectional study of 165 screening mammography patients at Nashville General Hospital’s Breast Health Center (NGH-BHC), a public facility serving medically indigent and underserved women. Dietary and total (dietary plus supplements) vitamin D, calcium intakes were estimated by the AAFQ and blood samples were analyzed for 25-Hydroxyvitamin D [25(OH)D3]. Average percent breast density for the left and right breasts combined was estimated from digitized films using an interactive-thresholding method available through Cumulus software. After statistical adjustment for age, race and body mass index, the results revealed there were significant trends of decreasing breast density with increasing vitamin D and calcium intake among premenopausal, but not among postmenopausal women. There was no association between serum vitamin D and breast density in pre- or postmenopausal women. Confirmation of our findings in larger studies may assist in clarifying the role of vitamin D in breast density. PMID:26321093

  17. Does the addition of saline infusion sonohysterography to transvaginal ultrasonography prevent unnecessary hysteroscopy in premenopausal women with abnormal uterine bleeding?

    PubMed

    Short, John; Sharp, Benjamin; Elliot, Nikki; McEwing, Rachael; McGeoch, Graham; Shand, Brett; Holland, Kieran

    2016-08-01

    This observational case series in 65 premenopausal women with abnormal uterine bleeding evaluated whether transvaginal ultrasound followed by saline infusion sonohysterography (SIS) prevented unnecessary hysteroscopy. Although SIS indicated that hysteroscopy was unnecessary in eight women, this benefit was offset by the invasive nature of the scan, the number of endometrial abnormalities falsely detected by SIS and the cost of the additional investigation. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  18. Evaluation of Feasibility for a Case-Control Study of Pituitary-Ovarian Function in Premenopausal Women with Breast Cancer

    DTIC Science & Technology

    2005-07-01

    feasibility of a case-control study that uses gonadotropin releasing hormone (GnRH) stimulation tests to evaluate sensitivity of the hypothalamic...determine the safety and feasibility of conducting a case-control study that uses gonadotropin releasing hormone (GnHR) stimulation tests to evaluate...women. The full-scale study will determine if: 1) the anterior pituitary of pre-menopausal women with breast cancer secretes more luteinizing hormone (LH

  19. Testosterone Levels in Pre-Menopausal Women are Associated With Nonalcoholic Fatty Liver Disease in Midlife.

    PubMed

    Sarkar, Monika; Wellons, Melissa; Cedars, Marcelle I; VanWagner, Lisa; Gunderson, Erica P; Ajmera, Veeral; Torchen, Laura; Siscovick, David; Carr, J Jeffrey; Terry, James G; Rinella, Mary; Lewis, Cora E; Terrault, Norah

    2017-05-01

    Young women with hyperandrogenism have high risk of metabolic co-morbidities, including increased risk of nonalcoholic fatty liver disease (NAFLD). Whether testosterone (the predominant androgen) is associated with NAFLD independent of metabolic co-factors is unclear. Additionally, whether testosterone confers increased risk of NAFLD in women without hyperandrogenism is unknown. Among women in the prospective population-based multicenter Coronary Artery Risk Development in Young Adults (CARDIA) study, we assessed whether free testosterone levels measured at Year 2 (1987-1988) were associated with prevalent NAFLD at Year 25 (2010-2011) (n=1052). NAFLD was defined using noncontrast abdominal CT scan with liver attenuation≤40 Hounsfield units after excluding other causes of hepatic fat. The association of free testosterone with prevalent NAFLD was assessed by logistic regression. Increasing quintiles of free testosterone were associated with prevalent NAFLD at Year 25 (adjusted odds ratio (AOR) 1.25, 95% confidence interval (CI) 1.04-1.50, P=0.015), independent of insulin resistance, body mass index, waist circumference, and serum lipids. Importantly, the association persisted among n=955 women without androgen excess (AOR 1.27, 95% CI 1.05-1.53, P=0.016). Visceral adipose tissue (VAT) volume partially mediated the association of free testosterone with NAFLD (mediating effect 41.0%, 95% CI 22-119%). Increasing free testosterone is associated with prevalent NAFLD in middle age, even in women without androgen excess. Visceral adiposity appears to play an important role in the relationship between testosterone and NAFLD in women. Testosterone may provide a potential novel target for NAFLD therapeutics, and future studies in pre-menopausal women should consider the importance of testosterone as a risk factor for NAFLD.

  20. Physical activity in relation to long-term maintenance after intentional weight loss in premenopausal women

    PubMed Central

    Mekary, Rania A.; Feskanich, Diane; Hu, Frank B.; Willett, Walter C.; Field, Alison E.

    2009-01-01

    The type and amount of physical activity needed for prevention of weight regain are not well understood. We prospectively examined the associations between patterns of discretionary physical activity and 6-year maintenance of intentional weight loss among 4,558 healthy premenopausal women who were 26–45 years old in 1991 and had lost >5% of their body weight in the previous two years. Participants reported their physical activity and weight in 1991 and 1997. The outcome was weight regain, defined as regaining in 1997 >30% of the lost weight between 1989 and 1991. Between 1991 and 1997, 80% of women regained >30% of their previous intentional weight loss. An increase of 30 minutes/day in total discretionary activity between 1991 and 1997 was associated with less weight regain (−1.36kg, 95% confidence interval (CI) = −1.61, −1.12), particularly among overweight women (body mass index ≥25) (−2.45kg, −3.12 to −1.78). Increased jogging or running was associated with less weight regain (−3.26kg; −4.41 to −2.10) than increased brisk walking (−1.69kg; −2.15 to −1.22) or other activities (−1.26kg; −1.65 to −0.87). Compared to women who remained sedentary, women were less likely to regain >30% of the lost weight if they maintained 30+ minutes/day of discretionary physical activity (OR=0.69, 0.53 to 0.89) or increased to this activity level (OR=0.48, 0.39 to 0.60). Conversely, risk was elevated in women who decreased their activity. Increased physical activity, particularly high intensity activities, is associated with better maintenance of weight loss. The benefits of activity were greater among overweight/obese than normal weight women. PMID:19498346

  1. Relationships of Total Adiponectin and Molecular Weight Fractions of Adiponectin with Free Testosterone in African Men and Premenopausal Women

    PubMed Central

    Cui, Jie; Wu, XiangDong; Andrel, Jocelyn; Falkner, Bonita

    2010-01-01

    Adiponectin, a protein secreted by adipose tissue, has anti-inflammatory, anti-thrombogenic and anti-diabetogenic properties. Lower plasma adiponectin levels are present in diabetes, obesity, and metabolic syndrome. Adiponectin levels are higher in women compared to men. The purpose of this study was to determine if there are relationships between total adiponectin, or the molecular weight fractions of adiponectin, with testosterone levels in African American men and pre-menopausal women. A sample (N=48) of men and premenopausal women were selected, based on high and low serum free testosterone level. All cases had data on blood pressure, metabolic risk factors, and sex hormone levels. Stored plasma samples were assayed for total adiponectin (ELISA). Molecular weight fractions of adiponectin were separated by gel-electrophoresis and quantified by western blot. Data analysis compared adiponectin (total and fractions) levels with androgen status in both genders. Among men with high testosterone, all fractions of adiponectin were significantly lower than men with low testosterone (P<0.05). In women with high testosterone, total adiponectin (P=0.02) and all fractions of molecular weight adiponectin (P<0.05) were lower compared to women with low testosterone. Plasma adiponectin levels are lower in both men and pre-menopausal women with relatively higher testosterone levels. PMID:21122061

  2. Analysis of traditional and emerging risk factors in premenopausal women with coronary artery disease: A pilot-scale study from North India.

    PubMed

    Vijayvergiya, Rajesh; Kapoor, Divya; Aggarwal, Ajay; Sangwan, Sonal; Suri, Vanita; Dhawan, Veena

    2017-03-23

    Premenopausal women are known to have less heart disease than their menopausal counterparts and men. However, there is a rising prevalence of coronary artery disease (CAD) in premenopausal females, which necessitates determination of risk factors that negate the effects of hormonal protection. There are few studies describing the prevalence of traditional and emerging risk factors in premenopausal women with CAD. Thus, our objective was to explore the prevalence of traditional and emerging risk factors and features of coronary lesions in premenopausal women with CAD in an Indian population. Forty premenopausal female patients with angiographically proven CAD and undergoing treatment with conventional therapies and 40 age-matched premenopausal females without any evidence of CAD were enrolled. Premenopausal females with CAD most commonly had the single-vessel CAD and the left anterior descending artery was most commonly involved. The prevalence of hypertension, diabetes, obesity, metabolic syndrome, family history of CAD and 10-year risk score was higher in premenopausal females with CAD than controls. Even after treatment with conventional therapies, premenopausal women with CAD had dyslipidemia and significantly elevated levels of emerging risk factors such as ApoB, ApoB/ApoA1 ratio, hsCRP, lipoprotein (a), uric acid, T4, fibrinogen, and total leukocyte count as compared to controls (p < 0.05). Further, they had significantly lower levels of HDL-C, and Apolipoprotein A1 and T3 which are protective markers for vascular risk. Multivariate regression analysis demonstrated that low levels of Apo A1 and high levels of fibrinogen, hsCRP and TG drive the vascular risk, and therefore these factors should be considered as candidates for better diagnosis, early detection, and intervention of CAD in premenopausal women.

  3. Changes in tear film, corneal topography, and refractive status in premenopausal women during menstrual cycle.

    PubMed

    Cavdar, Ercument; Ozkaya, Abdullah; Alkin, Zeynep; Ozkaya, Hande Mefkure; Babayigit, Mustafa Alparslan

    2014-06-01

    To investigate the changes in a questionnaire based subjective symptomatology, tear film break-up time, tear volume, corneal topography, and refractive status in premenopausal women during menstrual cycle. Seventeen premenopausal females and 15 healthy males were enrolled in this prospective study. After routine ophthalmologic examination, an ocular surface disease index questionnaire was administered, tear film break-up time (TBUT), and Schirmer I tests were performed. Keratometry readings and refractive status were also obtained. All examinations were repeated at day 21, day 12 and day 2. OSDI score in day 21 was significantly lower than that in day 12 (p=0.004) and day 2 (p=0.01) in the female patients; however, no significant change was found in the male subjects (p>0.05). No statistically significant difference was found in TBUT and Schirmer I tests, keratometry, and refraction results in both of the female and male subjects at all of the test points (p>0.05). There was a significant correlation between OSDI score and TBUT (p=0.02, p=0.03, respectively), and Schirmer I test at day 12 (p=0.004, p=0.008, respectively). A significant negative correlation was found between oestrogen level and horizontal keratometry values at day 21 (r=-0.5, p=0.03; r=-0.4, p=0.04, respectively) for the right and left eyes in the female subjects. Our study confirms that fluctuations in the blood levels of oestrogen produce alterations in ocular surface equilibrium during the menstrual cycle and consequently affect the subjective dry eye symptoms in female patients. However, no ocular surface parameter changes were observed. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  4. Urinary Phytoestrogen Concentrations Are Not Associated with Incident Endometriosis in Premenopausal Women.

    PubMed

    Mumford, Sunni L; Weck, Jennifer; Kannan, Kurunthachalam; Buck Louis, Germaine M

    2017-02-01

    Phytoestrogens have been associated with subtle hormonal changes, but their effects on endometriosis are largely unknown. We assessed the association between urinary concentrations of phytoestrogens and incident endometriosis. We included an operative sample of 495 premenopausal women aged 18-44 y undergoing laparoscopies and laparotomies at 14 clinical sites between 2007 and 2009 and a general population sample of 131 women from the same geographic area who were matched on age and menstruation status. Endometriosis in the surgical sample was assessed by surgical visualization (clinical gold standard), whereas disease in the general population sample was assessed with the use of a pelvic MRI. Urine concentrations of genistein, daidzen, O-desmethylangolensin, equol, enterodiol, and enterolactone were measured at baseline. Poisson regression with robust error variance was used to estimate the risk of an endometriosis diagnosis for each sample after adjusting for age and body mass index (in kg/m(2)). Separate models were run for each phytoestrogen. Overall geometric mean urine concentrations of phytoestrogens were as follows: genistein [88 nmol/L (95% CI: 72, 108 nmol/L)], daidzein [194 nmol/L (95% CI: 160, 236 nmol/L)], O-desmethylangolensin [4 nmol/L (95% CI: 3, 6 nmol/L)], equol [4 nmol/L (95% CI: 4, 6 nmol/L)], enterodiol [29 nmol/L (95% CI: 22, 38 nmol/L)], and enterolactone [355 nmol/L (95% CI: 395, 544 nmol/L)]. Geometric mean concentrations of phytoestrogens did not significantly differ by endometriosis status in either sample. Adjusted RRs for endometriosis ranged from 0.87 to 1.09 for the 6 phytoestrogens measured, with all CIs including a value ≥1. Phytoestrogens were not associated with the severity of endometriosis when restricting the analysis to women with moderate-to-severe disease per the revised American Society for Reproductive Medicine criteria. Furthermore, no associations were observed between self-reported high soy intake and endometriosis

  5. The present situation of Korean women's organizations.

    PubMed

    Lee, Y S

    1991-01-01

    This report was translated and excerpted from the original research report on Korean women's organizations by the Korean Women Development Institute (KWDI). There were 2200 women's groups in 1988. Their collective strength has not been felt even though strong opinions on women's issues are expressed. 303 groups from the KWDI directory were selected of which 14 city or provincial councils of women's groups are represented: the cities of Pusan, Taegu, Inchon, Kwangju, Taejon and provinces of Kyungki, Kangwon, North Chungchong, South Chungchong, North Cholla, South Cholla, North Kyongsang, and South Kyongsang. The survey provides a general overview and is not representative of all women's groups. Results are presented in general, by organizational structure and facilities, by purpose of establishment and types of activities, and financial conditions. The results of the survey of 93 national organizations and the 210 local organizations show that 85.5% are registered (260 out of 303) and 14.2% are nonregistered (25 national and 18 local). 192 out of 210 local groups are part of national groups of which 148 are registered. Few groups at the local level are independent. Registration data are provided by Ministry. Organizational growth occurred in the 1980s with the addition of 115 groups. Most nonregistered groups were formed after 1981. New membership is dependent on fulfilling specified qualifications. 32.3% require professional credentials. 11% did not have qualifications. 40% of groups have 500 members, 14.8% with 1-5000 members, and 10.3% with 10,000 members. 43 groups have their own branches, i.e., 43.2% have 10 branches and 34.1% have 10-20 branches or 79.3% have 20 branches. 72.6% employ full-time staff, of which 35.5% are paid. 54.8% have 3 staff and 6.9% have 10 staff. 35.8% rent, 28.5% own, and the others use free space in houses or offices. Social welfare concerns were the most frequent objectives. "Improving women's social status and rights" was a more

  6. Efficient fat storage in premenopausal women and in early pregnancy: a role for estrogen.

    PubMed

    O'Sullivan, A J; Martin, A; Brown, M A

    2001-10-01

    There is a sexual dimorphism in body fat in humans. Adipose tissue increases with puberty and early pregnancy in women, suggesting gonadal steroids can influence body fat. Previously, we have observed that oral estrogen, compared with transdermal estrogen, reduced postprandial lipid oxidation and increased body fat, possibly due to suppressed hepatic lipid oxidation. If estrogen effects lipid oxidation, we predicted that subjects with significantly different endogenous estrogen production would oxidize lipids at different rates. The aim of this study was to compare energy metabolism in 12 pregnant (19 wk gestation, 29 +/- 1 yr, 1.66 +/- 0.02 m, 73.5 +/- 2.4 kg), 11 nonpregnant premenopausal (29 +/- 2 yr, 1.68 +/- 0.02 m, 63.1 +/- 1.8 kg), and 28 postmenopausal (58 +/- 1 yr, 1.62 +/- 0.01 m, 69.9 +/- 1.0 kg) women who were not receiving estrogen, and to relate these findings to endogenous estrogen concentrations. All women underwent indirect calorimetry under identical situations in the basal and postprandial state following a standard mixed meal. Basal (5998 +/- 184 vs. 5712 +/- 184 vs. 5800 +/- 121 kJ.24 h, respectively) and postprandial energy expenditure (7172 +/- 239 vs. 6964 +/- 210 vs. 6955 +/- 147 kJ.24 h) was similar among groups. However, basal lipid oxidation was reduced in pregnant (45.3 +/- 6.1 mg/min, P < 0.05) and nonpregnant women (44.5 +/- 6.3 mg/min, P < 0.05) compared with postmenopausal women (58.4 +/- 2.9 mg/min). Postprandial lipid oxidation differed among groups, being least in pregnant women (8.8 +/- 6.2 mg/min) compared with nonpregnant (28.9 +/- 6.4 mg/min, P < 0.04) and postmenopausal (48.1 +/- 4.0 mg/min, P = 0.0001) women. There was a significant reciprocal increase in postprandial carbohydrate oxidation. Mean postprandial glucose levels were slightly but nonsignificantly higher in pregnant women. Insulin levels were significantly higher in postmenopausal compared nonpregnant, but not pregnant, women. In a multiple regression analysis

  7. Variation in Inflammatory Cytokine/Growth-Factor Genes and Mammographic Density in Premenopausal Women Aged 50–55

    PubMed Central

    Ozhand, Ali; Lee, Eunjung; Wu, Anna H.; Ellingjord-Dale, Merete; Akslen, Lars A.; McKean-Cowdin, Roberta; Ursin, Giske

    2013-01-01

    Background Mammographic density (MD) has been found to be an independent risk factor for breast cancer. Although data from twin studies suggest that MD has a strong genetic component, the exact genes involved remain to be identified. Alterations in stromal composition and the number of epithelial cells are the most predominant histopathological determinants of mammographic density. Interactions between the breast stroma and epithelium are critically important in the maturation and development of the mammary gland and the cross-talk between these cells are mediated by paracrine growth factors and cytokines. The potential impact of genetic variation in growth factors and cytokines on MD is largely unknown. Methods We investigated the association between 89 single nucleotide polymorphisms (SNPs) in 7 cytokine/growth-factor genes (FGFR2, IGFBP1, IGFBP3, TGFB1, TNF, VEGF, IL6) and percent MD in 301 premenopausal women (aged 50 to 55 years) participating in the Norwegian Breast Cancer Screening Program. We evaluated the suggestive associations in 216 premenopausal Singapore Chinese Women of the same age. Results We found statistically significant associations between 9 tagging SNPs in the IL6 gene and MD in Norwegian women; the effect ranged from 3–5% in MD per variant allele (p-values = 0.02 to 0.0002). One SNP in the IL6 (rs10242595) significantly influenced MD in Singapore Chinese women. Conclusion Genetic variations in IL6 may be associated with MD and therefore may be an indicator of breast cancer risk in premenopausal women. PMID:23762340

  8. A feminist critique of breast cancer research among Korean women.

    PubMed

    Im, E O

    2000-08-01

    Studies indicate ethnic differences in incidence, mortality, and survival rate of breast cancer. Despite the low incidence rate of breast cancer among the Korean population, Koreans are reported to be less likely to survive breast cancer. In this article, using a feminist perspective, the reasons why Korean women have been reported to be less likely to survive breast cancer are analyzed through a critical review of research among Korean women. A total of 469 studies (145 unpublished master's theses and doctoral dissertations and 324 articles published in South Korea and in the United States) were reviewed, analyzed, and critiqued in terms of biases present in the research process. Through a feminist critique of the literature, four possible reasons are proposed: androcentric views and assumptions underlying the research, modesty issues imbedded in Korean culture, the victim-blaming tendency of Korean culture, and intense emotions without adequate support.

  9. Interrelationship between serum 25-hydroxyvitamin D3 concentration and lipid profiles in premenopausal Indian women

    PubMed Central

    Patel, Pinal A.; Patel, Prerna P.; Mughal, Zulf; Padidela, Raja; Patel, Ashish D.; Patwardhan, Vivek; Chiplonkar, Shashi A.; Khadilkar, Vaman; Khadilkar, Anuradha

    2017-01-01

    Context: Vitamin D deficiency is prevalent worldwide, and observational studies have associated it with an atherogenic lipid profile. Aim: To determine the interrelationship between Vitamin D and lipid profile in apparently healthy premenopausal Indian women, considering confounding factors such as lifestyle that independently influence lipids. Setting and Design: Cross-sectional study. Subjects and Methods: One hundred and twenty healthy premenopausal women (20–45 year) were recruited from Gujarat, India. Data were collected on anthropometry, physical activity, sunlight exposure, and diet. Fasting blood samples were collected for the measurement of serum 25-hydroxyvitamin D3 (25[OH]D), parathyroid hormone, and lipid profile. Statistical Analysis: Pearson's correlation coefficient was used to derive correlation between serum 25[OH]D concentrations and serum lipids. Results: Ninety-three percent women showed Vitamin D deficiency (serum 25[OH]D < 20 ng/ml). Serum 25(OH)D concentrations showed significant inverse correlation with total cholesterol (TC) (r = −0.202, P = 0.027), triglycerides (TG) (r = −0.284, P = 0.002), and low-density lipoprotein-cholesterol (LDL-C) (r = −0.184, P = 0.044) and positive correlation with high-density lipoprotein-cholesterol (HDL-C) (r = 0.250, P = 0.006). On dichotomizing the population according to median 25(OH)D concentration (11.1 ng/dl), no significant differences were observed between the groups for anthropometry, sunlight exposure, and lifestyle. Serum lipid profiles were significantly different, above median serum 25(OH)D concentration group showed favorable serum lipids (TC: 179.3 ± 30 vs. 191.8 ± 31.7 mg/dl; TG: 140 ± 39.1 vs. 165.5 ± 53.4 mg/dl; LDL-C: 100 ± 30.2 vs. 112 ± 32 mg/dl; HDL-C: 53 ± 14 vs. 47.6 ± 9.3 mg/dl)(P < 0.05). Conclusions: This study demonstrates that association of 25(OH)D concentrations with lipid profile even after considering lifestyle factors which independently influence lipids

  10. Bone marrow fat contributes to insulin sensitivity and adiponectin secretion in premenopausal women.

    PubMed

    Ermetici, Federica; Briganti, Silvia; Delnevo, Alessandra; Cannaò, Paola; Leo, Giovanni Di; Benedini, Stefano; Terruzzi, Ileana; Sardanelli, Francesco; Luzi, Livio

    2017-06-17

    Bone marrow fat is a functionally distinct adipose tissue that may contribute to systemic metabolism. This study aimed at evaluating a possible association between bone marrow fat and insulin sensitivity indices. Fifty obese (n = 23) and non-obese (n = 27) premenopausal women underwent proton magnetic resonance spectroscopy to measure vertebral bone marrow fat content and unsaturation index at L4 level. Abdominal visceral, subcutaneous fat, and epicardial fat were also measured using magnetic resonance imaging. Bone mineral density was measured by dual-energy X-ray absorptiometry. Body composition was assessed by bioelectrical impedance analysis. Fasting serum glucose, insulin, lipids, adiponectin were measured; the insulin resistance index HOMA (HOMA-IR) was calculated. Bone marrow fat content and unsaturation index were similar in obese and non-obese women (38.5 ± 0.1 vs. 38.6 ± 0.1%, p = 0.994; 0.162 ± 0.065 vs. 0.175 ± 0.048, p = 0.473, respectively). Bone marrow fat content negatively correlated with insulin and HOMA-IR (r = -0.342, r = -0.352, respectively, p = 0.01) and positively with high density lipoprotein cholesterol (r = 0.270, p = 0.043). From a multivariate regression model including lnHOMA-IR as a dependent variable and visceral, subcutaneous, epicardial fat, and bone marrow fat as independent variables, lnHOMA-IR was significantly associated with bone marrow fat (β = -0.008 ± 0.004, p = 0.04) and subcutaneous fat (β = 0.003 ± 0.001, p = 0.04). Bone marrow fat, among the other adipose depots, was a significant predictor of circulating adiponectin (β = 0.147 ± 0.060, p = 0.021). Bone marrow fat unsaturation index negatively correlated with visceral fat (r = -0.316, p = 0.026). There is a relationship between bone marrow fat content and insulin sensitivity in obese and non-obese premenopausal women, possibly mediated by adiponectin secretion

  11. Caffeinated beverage intake and reproductive hormones among premenopausal women in the BioCycle Study123

    PubMed Central

    Schisterman, Enrique F; Mumford, Sunni L; Pollack, Anna Z; Zhang, Cuilin; Ye, Aijun; Stanford, Joseph B; Hammoud, Ahmad O; Porucznik, Christina A; Wactawski-Wende, Jean

    2012-01-01

    Background: Caffeinated beverages are widely consumed among women of reproductive age, but their association with reproductive hormones, and whether race modifies any such associations, is not well understood. Objective: We assessed the relation between caffeine and caffeinated beverage intake and reproductive hormones in healthy premenopausal women and evaluated the potential effect modification by race. Design: Participants (n = 259) were followed for up to 2 menstrual cycles and provided fasting blood specimens for hormonal assessment at up to 8 visits per cycle and four 24-h dietary recalls per cycle. Weighted linear mixed models and nonlinear mixed models with harmonic terms were used to estimate associations between caffeine and hormone concentrations, adjusted for age, adiposity, physical activity, energy and alcohol intakes, and perceived stress. On the basis of a priori assumptions, an interaction between race and caffeine was tested, and stratified results are presented. Results: Caffeine intake ≥200 mg/d was inversely associated with free estradiol concentrations among white women (β = −0.15; 95% CI: −0.26, −0.05) and positively associated among Asian women (β = 0.61; 95% CI: 0.31, 0.92). Caffeinated soda intake and green tea intake ≥1 cup/d (1 cup = 240 mL) were positively associated with free estradiol concentrations among all races: β = 0.14 (95% CI: 0.06, 0.22) and β = 0.26 (95% CI: 0.07, 0.45), respectively. Conclusions: Moderate consumption of caffeine was associated with reduced estradiol concentrations among white women, whereas caffeinated soda and green tea intakes were associated with increased estradiol concentrations among all races. Further research is warranted on the association between caffeine and caffeinated beverages and reproductive hormones and whether these relations differ by race. PMID:22237060

  12. The impact of gastric bypass surgery on sex hormones and menstrual cycles in premenopausal women.

    PubMed

    Kjær, Mette Mandrup; Madsbad, Sten; Hougaard, David M; Cohen, Arieh S; Nilas, Lisbeth

    2017-02-01

    Obesity has adverse effects on ovulation, menstrual cyclicity and oocyte development leading to clinical symptoms such as infertility and menstrual disorders. The Roux-en-Y gastric bypass (RYGB) leads to weight loss, improved insulin sensitivity and may improve ovarian function. In 31 premenopausal women, 18 eu- and 13 oligo-/amenorrhoic, we followed the changes in follicular phase sex hormones 3, 6 and 12 month after RYGB. The average weight loss during the first postoperative year was 39.6 kg. The insulin sensitivity and serum insulin improved markedly especially within the first three postoperative months. SHBG increased progressively and was doubled after 12 months. In contrast, total and free androgens and DHEA declined about 50% during the first three postoperative months and remained fairly constant hereafter. One year after surgery, 85% (11/13) of the women with oligo-/amenorrhea gained regular menstrual cycles. Our results indicate that some of the endocrine changes related to regulation of ovarian function occur very early after bariatric surgery.

  13. Effect of alcohol consumption on hormones involved in carbohydrate and lipid metabolism in premenopausal women

    SciTech Connect

    Law, J.S.; Bhathena, S.J.; Kim, Y.C.; Berlin, E.; Judd, J.T.; Reichman, M.E.; Taylor, P.R.; Schatzkin, A. NCI, Bethesda, MD )

    1991-03-15

    Alcohol consumption alters carbohydrate and lipid metabolism which are in part regulated by pancreatic and adrenal hormones. The menstrual cycle per se produces changes in several peptide and steroid hormones besides the sex hormones. The authors investigated the effect of moderate alcohol consumption on plasma hormone levels in 40 premenopausal women. The subjects were fed controlled diets containing 35% of calories from fat. In a random crossover design women were given either alcohol or a soft-drink of equal caloric value for 3 menstrual cycles. Fasting blood samples were collected in the third cycle during follicular, ovulatory and luteal phases. Plasma dehydroepiandrosterone-sulphate (DHEA-S), insulin, glucagon and cortisol levels were measured by radioimmunoassay. Moderate alcohol consumption had no effect on plasma insulin and DHEA-S levels but significantly increased glucagon and cortisol levels. Menstrual cycle per se affected plasma glucagon level in that the levels were higher during follicular phase than luteal phase. Thus, changes in carbohydrate and lipid metabolism following alcohol consumption are mediated in part by alterations in hormones involved in their metabolism.

  14. Soy Isoflavones Have an Antiestrogenic Effect and Alter Mammary Promoter Hypermethylation in Healthy Premenopausal Women

    PubMed Central

    Qin, Wenyi; Zhu, Weizhu; Shi, Huidong; Hewett, John E.; Ruhlen, Rachel L.; MacDonald, Ruth S.; Rottinghaus, George E.; Chen, Yin-Chieh; Sauter, Edward R.

    2012-01-01

    We determined if soy isoflavones have dose-related estrogenic and methylation effects. Thirty-four healthy premenopausal women were randomized to 40 mg or 140 mg isoflavones daily through one menstrual cycle. Breast specific and systemic estrogenic effects were assessed measuring the estrogenic marker complement (C)3 and changes in cytology, whereas methylation assessment of 5 cancer related genes (p16, RASSF1A, RARβ2, ER, and CCND2) was performed on intraductal specimens. Serum genistein significantly increased after consuming both isoflavone doses. Cytology did not significantly change at either isoflavone dose. Serum C3 levels posttreatment were inversely related to change in serum genistein (r = −0.76, P = 0.0045) in women consuming low but not high dose isoflavones. The RARβ2 hypermethylation increase posttreatment correlated with the posttreatment genistein level considering the entire group (r 0.67, P = 0.0017) and those receiving high-dose isoflavones (r = 0.68, P = 0.021). At the low but not the high isoflavone dose, CCND2 hypermethylation increase correlated with posttreatment genistein levels (r = 0.79, P = 0.011). In summary, the inverse correlation between C3 and genistein suggests an antiestrogenic effect. Isoflavones induced dose-specific changes in RARβ2 and CCND2 gene methylation, which correlated with genistein levels. This work provides novel insights into estrogenic and methylation effects of dietary isoflavones. PMID:19235040

  15. Associations of Breast Cancer Risk Factors with Premenopausal Sex Hormones in Women with Very Low Breast Cancer Risk.

    PubMed

    Houghton, Lauren C; Ganmaa, Davaasambuu; Rosenberg, Philip S; Davaalkham, Dambadarjaa; Stanczyk, Frank Z; Hoover, Robert N; Troisi, Rebecca

    2016-10-31

    Breast cancer incidence rates are low but rising in urban Mongolia. We collected reproductive and lifestyle factor information and measured anthropometrics and serum sex steroid concentrations among 314 premenopausal women living in Ulaanbaatar, Mongolia. Mean differences in hormone concentrations by these factors were calculated using age-adjusted quadratic regression splines. Estrone and estradiol in college-educated women were, respectively, 18.2% (p = 0.03) and 23.6% (p = 0.03) lower than in high-school-educated women. Progesterone concentrations appeared 55.8% lower (p = 0.10) in women residing in modern housing compared with women living in traditional housing (gers), although this finding was not statistically significant. Testosterone concentrations were positively associated with adiposity and central fat distribution % difference for highest vs. lowest quarter for body mass index (17.1% (p = 0.001)) and waist-to-height ratio (15.1% (p = 0.005)). Estrogens were higher in the follicular phase of women who breastfed each child for shorter durations. A distinct hormonal profile was associated with an urban lifestyle in premenopausal, Mongol women. In particular, heavier, more-educated women living in urban dwellings had higher testosterone and lower estrogen and progesterone levels. Higher breast cancer incidence in urban compared with rural women suggest that the hormonal profile associated with a more traditional lifestyle may be protective among Mongol women.

  16. Associations of Breast Cancer Risk Factors with Premenopausal Sex Hormones in Women with Very Low Breast Cancer Risk

    PubMed Central

    Houghton, Lauren C.; Ganmaa, Davaasambuu; Rosenberg, Philip S.; Davaalkham, Dambadarjaa; Stanczyk, Frank Z.; Hoover, Robert N.; Troisi, Rebecca

    2016-01-01

    Breast cancer incidence rates are low but rising in urban Mongolia. We collected reproductive and lifestyle factor information and measured anthropometrics and serum sex steroid concentrations among 314 premenopausal women living in Ulaanbaatar, Mongolia. Mean differences in hormone concentrations by these factors were calculated using age-adjusted quadratic regression splines. Estrone and estradiol in college-educated women were, respectively, 18.2% (p = 0.03) and 23.6% (p = 0.03) lower than in high-school-educated women. Progesterone concentrations appeared 55.8% lower (p = 0.10) in women residing in modern housing compared with women living in traditional housing (gers), although this finding was not statistically significant. Testosterone concentrations were positively associated with adiposity and central fat distribution; 17.1% difference (p = 0.001) for highest vs. lowest quarter for body mass index and 15.1% difference (p = 0.005) for waist-to-height ratio. Estrogens were higher in the follicular phase of women who breastfed each child for shorter durations. A distinct hormonal profile was associated with an urban lifestyle in premenopausal, Mongol women. In particular, heavier, more-educated women living in urban dwellings had higher testosterone and lower estrogen and progesterone levels. Higher breast cancer incidence in urban compared with rural women suggest that the hormonal profile associated with a more traditional lifestyle may be protective among Mongol women. PMID:27809264

  17. The negative bone effects of the disease and of chronic corticosteroid treatment in premenopausal women affected by rheumatoid arthritis.

    PubMed

    Fassio, A; Idolazzi, L; Jaber, M A; Dartizio, C; Viapiana, O; Rossini, M; Gatti, D

    2016-09-09

    Osteoporosis is a well-known extra-articular complication in rheumatoid arthritis (RA). The chronic corticosteroid treatment, the functional impairment associated with RA and the disease itself appear to be the most relevant determinants. Most of the previous studies involved postmenopausal women, in whom the estrogenic deficiency might amplify the negative effect towards bone of both RA and corticosteroid therapy. We decided to evaluate bone health in a cohort of premenopausal RA patients. The study population includes 47 premenopausal women attending our outpatient clinic for RA and twice as many healthy age-matched control women selected from the hospital personnel. The bone density at the spine and femoral neck were significantly lower in patients with RA as compared with controls. When spine bone mineral density (BMD) values were adjusted for the cumulative glucocorticoid (GC) dose alone and for the cumulative GC dose plus body mass index (BMI) the mean differences between two groups decreased but they remained statistically significant. We found no difference when the spine BMD was adjusted for cumulative GC dose, BMI and health assessment questionnaire. The difference in femoral neck BMD remained statistically significant also after all the same adjustments. In conclusion, our study shows that a BMD deficiency is frequent also in premenopausal women affected by RA, especially at femoral site and that the main determinants of this bone loss are not only the disease-related weight loss, corticosteroid therapy and functional impairment, but also the systemic effects of the disease itself.

  18. A Pilot Study of Predictive Markers of Chemotherapy-Related Amenorrhea Among Premenopausal Women with Early Stage Breast Cancer

    PubMed Central

    Anders, Carey; Marcom, P. Kelly; Peterson, Bercedis; Gu, Lin; Unruhe, Sue; Welch, Renee; Lyons, Peggy; Kimmick, Gretchen; Shaw, Heather; Snyder, Stacey; Antenos, Monica; Woodruff, Teresa; Blackwell, Kimberly

    2010-01-01

    Background Premenopausal women treated for early stage breast cancer (ESBC) are at risk for chemotherapy-related amenorrhea (CRA). Prospectively-validated, predictive markers of CRA are needed. Patients and Methods Premenopausal women with ESBC and planned chemotherapy (≥ 25% risk of amenorrhea) were evaluated. Follicle stimulating hormone (FSH), estradiol, Inhibin A and B, anti-Müllerian hormone (AMH), and quality of life (QOL) were prospectively evaluated pre-, post-, 6 months and 1 year post-chemotherapy and correlated with age and menstrual status. CRA was defined as absence of menses 1 year post-chemotherapy. Results Forty-four women were evaluated at the time of analysis. Median age at diagnosis and FSH 1 year post-chemotherapy were higher among women with CRA (44 yrs [33–51] vs. 40 yrs [31–43]; p = 0.03; 39.8 vs. 5.0 mLU/mL, p = 0.0058, respectively). Median estradiol 1 year post-chemotherapy was higher among women who resumed menses (108.3 vs. 41.3 pg/mL, p = 0.01). Pre-chemotherapy median Inhibin B and AMH were lower among women with CRA (33.2 vs. 108.8 pg/mL; p = 0.03; 0.16 vs. 1.09 ng/mL, p = 0.02, respectively). The risk of CRA was increased among women with lower pre-chemotherapy Inhibin B (RR = 1.67, p = 0.15) and AMH (RR = 1.83, p = 0.05). Amongst women whose pre-chemotherapy Inhibin B and AMH values were below the median, the incidence of CRA was 87.5%. Conclusions Results indicate that pre-chemotherapy Inhibin B and AMH are lower among women experiencing CRA and may be predictive of CRA among premenopausal women facing chemotherapy for ESBC. PMID:18317970

  19. Mobile Phone App Aimed at Improving Iron Intake and Bioavailability in Premenopausal Women: A Qualitative Evaluation

    PubMed Central

    Riddell, Lynn; Lim, Karen; Byrne, Linda K; Nowson, Caryl; Rigo, Manuela; Szymlek-Gay, Ewa A; Booth, Alison O

    2015-01-01

    Background Low iron intake can lead to iron deficiency, which can result in impaired health and iron-deficiency anemia. A mobile phone app, combining successful dietary strategies to increase bioavailable iron with strategies for behavior change, such as goal setting, monitoring, feedback, and resources for knowledge acquisition, was developed with the aim to increase bioavailable iron intake in premenopausal women. Objective To evaluate the content, usability, and acceptability of a mobile phone app designed to improve intake of bioavailable dietary iron. Methods Women aged 18-50 years with an Android mobile phone were invited to participate. Over a 2-week period women were asked to interact with the app. Following this period, semistructured focus groups with participants were conducted. Focus groups were audio recorded and analyzed via an inductive open-coding method using the qualitative analysis software NVivo 10. Themes were identified and frequency of code occurrence was calculated. Results Four focus groups (n=26) were conducted (age range 19-36 years, mean 24.7, SD 5.2). Two themes about the app’s functionality were identified (frequency of occurrence in brackets): interface and design (134) and usability (86). Four themes about the app’s components were identified: goal tracker (121), facts (78), photo diary (40), and games (46). A number of suggestions to improve the interface and design of the app were provided and will inform the ongoing development of the app. Conclusions This research indicates that participants are interested in iron and their health and are willing to use an app utilizing behavior change strategies to increase intake of bioavailable iron. The inclusion of information about the link between diet and health, monitoring and tracking of the achievement of dietary goals, and weekly reviews of goals were also seen as valuable components of the app and should be considered in mobile health apps aimed at adult women. PMID:26416479

  20. Oestrogen levels in serum and urine of premenopausal women eating low and high amounts of meat.

    PubMed

    Harmon, Brook E; Morimoto, Yukiko; Beckford, Fanchon; Franke, Adrian A; Stanczyk, Frank Z; Maskarinec, Gertraud

    2014-09-01

    Based on the hypothesis that high-meat diets may increase breast cancer risk through hormonal pathways, the present analysis compared oestrogens in serum and urine by meat-eating status. Intervention with repeated measures. Two randomized soya trials (BEAN1 and BEAN2) among premenopausal healthy women. BEAN1 participants completed seven unannounced 24 h dietary recalls and donated five blood and urine samples over 2 years. BEAN2 women provided seven recalls and three samples over 13 months. Serum samples were analysed for oestrone (E₁) and oestradiol (E₂) using RIA. Nine oestrogen metabolites were measured in urine by LC-MS. Semi-vegetarians included women who reported consuming <30 g of red meat, poultry and fish daily, and pescatarians those who reported consuming <20 g of meat/poultry but >10 g of fish daily. All other women were classified as non-vegetarians. We applied mixed models to compute least-square means by vegetarian status adjusted for potential confounders. The mean age of the 272 participants was 41·9 (SD 4·5) years. Serum E₁ (85 v. 100 pg/ml, P = 0·04) and E₂ (140 v. 154 pg/ml, P = 0·04) levels were lower in the thirty-seven semi-vegetarians than in the 235 non-vegetarians. The sum of the nine urinary oestrogen metabolites (183 v. 200 pmol/mg creatinine, P = 0·27) and the proportions of individual oestrogens and pathways did not differ by meat-eating status. Restricting the models to the samples collected during the luteal phase strengthened the associations. Given the limitations of the study, the lower levels of serum oestrogens in semi-vegetarians than non-vegetarians need confirmation in larger populations.

  1. Mobile Phone App Aimed at Improving Iron Intake and Bioavailability in Premenopausal Women: A Qualitative Evaluation.

    PubMed

    Mann, Davina; Riddell, Lynn; Lim, Karen; Byrne, Linda K; Nowson, Caryl; Rigo, Manuela; Szymlek-Gay, Ewa A; Booth, Alison O

    2015-09-28

    Low iron intake can lead to iron deficiency, which can result in impaired health and iron-deficiency anemia. A mobile phone app, combining successful dietary strategies to increase bioavailable iron with strategies for behavior change, such as goal setting, monitoring, feedback, and resources for knowledge acquisition, was developed with the aim to increase bioavailable iron intake in premenopausal women. To evaluate the content, usability, and acceptability of a mobile phone app designed to improve intake of bioavailable dietary iron. Women aged 18-50 years with an Android mobile phone were invited to participate. Over a 2-week period women were asked to interact with the app. Following this period, semistructured focus groups with participants were conducted. Focus groups were audio recorded and analyzed via an inductive open-coding method using the qualitative analysis software NVivo 10. Themes were identified and frequency of code occurrence was calculated. Four focus groups (n=26) were conducted (age range 19-36 years, mean 24.7, SD 5.2). Two themes about the app's functionality were identified (frequency of occurrence in brackets): interface and design (134) and usability (86). Four themes about the app's components were identified: goal tracker (121), facts (78), photo diary (40), and games (46). A number of suggestions to improve the interface and design of the app were provided and will inform the ongoing development of the app. This research indicates that participants are interested in iron and their health and are willing to use an app utilizing behavior change strategies to increase intake of bioavailable iron. The inclusion of information about the link between diet and health, monitoring and tracking of the achievement of dietary goals, and weekly reviews of goals were also seen as valuable components of the app and should be considered in mobile health apps aimed at adult women.

  2. Changes in headache frequency in premenopausal obese women with migraine after bariatric surgery: a case series.

    PubMed

    Novack, V; Fuchs, L; Lantsberg, L; Kama, S; Lahoud, U; Horev, A; Loewenthal, N; Ifergane, G

    2011-10-01

    The association between migraine and obesity gives the clinician with an exciting possibility to alleviate migraine suffering through weight-reduction gastric-restrictive operations. We hypothesized that bariatric weight-reduction intervention (gastric banding) will be associated with reduction of migraine burden in this population. A total of 105 women between 18 and 50 years of age, admitted for bariatric surgery between April 2006 and February 2007, were screened for migraine. Twenty-nine with diagnosis of migraine were enrolled into the prospective phase. We followed the migraine pattern of these patients for 6 months post bariatric surgery. Baseline median migraine frequency was six headache days a month. Post bariatric surgery, the migraine-suffering women reported of a lower frequency of migraine attacks (p < 0.001), shorter duration of the attacks (p = 0.02), lower medication use during the attack (p = 0.005), less non-migraine pain (44.8 vs. 33%, p = 0.05), and post-bariatric surgery reduction in headache-related disability assessed by the MIDAS and HIT-6 scores. There was a reduction in migraine frequency among both episodic (from four to one episodes a month) and chronic (from 16.8 to 8.5 episodes per month) migraine patient cohorts separately and combined. Among migraine-suffering premenopausal obese women, we found a reduced frequency of migraine attacks and improvement of headache-related disability post bariatric surgery. Our findings should be interpreted cautiously. The absence of a control group and the non-blinded nature of our small study make it difficult to draw firm conclusions about the causal nature of the headache changes observed in this population. Further study is needed to evaluate the possible specific effects of surgical weight loss on migraine in obese women.

  3. Estrogen levels in serum and urine of vegetarian and omnivore premenopausal women

    PubMed Central

    Harmon, Brook; Morimoto, Yukiko; Beckford, Fanchon; Franke, Adrian A.; Stanczyk, Frank Z.; Maskarinec, Gertraud

    2014-01-01

    Objective Based on the hypothesis that high-meat diets may increase breast cancer risk through hormonal pathways, this analysis compared estrogens in serum and urine by meat-eating status. Design Intervention with repeated measures. Setting Two randomized soy trials (BEAN1 and BEAN2) among premenopausal healthy women. Subjects BEAN1 participants completed 7 unannounced 24-hour dietary recalls and donated 5 blood and urine samples over 2 years. BEAN2 women provided 7 recalls and 3 samples over 13 months. Serum samples were analyzed for estrone (E1) and estradiol (E2) using radioimmunoassays. Nine estrogen metabolites were measured in urine by liquid chromatography mass spectrometry. Semi-vegetarians included women who reported <30 g/day of red meat, poultry, and fish and pescatarians who consumed <20 g/day of meat/poultry but >10 g/day of fish. All other women were classified as non-vegetarians. We applied mixed models to compute least-square means by vegetarian status adjusted for potential confounders. Results The mean age of the 272 participants was 41.9±4.5 years. Serum E1 (85 vs 100 pg/mL, p=0.04) and E2 (140 vs 154 pg/mL, p=0.04) levels were lower in the 37 semi-vegetarians than in the 235 non-vegetarians. The sum of the 9 urinary estrogen metabolites (183 vs 200 pmol/mg creatinine, p=0.27) and the proportions of individual estrogens and pathways did not differ by meat-eating status. Restricting the models to the samples collected during the luteal phase strengthened the associations. Conclusions Given the limitations of this study, the lower levels of serum estrogens in semi-vegetarians than non-vegetarians need confirmation in larger populations. PMID:24050121

  4. Dietary Patterns and Plasma Sex Hormones, Prolactin, and Sex Hormone-Binding Globulin in Premenopausal Women.

    PubMed

    Hirko, Kelly A; Spiegelman, Donna; Barnett, Junaidah B; Cho, Eunyoung; Willett, Walter C; Hankinson, Susan E; Eliassen, A Heather

    2016-05-01

    Sex hormones are important for breast cancer, but it is unclear whether dietary patterns influence hormone concentrations. Dietary pattern adherence scores for the alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Alternative Healthy Eating Index (AHEI) were calculated from semiquantitative food frequency questionnaires administered in 1995 and 1999. Premenopausal plasma concentrations of sex hormones were measured in samples collected in 1996 to 1999. We used generalized linear models to calculate geometric mean hormone concentrations across quartiles of dietary pattern scores among 1,990 women in the Nurses' Health Study II. We did not observe significant associations between sex hormone concentrations and the DASH pattern and only one suggestive association between follicular estrone concentrations and the aMED pattern [top vs. bottom quartile -4.4%, 95% confidence interval (CI), -10.6% to 2.1%; Ptrend = 0.06]. However, women in the top versus bottom quartile of AHEI score had lower concentrations of follicular (-9.1%; 95% CI, -16.1% to -1.4%; Ptrend = 0.04) and luteal (-7.5%; 95% CI, -13.6% to -0.9%; Ptrend = 0.01) estrone, luteal-free (-9.3%; 95% CI, -16.8% to -1.1%; Ptrend = 0.01) and total (-6.7 %; 95% CI, -14.3% to 1.5%; Ptrend = 0.04) estradiol, follicular estradiol (-14.2%; 95% CI, -24.6% to -2.4%; Ptrend = 0.05), and androstenedione (-7.8%; 95% CI, -15.4% to 0.4%; Ptrend = 0.03). Diet quality measured by the AHEI is inversely associated with premenopausal estrogen concentrations. Given that we did not observe similar associations with the aMED or DASH patterns, our findings should be interpreted with caution. Given the role of estrogens in breast cancer etiology, our findings add to the substantial evidence on the benefits of adhering to a healthy diet. Cancer Epidemiol Biomarkers Prev; 25(5); 791-8. ©2016 AACR. ©2016 American Association for Cancer Research.

  5. Sexual dysfunction in pre-menopausal diabetic women: clinical, metabolic, psychological, cardiovascular, and neurophysiologic correlates.

    PubMed

    Cortelazzi, Donatella; Marconi, Annamaria; Guazzi, Marco; Cristina, Maurizio; Zecchini, Barbara; Veronelli, Annamaria; Cattalini, Claudio; Innocenti, Alessandro; Bosco, Giovanna; Pontiroli, Antonio E

    2013-12-01

    An increased prevalence of female sexual dysfunction (FSD) has been reported in women with diabetes mellitus (DM). Our aim was to evaluate correlates (psychological, cardiovascular, and neurophysiologic) of FSD in DM women without chronic diabetic complications. Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), Michigan Diabetic Neuropathy Index (DNI), and the symptoms of diabetic neuropathy (SDN) questionnaires, metabolic variables, endothelial vascular function (flow-mediated dilation, FMD), echocardiography, and electromyography were studied. 109 pre-menopausal women (18-50 years) [48 with DM (14 type 1 DM, 34 type 2 DM, duration 12.6 ± 1.91 years), and 61 healthy women] received the above questionnaires; physical activity, smoking habits, parity, BMI, waist circumference, HOMA-IR index, fibrinogen, cholesterol (total, HDL, LDL), triglycerides, HbA1c, high-sensitivity C-reactive protein, total testosterone, and estradiol were measured; echocardiography, assessment of intima-media thickness (IMT), FMD, ECG (heart rate and Qtc, indexes of sympathetic activity), and electromyography were performed. FSFI total score and score for arousal, lubrication, and orgasm domains were lower in DM women than in controls (P < 0.05); DM women had higher BDI, Doppler A wave peak velocity, DNI, and SDN score (P < 0.001 to P < 0.04). Doppler E wave peak velocity, peroneal, posterior tibial and sural nerves conduction velocity and amplitude were lower in diabetic women than in controls (P < 0.05 to P < 0.001). FSFI score was positively correlated with physical activity, Doppler E wave peak velocity, and peroneal nerve amplitude and negatively with BDI, parity, IMT, SDN, and HbA1c (P < 0.05 to P < 0.001). At stepwise regression, SDN score (negatively) and Doppler E wave peak velocity (positively) predicted FSFI score (r = 507, P < 0.001). In conclusion, cardiovascular and neurological impairments are associated with FSD in diabetic women. Follow-up studies are

  6. Markers of subclinical atherosclerosis in premenopausal women with vitamin D deficiency and effect of vitamin D replacement.

    PubMed

    Gurses, Kadri Murat; Tokgozoglu, Lale; Yalcin, Muhammed Ulvi; Kocyigit, Duygu; Dural, Muhammet; Canpinar, Hande; Yorgun, Hikmet; Sahiner, Mehmet Levent; Kaya, Ergun Baris; Akin, Safak; Gurlek, Alper; Guc, Dicle; Aytemir, Kudret

    2014-12-01

    Recent studies have revealed a relationship between vitamin D deficiency and atherosclerosis. This study aims to investigate the impact of vitamin D deficiency and replacement on markers of subclinical atherosclerosis in young premenopausal women in whom vitamin D deficiency is prevalent. Thirty-one premenopausal vitamin D deficient women and 27 age and gender-matched control subjects were enrolled in this study. Markers of subclinical atherosclerosis including carotid intima-media thickness (cIMT), flow-mediated dilatation (FMD), endothelial progenitor cell (EPC) count and cytokine levels were determined at baseline. All measurements were repeated at 6-month follow-up in vitamin D-deficient subjects after vitamin D replacement. Vitamin D deficient premenopausal women had lower FMD (9.9 ± 1.3 vs. 13.8 ± 1.7%, p < 0.001) and EPC counts at baseline. This population also had lower IL-10 and higher IL-17 levels. A 6-month vitamin D replacement therapy resulted in a significant increase in FMD (9.9 ± 1.3 vs. 11.4 ± 1.4%, p < 0.001) and EPC counts. Furthermore, cytokine profile shifted toward a more anti-inflammatory phenotype including elevated IL-10 and decreased IL-17 levels. cIMT was not different between patient and control groups and did not change following vitamin D replacement. Change in 25(OH)D and IL-17 levels were independent predictors of the change in FMD measurements following vitamin D replacement. This study demonstrates that endothelial function is impaired in otherwise healthy vitamin D deficient young premenopausal women and improves with 6-month replacement therapy. Immune-modulatory effects of vitamin D may, at least partly, be responsible for its beneficial effects on vascular health. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Chemotherapy-induced amenorrhea and the resumption of menstruation in premenopausal women with hormone receptor-positive early breast cancer.

    PubMed

    Koga, Chinami; Akiyoshi, Sayuri; Ishida, Mayumi; Nakamura, Yoshiaki; Ohno, Shinji; Tokunaga, Eriko

    2017-09-01

    For premenopausal women with breast cancer, information on the effects of chemotherapy and the risk of infertility is important. In this study, the effect of chemotherapy on the ovarian function in premenopausal women with hormone receptor-positive breast cancer was investigated, with an age-stratified analysis of the appearance of amenorrhea and the resumption of menstruation after the use of chemotherapy with anthracyclines or taxanes. Premenopausal women diagnosed with operable Stage I-III hormone receptor-positive breast cancer and underwent neoadjuvant or adjuvant chemotherapy with the standard regimen of anthracyclines and/or taxanes were included. The patients were classified into age groups in 5-year increments, and the rates of chemotherapy-induced amenorrhea (CIA), resumption of menstruation, and duration of CIA after chemotherapy were analyzed. The subjects consisted of 101 patients (median age 45 years). CIA occurred in 97 (96%) patients and 40 patients resumed menstruation. In all patients aged ≤39 years menstruation restarted, whereas in all patients aged ≥50 years, menstruation did not restart. For the patients who resumed menstruation, the younger the patients, the sooner menstruation tended to restart. The resumption of menstruation occurred within 1 year for younger patients aged around 30 years, but for those aged ≥35 years, 60% of cases took around 2-3 years for resumption. The incidence of CIA, the resumption of menstruation and duration of CIA after chemotherapy depend greatly on the patient's age.

  8. High-density lipoprotein cholesterol, obesity, and mammographic density in Korean women: the Healthy Twin study.

    PubMed

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung; Kim, Sun-Young

    2011-01-01

    High-density lipoprotein cholesterol (HDL-C) is reported to be associated with breast cancer risk. To better understand this association, we examined the relationship between HDL-C and mammographic density, a putative intermediate risk factor for breast cancer. The study subjects were 711 Korean women from the Healthy Twin study. Lipid parameters were assayed enzymatically in fresh sera, and percent dense area (PDA) and absolute dense area were measured from digital mammograms using a computer-assisted method. PDA was positively associated with HDL-C in both premenopausal and postmenopausal women in a multivariable-adjusted linear mixed model, but the association did not persist when the model was additionally adjusted for body mass index (BMI). BMI was inversely associated with PDA, and this association did not change after additional adjustment for any lipid parameter. Multivariable-adjusted analysis showed that there were significant additive genetic cross-trait correlations between PDA and both HDL-C (coefficient, 0.175) and triglyceride (coefficient, -0.262). However, those correlations disappeared after additional adjustment for BMI. HDL-C alone is unlikely to increase the risk of breast cancer in Korean women, particularly through changes in breast parenchyma that are apparent in mammographic density. BMI should be included in studies using analytical models where mammographic density is used as an intermediate risk factor for breast cancer.

  9. Association of body size measurements and mammographic density in Korean women: the Healthy Twin study.

    PubMed

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung; Kim, Sun-Young

    2010-06-01

    Both greater body size and higher mammographic density seem to be associated with a risk of breast cancer. To understand a mechanism through which body size confers a higher risk of breast cancer, associations between mammographic measures and various measures of body size were examined. Study subjects were 730 Korean women selected from the Healthy Twin study. Body size measurements were completed according to standard protocol. Mammographic density was measured from digital mammograms using a computer-assisted method from which the total area and the dense area of the breast were calculated, and nondense area and percent of dense area were straightforwardly derived. Linear mixed models considering familial correlations were used for analyses. Total and nondense areas were positively associated with current body mass index (BMI), BMI at 35 years, total fat percent, waist circumference, and waist-hip ratio, whereas percent dense area was inversely associated with these characteristics in both premenopausal and postmenopausal women. Height was not associated with any mammographic measure. Total and nondense areas had strong positive genetic correlations with current BMI, total fat percent, waist circumference, and waist-hip ratio, whereas percent dense area had strong inverse genetic correlations with these body size measurements. Mammographic density and obesity are inversely associated with each other possibly from common genetic influences that have opposite effects on mammographic density and obesity in Korean women. The association between obesity and breast cancer does not seem to be mediated through mammographic density. Copyright 2010 AACR.

  10. The relationship between bone mineral density and mammographic density in Korean women: the Healthy Twin study.

    PubMed

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung

    2011-09-01

    Mammographic density is one of the strong risk factors for breast cancer. A potential mechanism for this association is that cumulative exposure to mammographic density may reflect cumulative exposure to hormones that stimulate cell division in breast stroma and epithelium, which may have corresponding effects on breast cancer development. Bone mineral density (BMD), a marker of lifetime estrogen exposure, has been found to be associated with breast cancer. We examined the association between BMD and mammographic density in a Korean population. Study subjects were 730 Korean women selected from the Healthy Twin study. BMD (g/cm(2)) was measured with dual-energy X-ray absorptiometry. Mammographic density was measured from digital mammograms using a computer-assisted thresholding method. Linear mixed model considering familial correlations and a wide range of covariates was used for analyses. Quantitative genetic analysis was completed using SOLAR. In premenopausal women, positive associations existed between absolute dense area and BMD at ribs, pelvis, and legs, and between percent dense area and BMD at pelvis and legs. However, in postmenopausal women, there was no association between BMD at any site and mammographic density measures. An evaluation of additive genetic cross-trait correlation showed that absolute dense area had a weak-positive additive genetic cross-trait correlation with BMD at ribs and spines after full adjustment of covariates. This finding suggests that the association between mammographic density and breast cancer could, at least in part, be attributable to an estrogen-related hormonal mechanism.

  11. Effects of menstrual cycle phase on metabolomic profiles in premenopausal women.

    PubMed

    Wallace, M; Hashim, Y Z H-Y; Wingfield, M; Culliton, M; McAuliffe, F; Gibney, M J; Brennan, L

    2010-04-01

    Characterization of the normal degree of physiological variation in the metabolomic profiles of healthy humans is a necessary step in the development of metabolomics as both a clinical research and diagnostic tool. This study investigated the effects of the menstrual cycle on (1)H nuclear magnetic resonance (NMR) derived metabolomic profiles of urine and plasma from healthy women. In this study, 34 healthy women were recruited and a first void urine and fasting blood sample were collected from each woman at four different time points during one menstrual cycle. Serum hormone levels were used in combination with the menstrual calendar to classify the urine and plasma samples into five different phases i.e. menstrual, follicular, periovulatory, luteal and premenstrual. The urine and plasma samples were analysed using (1)H NMR spectroscopy and subsequent data were analysed using principal component analysis (PCA) and partial least squares discriminant analysis. PCA of the urine spectra showed no separation of samples based on the phases of the menstrual cycle. Multivariate analysis of the plasma spectra showed a separation of the menstrual phase and the luteal phase samples (R(2) = 0.61, Q(2) = 0.41). Subsequent analysis revealed a significant decrease in levels of glutamine, glycine, alanine, lysine, serine and creatinine and a significant increase in levels of acetoacetate and very low density lipoprotein (VLDL CH(2)) during the luteal phase. These results establish a need to control for metabolic changes that occur in plasma due to the menstrual cycle in the design of future metabolomic studies involving premenopausal women.

  12. Relationship between leptin, adiponectin, bone mineral density, and measures of adiposity among pre-menopausal Hispanic and Caucasian women.

    PubMed

    King, George A; Deemer, Sarah E; Thompson, Dixie L

    2010-01-01

    The purpose of this study was to examine the relationship between fasting serum leptin and adiponectin levels with bone mineral density (BMD) and body composition in pre-menopausal, middle-aged Hispanic and Caucasian women. Participants' (68 Hispanic and 36 Caucasian) BMD and bone mineral content were measured by dual-energy X-ray absorptiometry, and body density was measured by hydrodensitometry. Serum leptin was determined by enzyme immunoassay and adiponectin by ELISA. Hispanic women had significantly higher leptin, BMD, and fat mass (FM), and lower adiponectin than Caucasian women. There was no significant correlation between leptin and BMD for Hispanic or Caucasian women; adiponectin was inversely correlated with BMD in Caucasian women only (p = 0.01). In both Hispanic and Caucasian women, lean body mass and adiponectin best explained the variance in BMD (r(2) = 0.25, p < 0.001). These data demonstrate no significant relationship between leptin and BMD of pre-menopausal, middle-aged Hispanic and Caucasian women, and a significant inverse relationship between adiponectin and BMD in Caucasian women. The role of adipocytokines in the regulation of BMD remains inconclusive and may vary across ethnic groups.

  13. Effect of moderate alcohol consumption on plasma opiate levels in premenopausal women

    SciTech Connect

    Bhathena, S.J.; Kim, Y.C.; Law, J.S.; Berlin, E.; Judd. J.T.; Reichman, M.E.; Taylor, P.R.; Schatzkin, A. NCI, Bethesda, MD )

    1991-03-15

    Opiate changes have been reported in response to excessive alcohol consumption. Different phases of the menstrual cycle also affect the opiate tone. The authors studied the effect of moderate alcohol consumption and the menstrual cycle per se on plasma opiates. Forty premenopausal women were given alcohol or a soft drink of equal caloric value for 3 menstrual cycles in a cross over study. The subjects were fed a controlled diet containing 35% of energy from fat. Blood was collected in the third menstrual cycle of each period during follicular (F), ovulatory (O) and luteal (L) phases. {beta}-endorphin, met-enkephalin and lwu-enkephalin (LE) were measured by radioimmunoassay. None of the opiates showed significant change after alcohol consumption though LE was consistently higher after alcohol consumption during all three phases of the menstrual cycle. There was a significant decrease in BEN during L phase compared to F phase while both enkephalins were higher during L phase than during F phase. Opiate levels during O phase were intermediate between F and L. Thus, in contrast to previously observed opiate changes following excessive alcohol consumption, they did not observe changes with moderate consumption.

  14. Effects of weight lifting on bone mineral density in premenopausal women.

    PubMed

    Gleeson, P B; Protas, E J; LeBlanc, A D; Schneider, V S; Evans, H J

    1990-02-01

    A group of 68 premenopausal women participated in a controlled 12 month exercise program. Two groups were matched according to age, body size (body mass index), and typical activity level. Data collection included bone mineral density (BMD) of the lumbar spine with dual-photon absorptiometry and of the os calcis with single-photon absorptiometry, lean body mass, urinary calcium/creatinine, and urinary gamma-carboxyglutamic acid (Gla). Subjects were given a daily 500 mg supplement of elemental calcium. There was no significant difference between groups in terms of diet, in urinary calcium/creatinine or Gla, or in lean body mass. The weight lifting group had a nonsignificant increase in mean lumbar BMD of 0.81% and the control group exhibited a nonsignificant decrease of 0.5%. However, a paired t-test revealed a significant change in the means in either group or as matched pairs. The relatively small change seen as a result of this modified Nautilus exercise program may prevent moderate weight lifting from being a practical answer for osteoporosis, even in a highly motivated population.

  15. IGF-I Polymorphism is Associated with Lean Mass, Exercise Economy and Performance Among Premenopausal Women

    PubMed Central

    López-Alarcón, Mardya; Hunter, Gary R.; Gower, Barba A.; Fernández, José R.

    2007-01-01

    Background We undertook this study to investigate the association of a genetic polymorphism of the insulin-like growth factor, IGF-I189, on body composition, exercise performance and exercise economy, after controlling for the independent effect of race as assessed by African genetic admixture (AFADM). Methods A total of 114 premenopausal sedentary women were genotyped for IGF-I189, obtaining measures of fat mass, lean body mass, VO2 during cycling and stairclimbing, time on treadmill and leg strength. A quantitative value for AFADM was derived from genotypic information of approximately 40 ancestry informative markers and used as covariate in statistical models. Results After adjusting for AFADM, IGF-I189 was negatively associated with lean body mass (p = 0.029) and lean leg mass (p = 0.050). Leg strength was not associated with the presence/absence of IGF-I189 (p = 0.380), but carriers of the allele demonstrated a longer time on the treadmill (p = 0.015) after adjusting for AFADM. There was also a negative relationship between oxygen uptake during cycling and presence of the IGF-I189 independent of AFADM (p = 0.010). Conclusion Independent of AFADM, individuals with IGF-I189 are more likely to have low leg lean mass and to perform better in activities requiring exercise economy and endurance performance. PMID:17174724

  16. Ovarian macrocysts and gonadotrope-ovarian axis disruption in premenopausal women receiving mitotane for adrenocortical carcinoma or Cushing's disease.

    PubMed

    Salenave, Sylvie; Bernard, Valérie; Do Cao, Christine; Guignat, Laurence; Bachelot, Anne; Leboulleux, Sophie; Droumaguet, Céline; Bry-Gauillard, Hélène; Pierre, Peggy; Crinière, Lise; Santulli, Pietro; Touraine, Philippe; Chanson, Philippe; Schlumberger, Martin; Maiter, Dominique; Baudin, Eric; Young, Jacques

    2015-02-01

    Mitotane is an adrenolytic and anticortisolic drug used in adrenocortical carcinoma (ACC), Cushing's disease (CD), and ectopic ACTH syndrome. Its effects on the ovaries are unknown. To evaluate the ovarian and gonadotrope effects of mitotane therapy in premenopausal women. We studied 21 premenopausal women (ACC: n=13; CD: n=8; median age 33 years, range 18-45 years) receiving mitotane at a median initial dose of 3 g/day (range 1.5-6 g/day). Gynecological history was collected and ovarian ultrasound was performed. Four women also underwent ovarian CT or magnetic resonance imaging. Serum gonadotropin, estradiol (E2), androgens, sex hormone-binding globulin (SHBG), and circulating mitotane levels were determined at diagnosis and during mitotane therapy. In the women included, ovarian macrocysts (bilateral in 51%) were detected after a median 11 months (range: 3-36) of mitotane exposure. The median number of macrocysts per woman was two (range: 1-4) and the median diameter of the largest cysts was 50 mm (range: 26-90). Menstrual irregularities and/or pelvic pain were present in 15 out of 21 women at macrocyst diagnosis. In two women, the macrocysts were revealed by complications (ovarian torsion and hemorrhagic macrocyst rupture) that required surgery. Mitotane therapy was associated with a significant decrease in androstenedione and testosterone levels and a significant increase in LH levels. Serum FSH and E2 levels were also increased, and SHBG levels rose markedly. Mitotane therapy causes significant morphological and ovarian/gonadotrope hormonal abnormalities in premenopausal women. Follicular thecal steroid synthesis appears to be specifically altered and the subsequent increase in gonadotropins might explain the development of macrocysts. The mechanisms underlying these adverse effects, whose exact prevalence in this population still needs to be determined, are discussed. © 2015 European Society of Endocrinology.

  17. Biology and etiology of young-onset breast cancers among premenopausal African American women: results from the AMBER Consortium.

    PubMed

    Chollet-Hinton, Lynn; Olshan, Andrew F; Nichols, Hazel B; Anders, Carey K; Lund, Jennifer L; Allott, Emma H; Bethea, Traci N; Hong, Chi-Chen; Cohen, Stephanie M; Khoury, Thaer; Zirpoli, Gary R; Borges, Virginia F; Rosenberg, Lynn A; Bandera, Elisa V; Ambrosone, Christine B; Palmer, Julie R; Troester, Melissa A

    2017-09-13

    African American (AA) women have higher incidence of aggressive, young-onset (<40 years) breast cancers. Young- and older-onset disease may have distinct tumor biologies and etiologies; however, studies investigating age differences among AA women have been rare and generally underpowered. We examined tumor characteristics and breast cancer risk factors associated with premenopausal young (<40) vs. older (≥40) AA women's breast cancer in the African American Breast Cancer Epidemiology and Risk Consortium (2,008 cases and 5,144 controls). Unconditional logistic regression models assessed heterogeneity of tumor biology and risk factor associations by age, overall and by estrogen receptor status. Premenopausal AA women <40 years had higher frequency of poorer-prognosis tumor characteristics compared to older women, including negative estrogen and progesterone receptor status, triple-negative subtype, high grade, higher stage, and larger tumors. Adiposity (i.e., waist-to-hip ratio) and family history of breast cancer were more strongly associated with young-onset disease (case-control OR=1.46, 95% CI=1.04,2.05; OR=3.10, 95% CI=2.08,4.63, respectively) compared to older-onset disease (OR=1.11, 95% CI=0.91,1.35; OR=1.57, 95% CI=1.26,1.94). Breastfeeding showed a slight inverse risk association among young women (OR=0.70, 95% CI=0.43,1.16). Oral contraceptive use was associated with increased risk regardless of age. Considering various cutpoints for young age (<40, <45, <50), age-related heterogeneity was greatest when <40 was used. Among premenopausal AA women, diagnosis before age 40 is associated with more aggressive breast tumor biology and some etiologic differences. Modifiable risk factors including breastfeeding, adiposity, and oral contraceptive use may be important targets for mitigating harms of young-onset breast cancer. Copyright ©2017, American Association for Cancer Research.

  18. Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration.

    PubMed

    Krayenbuehl, Pierre-Alexandre; Battegay, Edouard; Breymann, Christian; Furrer, Joerg; Schulthess, Georg

    2011-09-22

    This is the first study to investigate the efficacy of intravenous iron in treating fatigue in nonanemic patients with low serum ferritin concentration. In a randomized, double-blinded, placebo-controlled study, 90 premenopausal women presenting with fatigue, serum ferritin ≤ 50 ng/mL, and hemoglobin ≥ 120 g/L were randomized to receive either 800 mg of intravenous iron (III)-hydroxide sucrose or intravenous placebo. Fatigue and serum iron status were assessed at baseline and after 6 and 12 weeks. Median fatigue at baseline was 4.5 (on a 0-10 scale). Fatigue decreased during the initial 6 weeks by 1.1 in the iron group compared with 0.7 in the placebo group (P = .07). Efficacy of iron was bound to depleted iron stores: In patients with baseline serum ferritin ≤ 15 ng/mL, fatigue decreased by 1.8 in the iron group compared with 0.4 in the placebo group (P = .005), and 82% of iron-treated compared with 47% of placebo-treated patients reported improved fatigue (P = .03). Drug-associated adverse events were observed in 21% of iron-treated patients and in 7% of placebo-treated patients (P = .05); none of these events was serious. Intravenous administration of iron improved fatigue in iron-deficient, nonanemic women with a good safety and tolerability profile. The efficacy of intravenous iron was bound to a serum ferritin concentration ≤ 15 ng/mL. This study was registered at the International Standard Randomized Controlled Trial Number Register (www.isrctn.org) as ISRCTN78430425.

  19. Korean and American music reduces pain in Korean women after gynecologic surgery.

    PubMed

    Good, Marion; Ahn, Sukhee

    2008-09-01

    American music has been found to relieve pain in adults in several countries but has not been tested in Korea. Korean women have reported that they would like American music as well as Korean folk songs and religious music sung in Korean. The study purpose was to pilot-test the effects of music on pain after gynecologic surgery in Korean women and to compare pain relief between those who chose American or Korean music. Using a quasiexperimental pretest-posttest design, 73 South Korean women on a preoperative unit were assigned by day of the week to receive music (n = 34; 47%) or no music (n = 39; 53%). The music group chose among Korean (ballads and religious and popular songs) and American (soft slow piano and orchestra) music and heard it for 15 minutes at four time points (postoperatively), whereas the controls rested in bed. They marked VAS Sensation and Distress of Pain scales before and after each test. The two groups were similar on pretest pain. When controlling for pretest pain, MANCOVA indicated that there was significantly less posttest pain in those with music plus analgesics than those with analgesics alone at three of the four tests: p = .04 to .001. Two-thirds in the music group (n = 21; 62%) chose Korean music and one-third (n = 13; 38%) chose American, with no difference in pain: both were effective. In addition to analgesics, music can be used to reduce postoperative pain in Korean women. Patients selected music that was appealing to them. Nurses in many countries can consider music of the country and seek individual preferences to use in addition to analgesics for postoperative pain.

  20. Low Skeletal Muscle Mass is Associated with the Risk of Low Bone Mineral Density in Urban Dwelling Premenopausal Women.

    PubMed

    Kim, In Je; Kang, Kwi Young

    2017-08-21

    To evaluate the relationship between skeletal muscle mass and bone mineral density (BMD) and to determine the association between low skeletal muscle mass and low BMD in urban dwelling young adults. This study was based on data from the 2008-2011 Korea National Health and Nutrition Examination Surveys. The subjects were 1702 20-49-year-old men and 2192 premenopausal women (age 20-55 years). BMD at the lumbar spine, femoral neck, and total hip and the appendicular skeletal muscle mass (ASM) were measured by dual-energy X-ray absorptiometry. Skeletal muscle mass index (SMI) was defined as weight-adjusted ASM. Mildly and severely low muscle skeletal mass were defined as SMI that was 1-2 and >2 standard deviations below the sex-specific mean ASM of young adults, respectively. Low BMD was defined as T score of less than -1.0 at the lumbar spine, femoral neck, and/or total hip. After adjusting for confounders, skeletal muscle mass was positively associated with BMD at the lumbar spine, femoral neck, and total hip in both men and women. Mildly and severely low skeletal muscle mass increased the risk of low BMD in premenopausal women [OR (95% CI) = 1.4 (1.1-1.9) and 2.4 (1.2-4.6), respectively] but not men. In women, low skeletal muscle mass independently was associated with the risk of low BMD at the femoral neck and total hip but not the lumbar spine. Skeletal muscle mass was independently associated with BMD in urban dwelling young men and women, but low skeletal muscle mass was associated with the risk of low BMD in premenopausal women only.

  1. [Effect of angiotensin converting enzyme lisinopril on the state of vascular bed in premenopausal women with arterial hypertension].

    PubMed

    Khabibulina, M M

    2013-01-01

    We assessed effect of lisinopril on structural-functional state of vascular bed in 82 premenopausal women with hypoestrogenia and arterial hypertension (AH). Test with postocclusion reactive hyperemia showed that at the background of significant lowering of endothelial vasomotor function before treatment 47.5% of women had inertial type of vasomotor reaction. This evidenced for considerable role of dyshormonal states in progression of AH first of all at the account of increase of vascular stiffness and development of endothelial dysfunction. Lisinopril improved structural-functional state of vascular wall of common carotid arteries, affected positively dysfunction of endothelium, lowered stiffness of arterial vascular wall.

  2. Adherence to cancer prevention recommendations and antioxidant and inflammatory status in premenopausal women.

    PubMed

    Morimoto, Yukiko; Beckford, Fanchon; Cooney, Robert V; Franke, Adrian A; Maskarinec, Gertraud

    2015-07-14

    For cancer prevention, the World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) emphasise recommendations to improve individual behaviour, including avoidance of tobacco products, maintaining a lean body mass, participating in physical activity, consuming a plant-based diet, and minimising the consumption of energy-dense foods, such as sodas, red and processed meats and alcohol. In the present study of 275 healthy premenopausal women, we explored the association of adherence scores with levels of three biomarkers of antioxidant and inflammation status: serum C-reactive protein (CRP), serum γ-tocopherol and urinary F2-isoprostane. The statistical analysis applied linear regression across categories of adherence to WCRF/AICR recommendations. Overall, seventy-two women were classified as low ( ≤ 4), 150 as moderate (5-6), and fifty-three as high adherers ( ≥ 7). The unadjusted means for CRP were 2.7, 2.0 and 1.7 mg/l for low, moderate and high adherers (P trend= 0.03); this association was strengthened after adjustment for confounders (P trend= 0.006). The respective values for serum γ-tocopherol were 1.97, 1.63 and 1.45 μg/ml (P trend= 0.02 before and P trend= 0.03 after adjustment). Only for urinary F2-isoprostane, the lower values in high adherers (16.0, 14.5, and 13.3 ng/ml) did not reach statistical significance (P trend= 0.18). In an analysis by BMI, overweight and obese women had higher biomarker levels than normal weight women; the trend was significant for CRP (P trend< 0.001) and γ-tocopherol (P trend= 0.003) but not for F2-isoprostane (P trend= 0.14). These findings suggest that both adherence to the WCRF/AICR guidelines and normal BMI status are associated with lower levels of biomarkers that indicate oxidative stress and inflammation.

  3. Adjuvant treatment of premenopausal women with endocrine-responsive early breast cancer: Design of the TEXT and SOFT trials

    PubMed Central

    Regan, Meredith M.; Pagani, Olivia; Fleming, Gini F.; Walley, Barbara A.; Price, Karen N.; Rabaglio, Manuela; Maibach, Rudolf; Ruepp, Barbara; Coates, Alan S.; Goldhirschi, Aron; Colleoni, Marco; Gelber, Richard D.; Francisl, Prudence A.

    2013-01-01

    Objectives In 2003 the International Breast Cancer Study Group (IBCSG) initiated the TEXT and SOFT randomized phase III trials to answer two questions concerning adjuvant treatment for premenopausal women with endocrine-responsive early breast cancer: 1-What is the role of aromatase inhibitors (AI) for women treated with ovarian function suppression (OFS)? 2-What is the role of OFS for women who remain premenopausal and are treated with tamoxifen? Methods TEXT randomized patients to receive exemestane or tamoxifen with OFS. SOFT randomized patients to receive exemestane with OFS, tamoxifen with OFS, or tamoxifen alone. Treatment was for 5 years from randomization. Results TEXT and SOFT successfully met their enrollment goals in 2011. The 5738 enrolled women had lower-risk disease and lower observed disease-free survival (DFS) event rates than anticipated. Consequently, 7 and 13 additional years of follow-up for TEXT and SOFT, respectively, were required to reach the targeted DFS events (median follow-up about 10.5 and 15 years). To provide timely answers, protocol amendments in 2011 specified analyses based on chronological time and median follow-up . To assess the AI question, exemestane+OFS versus tamoxifen+OFS, a combined analysis of TEXT and SOFT became the primary analysis (n=4717). The OFS question became the primary analysis from SOFT, the unique comparison of tamoxifen+OFS versus tamoxifen alone (n=2045). The first reports are anticipated in mid- and late-2014. Conclusions We present the original designs of TEXT and SOFT and adaptations to ensure timely answers to two questions concerning optimal adjuvant endocrine treatment for premenopausal women with endocrine-responsive breast cancer. PMID:24095609

  4. Expression profile of BRCA1 and BRCA2 genes in premenopausal Mexican women with breast cancer: clinical and immunohistochemical correlates.

    PubMed

    Loredo-Pozos, Gloria; Chiquete, Erwin; Oceguera-Villanueva, Antonio; Panduro, Arturo; Siller-López, Fernando; Ramos-Márquez, Martha E

    2009-01-01

    Low BRCA1 gene expression is associated with increased invasiveness and influences the response of breast carcinoma (BC) to chemotherapeutics. However, expression of BRCA1 and BRCA2 genes has not been completely characterized in premenopausal BC. We analyzed the clinical and immunohistochemical correlates of BRCA1 and BRCA2 expression in young BC women. We studied 62 women (mean age 38.8 years) who developed BC before the age of 45 years. BRCA1 and BRCA2 mRNA expression was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR) and that of HER-2 and p53 proteins by immunohistochemistry. Body mass index (BMI) > or = 27 (52%) and a declared family history of BC (26%) were the main risk factors. Ductal infiltrative adenocarcinoma was found in 86% of the cases (tumor size >5 cm in 48%). Disease stages I-IV occurred in 2, 40, 55, and 3%, respectively (73% implicating lymph nodes). Women aged < or = 35 years (24%) had more family history of cervical cancer, stage III/IV disease, HER-2 positivity, and lower BRCA1 expression than older women (P < 0.05). BRCA1 and BRCA2 expression correlated in healthy, but not in tumor tissues (TT). Neither BRCA1 nor BRCA2 expression was associated with tumor histology, differentiation, nodal metastasis or p53 and HER-2 expression. After multivariate analysis, only disease stage explained BRCA1 mRNA levels in the lowest quartile. Premenopausal BC has aggressive clinical and molecular characteristics. Low BRCA1 mRNA expression is associated mainly with younger ages and advanced clinical stage of premenopausal BC. BRCA2 expression is not associated with disease severity in young BC women.

  5. Demographic, lifestyle, and other factors in relation to antimüllerian hormone levels in mostly late premenopausal women.

    PubMed

    Jung, Seungyoun; Allen, Naomi; Arslan, Alan A; Baglietto, Laura; Brinton, Louise A; Egleston, Brian L; Falk, Roni; Fortner, Renée T; Helzlsouer, Kathy J; Idahl, Annika; Kaaks, Rudolph; Lundin, Eva; Merritt, Melissa; Onland-Moret, Charlotte; Rinaldi, Sabina; Sánchez, María-José; Sieri, Sabina; Schock, Helena; Shu, Xiao-Ou; Sluss, Patrick M; Staats, Paul N; Travis, Ruth C; Tjønneland, Anne; Trichopoulou, Antonia; Tworoger, Shelley; Visvanathan, Kala; Krogh, Vittorio; Weiderpass, Elisabete; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Dorgan, Joanne F

    2017-04-01

    To identify reproductive, lifestyle, hormonal, and other correlates of circulating antimüllerian hormone (AMH) concentrations in mostly late premenopausal women. Cross-sectional study. Not applicable. A total of 671 premenopausal women not known to have cancer. None. Concentrations of AMH were measured in a single laboratory using the picoAMH ELISA. Multivariable-adjusted median (and interquartile range) AMH concentrations were calculated using quantile regression for several potential correlates. Older women had significantly lower AMH concentrations (≥40 [n = 444] vs. <35 years [n = 64], multivariable-adjusted median 0.73 ng/mL vs. 2.52 ng/mL). Concentrations of AMH were also significantly lower among women with earlier age at menarche (<12 [n = 96] vs. ≥14 years [n = 200]: 0.90 ng/mL vs. 1.12 ng/mL) and among current users of oral contraceptives (n = 27) compared with never or former users (n = 468) (0.36 ng/mL vs. 1.15 ng/mL). Race, body mass index, education, height, smoking status, parity, and menstrual cycle phase were not significantly associated with AMH concentrations. There were no significant associations between AMH concentrations and androgen or sex hormone-binding globulin concentrations or with factors related to blood collection (e.g., sample type, time, season, and year of blood collection). Among premenopausal women, lower AMH concentrations are associated with older age, a younger age at menarche, and currently using oral contraceptives, suggesting these factors are related to a lower number or decreased secretory activity of ovarian follicles. Copyright © 2017 American Society for Reproductive Medicine. All rights reserved.

  6. Association of SLC2A9 genotype with phenotypic variability of serum urate in pre-menopausal women

    PubMed Central

    Topless, Ruth K.; Flynn, Tanya J.; Cadzow, Murray; Stamp, Lisa K.; Dalbeth, Nicola; Black, Michael A.; Merriman, Tony R.

    2015-01-01

    The SLC2A9 gene, that encodes a renal uric acid reuptake transporter, has genetic variants that explain ∼3% of variance in urate levels. There are previous reports of non-additive interaction between SLC2A9 genotype and environmental factors which influence urate control. Therefore, our aim was to further investigate the general phenomenon that such non-additive interactions contribute to genotype-specific association with variance at SLC2A9. Data from 14135 European individuals were used in this analysis. The measure of variance was derived from a ranked inverse normal transformation of residuals obtained by regressing known urate-influencing factors (sex, age, and body mass index) against urate. Variant rs6449173 showed the most significant effect on serum urate variance at SLC2A9 (P = 7.9 × 10-14), which was maintained after accounting for the effect on average serum urate levels (P = 0.022). Noting the stronger effect in a sub-cohort that consisted of pre-menopausal women and younger men, the participants were stratified into males and pre-menopausal and post-menopausal women. This revealed a strong effect on variance in pre-menopausal women (P = 3.7 × 10-5) with a weak effect in post-menopausal women (P = 0.032) and no effect in men (P = 0.22). The T-allele of rs6449173, which associates with increased urate levels, was associated with the greater variance in urate. There was a non-additive interaction between rs6449173 genotype and female gender in control of serum urate levels that was driven by a greater increase in urate levels associated with the T-allele in women. Female hormones, and/or other factors they influence or are associated with (such as iron levels, temperature, testosterone) interact with SLC2A9 genotype in women to determine urate levels. The association of SLC2A9 with greater variance in pre-menopausal women may reflect the cyclical changes resulting from menstruation. PMID:26528330

  7. Total dietary antioxidant capacity and lung function in an Italian population: a favorable role in premenopausal/never smoker women.

    PubMed

    di Giuseppe, R; Arcari, A; Serafini, M; Di Castelnuovo, A; Zito, F; De Curtis, A; Sieri, S; Krogh, V; Pellegrini, N; Schünemann, H J; Donati, M B; de Gaetano, G; Iacoviello, L

    2012-01-01

    Antioxidant-rich foods may favorably influence lung function. We examined possible associations between the total dietary antioxidant capacity (TAC) and pulmonary function in a healthy Italian population. Until May 2009, 22,300 persons were randomly recruited from the general population in the Moli-sani project. A sample only including healthy women (5824) and men (5848) was analyzed. TAC was measured in foods by three different assays and the ferric reducing-antioxidant power (FRAP) assay was selected as the better indicator of dietary TAC. The European Investigation into Cancer and Nutrition Food Frequency Questionnaire was used for dietary assessment. The association between quintiles of dietary FRAP and pulmonary indexes was assessed using analysis of variance separately for men and women. After adjustment for confounders, women in the highest quintile of FRAP intake had +39 ml forced expiratory volume in the first second (FEV(1)) and +54 ml forced vital capacity, compared with those in the lowest quintile (P for trend ≤0.006). Stratified analysis showed that this relationship only occurred in women who were premenopausal/never smokers. In this subgroup, the observed effect of higher FRAP intake on FEV(1) was equivalent to an improvement in pulmonary age of 3.3 years. In men, all significant associations between pulmonary function and TAC were lost after adjustment for confounding. Dietary TAC may have a favorable role in respiratory health, particularly in premenopausal/never smoker women.

  8. Significant bone microarchitecture impairment in premenopausal women with active celiac disease.

    PubMed

    Zanchetta, María Belén; Costa, Florencia; Longobardi, Vanesa; Longarini, Gabriela; Mazure, Roberto Martín; Moreno, María Laura; Vázquez, Horacio; Silveira, Fernando; Niveloni, Sonia; Smecuol, Edgardo; Temprano, María de la Paz; Hwang, Hui Jer; González, Andrea; Mauriño, Eduardo César; Bogado, Cesar; Zanchetta, Jose R; Bai, Julio César

    2015-07-01

    Patients with active celiac disease (CD) are more likely to have osteoporosis and increased risk of fractures. High-resolution peripheral quantitative computed tomography (HR-pQCT) permits three-dimensional exploration of bone microarchitectural characteristics measuring separately cortical and trabecular compartments, and giving a more profound insight into bone disease pathophysiology and fracture. We aimed to determine the volumetric and microarchitectural characteristics of peripheral bones-distal radius and tibia-in an adult premenopausal cohort with active CD assessed at diagnosis. We prospectively enrolled 31 consecutive premenopausal women with newly diagnosed CD (median age 29 years, range: 18-49) and 22 healthy women of similar age (median age 30 years, range 21-41) and body mass index. Compared with controls, peripheral bones of CD patients were significantly lower in terms of total volumetric density mg/cm(3) (mean ± SD: 274.7 ± 51.7 vs. 324.7 ± 45.8, p 0.0006 at the radius; 264.4 ± 48.7 vs. 307 ± 40.7, p 0.002 at the tibia), trabecular density mg/cm(3) (118.6 ± 31.5 vs. 161.9 ± 33.6, p<0.0001 at the radius; 127.9 ± 28.7 vs. 157.6 ± 15.6, p < 0.0001 at the tibia); bone volume/trabecular volume ratio % (9.9 ± 2.6 vs. 13.5 ± 2.8, p<0.0001 at the radius; 10.6 ± 2.4 vs. 13.1 ± 1.3, p < 0.0001 at the tibia); number of trabeculae 1/mm (1.69 ± 0.27 vs. 1.89 ± 0.26, p 0.009 at the radius; 1.53 ± 0.32 vs. 1.80 ± 0.26, p 0.002 at the tibia); and trabecular thickness mm (0.058 ± 0.010 vs. 0.071 ± 0.008, p < 0.0001 at the radius with no significant difference at the tibia). Cortical density was significantly lower in both regions (D comp mg/cm(3) 860 ± 57.2 vs. 893.9 ± 43, p 0.02; 902.7 ± 48.7 vs. 932.6 ± 32.6, p 0.01 in radius and tibia respectively). Although cortical thickness was lower in CD patients, it failed to show any significant inter-group difference (a-8% decay with p 0.11 in both bones). Patients with symptomatic CD (n = 22) had

  9. Laparoscopic hysterectomy with morcellation versus abdominal hysterectomy for presumed fibroids in premenopausal women: a decision analysis

    PubMed Central

    SIEDHOFF, Matthew T.; WHEELER, Stephanie B.; RUTSTEIN, Sarah E.; GELLER, Elizabeth J.; DOLL, Kemi M.; WU, Jennifer M.; CLARKE-PEARSON, Daniel L.

    2016-01-01

    Objective To model outcomes in laparoscopic hysterectomy with morcellation compared to abdominal hysterectomy for the presumed fibroid uterus, examining short-and long-term complications, as well as mortality. Study Design A decision tree was constructed to compare outcomes for a hypothetical cohort of 100,000 premenopausal women undergoing hysterectomy for presumed fibroids over a 5-year time horizon. Parameter and quality of life utility estimates were determined from published literature for postoperative complications, leiomyosarcoma incidence, death related to leiomyomsarcoma, and procedure-related death. Results The decision analysis predicted fewer overall deaths with laparoscopic hysterectomy compared to abdominal hysterectomy (98 vs. 103 per 100,000). While there were more deaths from leiomyosarcoma following laparoscopic hysterectomy (86 vs. 71 per 100,000), there were more hysterectomy-related deaths with abdominal hysterectomy (32 vs. 12 per 100,000). The laparoscopic group had lower rates of transfusion (2,400 vs. 4,700 per 100,000), wound infection (1,500 vs 6,300 per 100,000), venous thromboembolism (690 vs. 840 per 100,000) and incisional hernia (710 vs. 8,800 per 100,000), but a higher rate of vaginal cuff dehiscence (640 vs. 290 per 100,000). Laparoscopic hysterectomy resulted in more quality-adjusted life years (499,171 vs. 490,711 over five years). Conclusion The risk of leiomyosarcoma morcellation is balanced by procedure-related complications associated with laparotomy, including death. This analysis provides patients and surgeons with estimates of risk and benefit, upon which patient-centered decisions can be made. PMID:25817518

  10. The effects of power and strength training on bone mineral density in premenopausal women.

    PubMed

    Gray, M; Di Brezzo, R; Fort, I L

    2013-08-01

    The purpose of this 48-week exercise intervention was designed to examine the effects of power and resistance training on bone mineral density (BMD). Premenopausal women were recruited and randomly assigned to either a power (N.=8) or resistance (N.=11) training group. The power exercises included jumping rope, skipping, hopping, and other power-type exercises. The resistance training group performed 8-10 whole-body strengthening exercises at 70% one-repetition maximum (1RM). Before and after the exercise intervention, BMD was measured via dual energy x-ray absorptiometry (DXA) for the total-body, lumbar spine, left femoral neck, and left greater trochanter. Muscular strength was measured by hand grip dynamometer and 1RM of chest press and leg press. Muscular power was assessed by the Margaria-Kalamen stair climb test. Data were analyzed using repeated measures ANOVA. There were no statistical differences between the two training groups for any of the BMD measurements. Chest press strength was different between the two groups, increasing 6.41 and 1.1kg for the resistance and power groups, respectively over the course of the training period (F[1.15]=9.44, P<0.01). There was a significant time effect for leg press 1RM (F[1.15]=6.04, P=0.03). The participants increased by 12.37kg after the 48-week intervention. Hand grip strength also increased after the study intervention (F[1.16]=46.32, P<0.01). The results of this study suggest that power and resistance training are comparable techniques for maintaining bone density.

  11. Allopregnanolone Association with Psychophysiological and Cognitive Functions during Acute Smoking Abstinence in Premenopausal Women

    PubMed Central

    Allen, Alicia M.; al’Absi, Mustafa; Lando, Harry; Allen, Sharon S.

    2015-01-01

    Nicotine response may predict susceptibility to smoking relapse. Allopregnanolone, a neuroactive steroid metabolized from progesterone, has been shown to be associated with several symptoms of nicotine response. We sought to explore the association between allopregnanolone and response to nicotine during acute smoking abstinence in premenopausal women. Participants completed 2 nicotine response laboratory sessions, 1 in their follicular (low allopregnanolone) and 1 in their luteal (high allopregnanolone) menstrual phase, on the fourth day of biochemically confirmed smoking abstinence. During the laboratory sessions, participants self-administered a nicotine nasal spray and completed a timed series of cardiovascular, cognitive, and subjective assessments of response to nicotine. The relationships of allopregnanolone with baseline values and change scores of outcome measures were assessed via covariance pattern modeling. Study participants (n = 77) had a mean age of 29.9 (SD = 6.8) years and smoked 12.2 (4.9) cigarettes per day. Allopregnanolone concentration measured before nicotine administration was positively associated with systolic (β = 0.85, p = .04) and diastolic blood pressure (β = 1.19, p < .001); and self-report of physical symptoms (β = 0.58, p < .001), dizziness (β = 0.88, p < .01), jitteriness (β = 0.90, p = .04), and pleasantness (β = 2.05, p = .04). Allopregnanolone also had significant positive associations with change in cognition following nicotine nasal spray administration, specifically discriminability as a measure of attention (β = 1.15, p = .05) and response bias as a measure of impulsivity (β = 0.13, p = .02). These data suggest that allopregnanolone may be related to cardiovascular and subjective physical state during acute smoking abstinence, as well as cognitive response to nicotine. PMID:25643026

  12. Randomized trial of bilateral oophorectomy versus tamoxifen in premenopausal women with metastatic breast cancer.

    PubMed

    Ingle, J N; Krook, J E; Green, S J; Kubista, T P; Everson, L K; Ahmann, D L; Chang, M N; Bisel, H F; Windschitl, H E; Twito, D I

    1986-02-01

    A randomized clinical trial was performed to compare the efficacy of bilateral oophorectomy with that of tamoxifen at a dose of 10 mg twice daily in premenopausal women with metastatic breast cancer, and to examine the efficacy of each as a crossover treatment. Initial treatment responses were seen in ten of 27 patients (37%) treated with oophorectomy and seven of 26 patients (27%) treated with tamoxifen. The difference was not statistically significant. Crossover responses were seen in five of 15 patients (33%) treated with oophorectomy, including three responses in ten prior tamoxifen nonresponders; and two of 18 patients (11%) treated with tamoxifen. Time to progression distributions were not significantly different during initial treatment, and no significant differences in survival were noted. Thus, there was no overall disadvantage to the use of tamoxifen as opposed to oophorectomy as initial hormonal therapy, and a failure to respond to tamoxifen did not preclude a response to subsequent oophorectomy. Exploratory data analysis within subsets indicated consistent differential treatment effects in the visceral dominant patients. Of the 16 such patients treated with oophorectomy, eight (50%) experienced objective responses but there were no responses in the 14 patients treated with tamoxifen. In the nine visceral dominant crossover patients who had not responded to initial tamoxifen, three (33%) subsequently responded to oophorectomy. Time to progression distributions within the visceral dominant subset appeared to be better for the patients treated initially with oophorectomy. However, one must be very cautious in drawing conclusions from exploratory subset analyses, especially with the small sample size. Further studies would be required to test any hypothesis of differential organ site responsiveness.

  13. Impact exercise and bone density in premenopausal women with below average bone density for age.

    PubMed

    Greenway, Kathleen G; Walkley, Jeff W; Rich, Peter A

    2015-11-01

    To study the effects of two home-based impact exercise programs on areal bone mineral density (aBMD) in adult premenopausal women with below average aBMD for age (negative Z-scores; 40.8 years; n = 107). Two unilateral impact exercise programs were employed, one targeting the total hip and lumbar spine (n = 42 pairs), the other the distal radius (n = 24 pairs) with some individuals performing both. Force plate data were used to establish exercise loading characteristics (peak loads, time to peak), dual-energy X-ray absorptiometry (DXA) provided bone data. Calcium intake, health and extraneous physical activity (PA) were determined by survey. Exercise for both hip and spine consisted of unilateral landings from adjustable steps (maximum height 63.5 cm) while impacts were delivered to the forearm by arresting falls against a wall. An exercise log was used to provide the exercise prescription, record each exercise bout and any injuries. Participants were randomly assigned to exercise or control groups and pair-matched (age, BMI, Z-score, aBMD). Compliance was calculated as the number of sessions completed divided by the total prescribed number (mean ~50 %). The programs delivered significant gains pre to post at each site compared with significant losses in controls (forearm: 3.9 vs -3.9 %; total hip: 2.0 vs -2.6 %; lumbar spine: 2.8 vs -2.9 % exercise and controls, respectively, all p < 0.001). No exerciser lost bone at the target site regardless of compliance which was strongly correlated with bone gains (R (2) = 0.53-0.68, all p < 0.001). Impact exercise provides an effective means of improving below average aBMD without supervision in this at risk population.

  14. Age at menarche and its association with dysglycemia in Korean middle-aged women.

    PubMed

    Baek, Tae-Hwa; Lim, Nam-Kyoo; Kim, Min-Ju; Lee, Joungwon; Ryu, Seungho; Chang, Yoosoo; Choi, Yuni; Park, Hyun-Young

    2015-05-01

    Recent studies have demonstrated that earlier menarche is associated with increased risks of prediabetes and diabetes in white women; however, the associations have not been fully explored in Asian populations. We investigated the associations between age at menarche and prediabetes and/or diabetes in Korean middle-aged women. This was a cross-sectional study of 2,039 premenopausal and postmenopausal women aged 44 to 56 years who visited the health promotion center for medical checkups. Participants were divided into three groups based on age at menarche: early (<13 y), average (13-16 y), and late (>16 y). The mean (SD) age at menarche was 14.6 (1.6) years. Of 2,039 women, 820 and 85 women had prediabetes (impaired fasting glucose and/or 5.7%-6.4% glycated hemoglobin) and diabetes, respectively. On logistic regression analysis, earlier menarche was significantly associated with prediabetes (odds ratio [OR], 1.80; 95% CI, 1.24-2.61; P = 0.002), diabetes (OR, 2.43; 95% CI, 1.04-5.69; P = 0.04), and dysglycemia (OR, 1.85; 95% CI, 1.28-2.66; P = 0.001), after adjusting for a number of confounding factors, compared with average age at menarche. On linear regression analysis, earlier age at menarche was significantly associated with increased fasting insulin, homeostatic model assessment for insulin resistance, homeostatic model assessment for β-cell function, body mass index, and waist circumference. Age at menarche is inversely associated with various forms of dysglycemia. A history of earlier menarche may be helpful in predicting prediabetes and subsequent diabetes in Korean women.

  15. The effect of exercise on water balance in premenopausal physically active women.

    PubMed

    Weinheimer, Eileen M; Martin, Berdine R; Weaver, Connie M; Welch, Jo M; Campbell, Wayne W

    2008-10-01

    This controlled feeding study examined the effects of exercise on daily water intake (particularly ad libitum water intake), water output, whole-body water balance, and hydration status in physically active, premenopausal women. The randomized crossover design consisted of three 8-day trials: placebo and no exercise, placebo and exercise (1-hour cycling bout per day at 65%-70% of heart rate reserve), and 800 mg calcium supplementation and exercise. During each trial, controlled quantities of the same foods and beverages were provided and ad libitum water intake was quantified. Water input included measured water from foods and beverages, measured ad libitum intake, and estimated metabolic production. Water output included measured losses in urine and stool, and estimated insensible losses from respiration and non-sweating perspiration (insensible diffusion through the skin). Participants were 26 women, age 25+/-5 years, body mass index 22+/-2, and VO(2peak) 43+/-6 mLxkg(-1)xmin(-1) (mean+/-standard deviation). Ad libitum water intake was 363 g/day more (P<0.05) for the placebo and exercise (1,940+/-654 g/day) and calcium supplementation and exercise (1,935+/-668 g/day) trials, compared with placebo and no exercise trial (1,575+/-667 g/day), and total water input was correspondingly higher in placebo and exercise and calcium supplementation and exercise trials compared with the placebo and no exercise trial. Urine, stool, and total water outputs were not different among trials. Apparent net water balance (representative of sweat water output) was 367 g/day more (P<0.05) in placebo and exercise (679+/-427 g/day) and calcium supplementation and exercise (641+/-519 g/day) trials compared with placebo and no exercise trial (293+/-419 g/day). Hydration status was clinically normal during all three trials. Calcium supplementation did not influence water balance. These results support that young, physically active women can completely compensate for exercise-induced sweat

  16. Potential adverse effects of prophylactic bilateral salpingo-oophorectomy on skin aging in premenopausal women undergoing hysterectomy for benign conditions.

    PubMed

    Töz, Emrah; Özcan, Aykut; Balsak, Deniz; Avc, Muhittin Eftal; Eraslan, Arzu Görgülü; Balc, Didem Didar

    2016-02-01

    This study aimed to assess the effects of hysterectomy and bilateral salpingo-oophorectomy (BSO)--compared with the effects of hysterectomy alone--on skin aging in premenopausal women undergoing hysterectomy for benign conditions. One hundred thirty-five premenopausal women who underwent hysterectomy with BSO were compared with a control group of women who underwent hysterectomy alone based on skin parameters (including wrinkling, laxity/sagging, and texture/dryness) and Skindex-29 questionnaire scores. The inclusion criteria were as follows: aged between 40 and 50 years, follicle-stimulating hormone level lower than 40 mIU/mL, undergoing hysterectomy with or without BSO for benign conditions, and not receiving estrogen or progesterone treatment. The exclusion criteria were as follows: adrenocortical hyperplasia or Cushing's syndrome; use of corticosteroids for autoimmune diseases; malignancy, connective tissue diseases (eg, Ehlers-Danlos syndrome), or dermatological diseases (eg, lichen sclerosus); or regular use of medications known to interfere with the condition of the skin. All skin parameters in the hysterectomy group and the hysterectomy with BSO group worsened on weeks 24 and 48. Laxity/sagging and texture/dryness scores on weeks 24 and 48 were significantly worse in the BSO group; laxity/sagging and texture/dryness scores continued to worsen between 24 and 48 weeks. Scores for the Skindex-29 questionnaire emotion and symptom subscales were significantly higher in the BSO group compared with the non-BSO group. Prophylactic BSO during hysterectomy is a significant independent risk factor for worsening skin laxity/sagging and texture/dryness in premenopausal women undergoing hysterectomy for benign conditions. Prophylactic BSO in the presence of dermatological conditions is also associated with reduced quality of life.

  17. Birth outcomes of Korean women in Hawaii.

    PubMed Central

    Mor, J M; Alexander, G R; Kieffer, E C; Baruffi, G

    1993-01-01

    Since the end of the Korean War, immigration of Koreans to the United States has increased rapidly. In 1990, 11.6 percent of all Asians in the United States were of Korean ethnicity, and it is projected that Koreans will outnumber all other Asian groups, except Filipinos, in the United States by the year 2030. Despite the growing size of this population, very little is known about their health status. This study, using 1979-89 Hawaii vital record data, investigates the relationship between maternal sociodemographic characteristics, prenatal care utilization factors, and birth outcomes among Koreans as compared with Caucasians. The ethnic term "Caucasian" is used in Hawaii's vital records and is synonymous with non-Hispanic whites. Korean mothers were more likely to be older and have lower educational attainment, and less likely to be adolescent, single, or to have received adequate prenatal care than Caucasian mothers. More than 80 percent of the Korean mothers were foreign born. Significantly higher risks for very preterm delivery (less than 33 weeks) and very low birth weight births were observed for Koreans as compared with Caucasians. Nativity had no effect on birth outcome in this population. The results of this study suggest that prevention of preterm birth is an important focus for improving pregnancy outcomes in this growing ethnic group. PMID:8341786

  18. Influence of Body Composition, Oral Contraceptive Use, and Physical Activity on Bone Mineral Density in Premenopausal Women.

    PubMed

    Sherk, Vanessa D; Howard, Clint D; Bemben, Michael G; Bemben, Debra A

    In premenopausal women, low bone density may reflect attainment of a lower peak bone mass which can increase risk of osteoporosis after menopause. The purpose of this study was to examine the relationship between total body, lumbar spine, and proximal femur bone mineral density (BMD) and body composition and oral contraceptive (OC) use in 18-30 year old women. Sixty-five healthy women, split into groups of oral contraceptive users (OC, n = 36) and non oral contraceptive users (Non-OC, n = 29), completed Baecke physical activity, calcium intake, and menstrual history questionnaires. Total body, AP lumbar spine, and dual proximal femur scans were performed using Dual Energy X-Ray Absorptiometry (DXA). Body composition measures were obtained from the total body scan analysis. No significant differences were found for BMD in OC users and non-users. Bone free lean body mass (BFLBM) and weight were positively correlated to all BMD sites, and fat mass was related to total body and L1-L4 spine BMD (p < 0.05). Stepwise regression analyses determined that weight was a significant predictor for all BMD sites (p < 0.05). When separating the two components of body weight, BFLBM was a significant predictor for all BMD sites, and fat mass only predicted total body BMD. In conclusion, this study indicates that weight and BFLBM are significant contributors to BMD in young healthy premenopausal women, and OC use did not influence the relationship between BMD and BFLBM.

  19. Weight loss associated with reduced intake of carbohydrate reduces the atherogenicity of LDL in premenopausal women.

    PubMed

    Lofgren, Ingrid; Zern, Tosca; Herron, Kristin; West, Kristy; Sharman, Matthew J; Volek, Jeff S; Shachter, Neil S; Koo, Sung I; Fernandez, Maria Luz

    2005-09-01

    The effect of a 3-tier intervention including dietary modifications (ie, moderate energy restriction, decreased carbohydrate, increased protein), increased physical activity, and the use of carnitine as a dietary supplement was evaluated on plasma lipids and the atherogenicity of low-density lipoprotein (LDL) particles in a population of overweight and obese premenopausal (aged 20-45 years) women. Carnitine or a placebo (cellulose) was randomly assigned to the participants using a double-blind design. Carnitine supplementation was postulated to enhance fat oxidation resulting in lower concentrations of plasma triglycerides. Seventy women completed the 10-week protocol, which followed a reduction in their energy intake by 15% and a macronutrient energy distribution of 30% protein, 30% fat, and 40% carbohydrate. In addition, subjects increased the number of steps taken per day by 4500. As no differences were observed between the carnitine and placebo groups in all the measured parameters, all subjects were pooled together for statistical analysis. Participants decreased (P<.01) their caloric intake (between 4132.8 and 7770 kJ) and followed prescribed dietary modifications as assessed by dietary records. The average number of steps increased from 8950+/-3432 to 12764+/-4642 (P<.001). Body weight, plasma total cholesterol, LDL cholesterol, and triglyceride were decreased by 4.5%, 8.0%, 12.3%, and 19.2% (P<.0001), respectively, after the intervention. Likewise, apolipoproteins B and E decreased by 4.5% and 15% (P<.05) after 10 weeks. The LDL mean particle size was increased from 26.74 to 26.86 nm (P<.01), and the percent of the smaller LDL subfraction (P<.05) was decreased by 26.5% (P<.05) after 10 weeks. In addition, LDL lag time increased by 9.3% (P<.01), and LDL conjugated diene formation decreased by 23% (P<.01), indicating that the susceptibility of LDL to oxidation was decreased after the intervention. This study suggests that moderate weight loss (<5% of body

  20. Association between Intake of Sugar-Sweetened Beverages and Circulating 25-Hydroxyvitamin D Concentration among Premenopausal Women

    PubMed Central

    Duchaine, Caroline S.; Diorio, Caroline

    2014-01-01

    Intake of sugar-sweetened beverages has increased in North America and seems to have several adverse health effects possibly through decreased circulating 25-hydroxyvitamin D (25(OH)D) concentrations. The aim of this cross-sectional study was to evaluate the association between sugar-sweetened beverages intake and 25(OH)D concentrations among premenopausal women. Intake of sugar-sweetened beverages including colas, other carbonated beverages and sweet fruit drinks was assessed using a validated food frequency questionnaire among 741 premenopausal women. Plasma concentrations of 25(OH)D were quantified by radioimmunoassay. The association between sugar-sweetened beverages intake and 25(OH)D concentrations was evaluated using multivariate generalized linear models and Spearman correlations. A higher intake of colas was associated with lower mean 25(OH)D levels (67.0, 63.7, 64.7 and 58.5 nmol/L for never, <1, 1–3 and >3 servings/week, respectively; r = −0.11 (p = 0.004)). A correlation was observed between intake of other carbonated beverages and 25(OH)D concentrations but was not statistically significant (r = −0.06 (p = 0.10)). No association was observed between intake of sweet fruit drinks and 25(OH)D concentrations. This study suggests that high intake of colas may decrease 25(OH)D levels in premenopausal women. Considering the high consumption of these drinks in the general population and the possible consequences of vitamin D deficiency on health, this finding needs further investigation. PMID:25072269

  1. Association between intake of sugar-sweetened beverages and circulating 25-hydroxyvitamin D concentration among premenopausal women.

    PubMed

    Duchaine, Caroline S; Diorio, Caroline

    2014-07-28

    Intake of sugar-sweetened beverages has increased in North America and seems to have several adverse health effects possibly through decreased circulating 25-hydroxyvitamin D (25(OH)D) concentrations. The aim of this cross-sectional study was to evaluate the association between sugar-sweetened beverages intake and 25(OH)D concentrations among premenopausal women. Intake of sugar-sweetened beverages including colas, other carbonated beverages and sweet fruit drinks was assessed using a validated food frequency questionnaire among 741 premenopausal women. Plasma concentrations of 25(OH)D were quantified by radioimmunoassay. The association between sugar-sweetened beverages intake and 25(OH)D concentrations was evaluated using multivariate generalized linear models and Spearman correlations. A higher intake of colas was associated with lower mean 25(OH)D levels (67.0, 63.7, 64.7 and 58.5 nmol/L for never, <1, 1-3 and >3 servings/week, respectively; r = -0.11 (p = 0.004)). A correlation was observed between intake of other carbonated beverages and 25(OH)D concentrations but was not statistically significant (r = -0.06 (p = 0.10)). No association was observed between intake of sweet fruit drinks and 25(OH)D concentrations. This study suggests that high intake of colas may decrease 25(OH)D levels in premenopausal women. Considering the high consumption of these drinks in the general population and the possible consequences of vitamin D deficiency on health, this finding needs further investigation.

  2. High Prevalence of Vitamin D Deficiency Despite Supplementation in Premenopausal Women With Breast Cancer Undergoing Adjuvant Chemotherapy

    PubMed Central

    Crew, Katherine D.; Shane, Elizabeth; Cremers, Serge; McMahon, Donald J.; Irani, Dinaz; Hershman, Dawn L.

    2009-01-01

    Purpose Vitamin D deficiency is associated with increased breast cancer risk and decreased breast cancer survival. The purpose of this study was to determine the prevalence of vitamin D deficiency, as measured by serum 25-hydroxyvitamin D (25-OHD), in premenopausal women at initiation of adjuvant chemotherapy for breast cancer and after 1 year of vitamin D supplementation. Patients and Methods The study included 103 premenopausal women from the northeastern United States with stages I to III breast cancer who received adjuvant chemotherapy and participated in a 1-year zoledronate intervention trial. All patients were prescribed vitamin D3 (cholecalciferol) 400 IU and calcium carbonate 1,000 mg daily. At baseline and at 6 and 12 months, bone mineral density (BMD) measurements were obtained and blood was collected and analyzed in batches for serum 25-OHD. Vitamin D deficiency was defined as serum 25-OHD less than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as 30 ng/mL or greater. Results At baseline, 74% of women were vitamin D deficient (median, 17 ng/mL). Vitamin D deficiency was slightly less common in white women (66%) compared with black (80%) and Hispanic (84%) women. After vitamin D supplementation for 1 year, less than 15% of white and Hispanic women, and no black women, achieved sufficient 25-OHD levels. Vitamin D levels did not correlate with baseline BMD and were not altered by chemotherapy or bisphosphonate use. Conclusion Vitamin D deficiency is highly prevalent in women with breast cancer. The current recommended dietary allowance of vitamin D is too low to increase serum 25-OHD greater than 30 ng/mL. Optimal dosing for bone health and, possibly, improved survival has yet to be determined. PMID:19349547

  3. Studies of Korean and Japanese Women: An Analytical Guide.

    ERIC Educational Resources Information Center

    Koh, Hesung Chun, Comp.; And Others

    This is the first English language, book-length bibliography on Korean and Japanese women. The primary aim of the guide is to facilitate a wide variety of research, either descriptive or comparative, on Asian American women. The guide was designed with on-line interactive data retrieval in mind. Work toward this goal is now underway at the…

  4. Elevated neuroimmune biomarkers in sweat patches and plasma of premenopausal women with major depressive disorder in remission: the POWER study.

    PubMed

    Cizza, Giovanni; Marques, Andrea H; Eskandari, Farideh; Christie, Israel C; Torvik, Sara; Silverman, Marni N; Phillips, Terry M; Sternberg, Esther M

    2008-11-15

    Major depressive disorder (MDD) is inconsistently associated with elevations in proinflammatory cytokines and neuropeptides. We used a skin sweat patch, recently validated in healthy control subjects, and recycling immunoaffinity chromatography to measure neuroimmune biomarkers in patients with MDD mostly in remission. We collected blood at 8:00 am and applied skin sweat patches for 24 hours in 21- to 45-year-old premenopausal women (n = 19) with MDD (17/19 in remission) and age-matched healthy controls (n = 17) participating in the POWER (Premenopausal, Osteopenia/Osteoporosis, Women, Alendronate, Depression) Study. Proinflammatory cytokines, neuropeptide Y, substance P, and calcitonin-gene-related peptide were significantly higher and vasoactive intestinal peptide, a marker of parasympathetic activity, was significantly lower in patients compared to controls, and depressive symptomatology strongly correlated with biomarker levels. All analytes were strongly correlated in the skin sweat patch and plasma in patients (r = .73 to .99; p < .0004). The skin sweat patch allows detection of disrupted patterns of proinflammatory cytokines and neuropeptides in women with MDD in clinical remission, which could predispose to medical consequences such as cardiovascular disease, osteoporosis, and diabetes. This method permits measurement of cytokines in ambulatory settings where blood collection is not feasible.

  5. Brow archetype preferred by Korean women.

    PubMed

    Kim, Seong Kee; Cha, Seung Hyun; Hwang, Kun; Hwang, Se Won; Kim, Young Suk

    2014-07-01

    The aim of this study is to see which brow archetype is preferred by Korean women. The archetypes were chosen from a literature search, which contain detailed, replicable methods and have diagrams (Westmore, Lamas, Anastasia, Schreiber, and Hwang). A survey was conducted on 300 subjects (group A, 100 female medical students; group B, 100 women who had visited a plastic surgery clinic for periorbital rejuvenation; and group C, 100 women who visited the brow bar). They were asked whether they think there might be a method that yields an ideal brow archetype. In the cases where they said yes, they were asked to choose 1 of the illustrated 5 brow archetypes that they think is ideal. Among the 300 respondents, 232 (77.3%) thought there might be a method to yield an ideal brow archetype, whereas 68 (22.7%) answered they did not. The preference for the brow archetypes was different among the 5 archetypes (P = 0.0001, χ2). Anastasia was the most preferred (44.8%, brow starts on a perpendicular line drawn from the middle of the nostril, arches on a line drawn from the center of the nose through the center of the pupil, and ends on a line drawn from the edge of the corresponding nasal ala through the outer edge of the eye). Anastasia was followed by Lamas (22.0%). In group A, Anastasia (55.7%) was the most preferred, followed by Lamas (26.2%) and Westmore (13.1%). In group B, Anastasia (34.8%) was the most preferred, followed by Lamas (30.3%) and Westmore and Schreiber (both 13.5%). In group C, Anastasia (47.6%) was the most preferred, followed by Hwang (25.5%) and Westmore (11.0%). There was a significant difference (P < 0.001) among the 3 groups. There was a significant correlation between the preference of brow archetype and occupation (P = 0.0033). However, no significant differences were noted for the preference of brow archetype between the age groups of younger than 30 years and older than 30 years (P = 0.1374), level of education (P = 0.3403), marital status (P = 0

  6. Relationship between breast-feeding and bone mineral density among Korean women in the 2010 Korea National Health and Nutrition Examination Survey.

    PubMed

    Yeo, Ui Hyang; Choi, Chang Jin; Choi, Whan Seok; Kim, Kyung Soo

    2016-01-01

    Breast-feeding has the deleterious effect of hypoestrogenemia coupled with loss of calcium in the maternal bone mass. It is not clear whether changes in bone metabolism in lactating women lead to changes in maternal bone mineral density (BMD) over a longer period. The aim of the present study was to investigate the relationship between the duration of breast-feeding and BMD in healthy South Korean women. We analyzed data from the 2010 Korea National Health and Nutrition Examination Survey, a cross-sectional survey of Korean citizens. A total of 1342 women older than 19 years were selected for analysis. In postmenopausal women, the duration of breast-feeding per child was associated with low lumbar spine BMD after adjustment for age, body mass index, smoking, alcohol intake, physical activity, serum 25-hydroxyvitamin D level, and daily intake of calcium and calories (P < 0.05, P trend < 0.005). Prolonged breast-feeding for more than 1 year per child was associated with a deleterious effect on lumbar spine BMD compared with never breast-feeding or a shorter duration of breast-feeding (P < 0.05). These effects were not shown in premenopausal women or in femur BMD. In conclusion, the duration of breast-feeding per child is negatively correlated with lumbar spine BMD in postmenopausal women, but not in premenopausal women. Although the cause of the different results between postmenopausal and premenopausal women is not clear, our findings suggest that proper protective strategies should be recommended during prolonged breast-feeding to maintain bone health later in life.

  7. Predictors of coronary artery disease in middle-aged Taiwanese women at premenopause, postmenopause and after undergoing hysterectomy.

    PubMed

    Tsai, Ching-Ching; Hsieh, Ming-Hsiung; Yang, Hung-Yu; Chan, Paul; Jeng, Chii

    2016-09-01

    To examine the predictors of coronary artery disease among middle-aged women at various menopausal statuses. Few studies have explored coronary artery disease predictors among middle-aged women at various menopausal statuses, particularly with the inclusion of women who underwent a hysterectomy. A cross-sectional design was adopted. Two hundred and twenty-five middle-aged women who were waiting for catheterisation examinations because of possible coronary artery disease were selected. These patients were divided into premenopausal (n = 41), postmenopausal (n = 143) and women who had undergone a hysterectomy groups (n = 41). The differences in the risk factors for coronary artery disease between patients with coronary artery disease (catheterisation results showing stenosis of >50% in at least one major coronary artery) and those without coronary artery disease in the three groups were compared. The participants were aged 56·8 ± 5·9 years. In the premenopausal group, the odds of coronary artery disease among ever or current smokers was 8·46 times the odds of coronary artery disease for the never smokers. In the postmenopausal group, the odds of coronary artery disease among diabetes patients was 2·89 times the odds of coronary artery disease for those without diabetes. Each additional point on the Chinese Beck Depression Inventory-II increased the risk of coronary artery disease by 5%. In the hysterectomy group, each additional increase in 1 mmHg in systolic blood pressure increased the risk of coronary artery disease by 4%. Smoking, diabetes, depression and systolic blood pressure are predictors of coronary artery disease in middle-aged women at premenopause, postmenopause and after undergoing hysterectomy respectively. These results are beneficial for middle-aged women at various menopausal stages to effectively implement prevention of coronary artery disease. These findings were among women being evaluated for possible coronary artery disease, we

  8. Effect of fenretinide and low-dose tamoxifen on insulin sensitivity in premenopausal women at high risk for breast cancer.

    PubMed

    Johansson, Harriet; Gandini, Sara; Guerrieri-Gonzaga, Aliana; Iodice, Simona; Ruscica, Massimiliano; Bonanni, Bernardo; Gulisano, Marcella; Magni, Paolo; Formelli, Franca; Decensi, Andrea

    2008-11-15

    The prevalence of metabolic syndrome is increasing along with breast cancer incidence worldwide. Because fenretinide improves insulin action and glucose tolerance in insulin-resistant obese mice and because tamoxifen has shown to regulate several markers involved in metabolic syndrome, we sought to investigate the effect of fenretinide or tamoxifen at low dose on features linked to insulin resistance in premenopausal women at risk for breast cancer. We randomized 235 women to low-dose tamoxifen (5 mg/daily), fenretinide (200 mg/daily), or their combination or placebo for 2 years. We used the homeostasis model assessment (HOMA; fasting insulin x glucose/22.5) to estimate insulin sensitivity. Women were considered to improve insulin sensitivity when they shifted from a HOMA >/=2.8 to <2.8. There was no effect of fenretinide or tamoxifen on HOMA overall, but overweight women (body mass index, >or=25 kg/m(2)) had a 7-fold greater probability to normalize HOMA after 2 years of fenretinide treatment [odds ratio (OR), 7.0; 95% confidence interval (95% CI), 1.2-40.5], with 25% of women improving their insulin sensitivity, whereas tamoxifen decreased insulin sensitivity by almost 7 times compared with subjects not taking tamoxifen (OR, 0.15; 95% CI, 0.03-0.88). In this group only, 5% improved their insulin sensitivity. Interestingly, women with intraepithelial or microinvasive neoplasia had higher HOMA (3.0) than unaffected subjects (2.8; P = 0.07). Fenretinide can positively balance the metabolic profile in overweight premenopausal women and this may favorably affect breast cancer risk. Furthermore, features of the metabolic syndrome should be taken into consideration before proposing tamoxifen for breast cancer prevention. The clinical implications of these results require further investigations.

  9. The effect of exercise and estrogen on osteoprotegerin in premenopausal women.

    PubMed

    West, Sarah L; Scheid, Jennifer L; De Souza, Mary Jane

    2009-01-01

    The benefits of exercise are widely recognized, however physically active women can develop exercise associated menstrual cycle disturbances such as amenorrhea (i.e., estrogen deficiency) secondary to a chronic energy deficiency. To assess the effects of exercise status and estrogen deficiency on osteoprotegerin (OPG) and its relationship to bone resorption in premenopausal exercising women. Cross-sectional study of serum OPG, urinary c-telopeptides (uCTX), urinary estrone 3-glucuronide (E1G), urinary pregnanediol 3-glucuronide (PdG) and bone mineral density (BMD) measured on multiple occasions in 67 women. Volunteers were retrospectively grouped: 1) sedentary menstruating group (SedMen n=8), 2) exercising menstruating group (ExMen, n=36), and 3) exercising amenorrheic group (ExAmen, n=23). One-way ANOVAs were performed, and LSD post-hoc tests were performed when differences were detected. Subjects were similar with respect to age (24.2+/-1.0 years), weight (57.8+/-1.7 kg), and height (164.3+/-1.3 cm) (p>0.05). ExMen and ExAmen groups were more aerobically fit (p=0.003) and had less body fat (p=0.002) than the SedMen group. Resting energy expenditure/fat free mass was lowest (p=0.001) in the ExAmen groups. Mean E1G across the measurement period (p<0.001) and overall E1G exposure as assessed by E1G area under the curve (AUC) (p<0.001) were lower in the ExAmen group vs. the SedMen and ExMen groups. U-CTX-I was elevated (p=0.033) in the ExAmen group (281.8+/-40.3 microg/L/mmCr), compared with the SedMen and ExMen groups (184.5+/-22.4, 197.2+/-14.7 microg/L/mmCr, respectively). OPG was suppressed (p=0.005) in the ExAmen group (4.6+/-0.2 pmol/L) vs. ExMen group (5.2+/-0.2 pmol/L), and OPG was lower in the SedMen group (4.1+/-0.3 pmol/L) compared with the ExMen group. Findings were translated to BMD; the ExAmen group had suppressed total body BMD (p=0.014) and L2-L4 BMD (p=0.015) vs. the ExMen group. Our results suggest that OPG responds to the bone loading effect of

  10. The influence of sex hormones on proinflammatory cytokines in gingiva of periodontally healthy premenopausal women.

    PubMed

    Markou, E; Boura, E; Tsalikis, L; Deligianidis, A; Konstantinidis, A

    2011-10-01

    The aim of this work was to investigate any correlation between the fluctuation of levels of specific proinflammatory cytokines in gingival crevicular fluid and the fluctuation of sex hormones in peripheral blood at ovulation and progesterone peak. Eighteen premenopausal women with normal and consistent menstrual cycles and healthy periodontium were included in this study. The exclusion criteria were as follows: (i) pregnancy; (ii) use of oral contraceptives; (iii) metabolic or systemic disease that might affect the periodontium; (iv) use of antimicrobial or nonsteroidal anti-inflammatory drugs during the past 6 mo; and (v) smoking. The measurements were performed at two specific time points for each participant [(i) on the day of ovulation; and (ii) on the day of the progesterone peak) and included the following: (i) plaque index; (ii) bleeding on probing; and (iii) the gingival crevicular fluid levels of interleukin (IL)-1β, IL-6, IL-8 and tumor necrosis factor-α (TNF-α). During the menstrual cycle, plaque index values remained unchanged (0.71 ± 0.07 at ovulation; 0.73 ± 0.08 at progesterone peak; p > 0.05), as did bleeding on probing (0.35 ± 0.07 at ovulation; 0.41 ± 0.07 at progesterone peak; p > 0.05). At ovulation, mean gingival crevicular fluid levels were as follows: IL-1β, 13.3 pg/sample; IL-6, 5.9 pg/sample; IL-8, 18.7 pg/sample; and TNF-α, 25.9 pg/sample. The corresponding values at progesterone peak were as follows: 14.1, 10.1, 19.5 and 26.3 pg/sample. Only IL-6 gingival crevicular fluid levels were significantly different between ovulation and progesterone peak (p < 0.05). This could reflect sensitivity to subclinical amounts of plaque and biofilm constituents. The subclinical increase of IL-6 at progesterone peak is not accompanied by clinical changes in the periodontium. © 2011 John Wiley & Sons A/S.

  11. Estrogen suppression in premenopausal women following 8 weeks of treatment with exemestane and triptorelin versus triptorelin alone.

    PubMed

    Jannuzzo, Maria Gabriella; Di Salle, Enrico; Spinelli, Riccardo; Pirotta, Nicoletta; Buchan, Peter; Bello, Akintunde

    2009-02-01

    Luteinizing hormone-releasing hormone (LHRH) agonists (e.g., triptorelin) reduce ovarian estrogen production in premenopausal women with hormone-sensitive breast cancer. Aromatase inhibitors (e.g., exemestane) inhibit extraovarian production of estrogen and may further reduce circulating estrogens when combined with an LHRH agonist. Healthy premenopausal women were randomized to receive 3.75 mg triptorelin (T) on days 1 and 29 with 25 mg exemestane (EX) or matched placebo once daily for 8 weeks, from day 1 to day 56. The primary objective was to evaluate the effect of T +/- EX on estradiol (E(2)) suppression by comparing the AUC(day 36-57 )for the 2 treatments. Secondary objectives included evaluation of estrone (E(1)), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) suppression; effects of EX on the T-induced gonadotrophin and estrogen flare; pharmacokinetics (PK); and safety. Twenty-eight (14 in each arm) were evaluable for efficacy and PK. Mean plasma estrogen levels (AUC(day 36-57)) were significantly lower for subjects who received T + EX than for subjects who received T alone (20.6 vs. 54.0 pg d/ml [-62%; P < 0.05], and 38.9 vs. 198.0 pg d/ml [-80%; P < 0.01] for E(2) and E(1), respectively). Coadministration of EX did not affect the initial flare or subsequent suppression of LH and FSH following the first dose of T, or the PK of T. Both treatments were well tolerated. Coadministration of T and EX resulted in greater estrogen suppression than when T was given alone. These findings could translate into improved clinical outcomes for premenopausal breast cancer patients receiving LHRH agonists.

  12. Impact of walking on eating behaviors and quality of life of premenopausal and early postmenopausal obese women.

    PubMed

    Riesco, Eléonor; Tessier, Sébastien; Pérusse, Francine; Turgeon, Sabrina; Tremblay, Angelo; Weisnagel, John; Doré, Jean; Mauriège, Pascale

    2010-01-01

    Aerobic exercise is known to improve health-related quality of life (QoL). The aim of this study was to compare the effects of a 16-week walking program on eating behaviors and QoL between late premenopausal and early postmenopausal obese and sedentary women, once chronological aging is taken into account. Sixteen women 49 +/- 2 years old and 14 women 53 +/- 2 years old, whose body mass index ranged between 29 and 35 kg/m, were subjected to three sessions per week of 45-minute walking at 60% of their heart rate reserve. Fat mass and lean mass (bioelectrical impedance), cardiorespiratory fitness estimated by maximum oxygen consumption (2-km walking test), eating behaviors (Three-Factor Eating Questionnaire), and QoL, estimated by the Short Form-36 Health Survey, Pittsburgh Sleep Quality Index, and Perceived Stress Scale-10 questionnaires, were recorded before and after exercise. With the exception of a higher attitude of self-regulation in postmenopausal than in premenopausal women (P = 0.05), no between-group differences were observed in body composition, eating behaviors, and QoL at baseline. In all participants, body weight and fat mass decreased, whereas cardiorespiratory fitness increased after walking (0.001 < P < 0.0001). Situational susceptibility was the only eating behavior reduced after training in all women (P = 0.02). Neither the sleep quality index nor the perceived stress score changed in response to endurance exercise. Finally, in all women, Short Form-36 physical and mental scores increased after walking (0.001 < P < 0.05). Despite modest body weight and fat mass losses, a 16-week walking program seems to be sufficient to improve physical and mental well-being, irrespective of menopause status.

  13. Immunoassay and Nb2 lymphoma bioassay prolactin levels and mammographic density in premenopausal and postmenopausal women the Nurses' Health Studies.

    PubMed

    Rice, Megan S; Tworoger, Shelley S; Bertrand, Kimberly A; Hankinson, Susan E; Rosner, Bernard A; Feeney, Yvonne B; Clevenger, Charles V; Tamimi, Rulla M

    2015-01-01

    Higher circulating prolactin levels have been associated with higher percent mammographic density among postmenopausal women in some, but not all studies. However, few studies have examined associations with dense area and non-dense breast area breast or considered associations with prolactin Nb2 lymphoma cell bioassay levels. We conducted a cross-sectional study among 1,124 premenopausal and 890 postmenopausal women who were controls in breast cancer case-control studies nested in the Nurses' Health Study (NHS) and NHSII. Participants provided blood samples in 1989-1990 (NHS) or 1996-1999 (NHSII) and mammograms were obtained from around the time of blood draw. Multivariable linear models were used to assess the associations between prolactin levels (measured by immunoassay or bioassay) with percent density, dense area, and non-dense area. Among 1,124 premenopausal women, percent density, dense area, and non-dense area were not associated with prolactin immunoassay levels in multivariable models (p trends = 0.10, 0.18, and 0.69, respectively). Among 890 postmenopausal women, those with prolactin immunoassay levels in the highest versus lowest quartile had modestly, though significantly, higher percent density (difference = 3.01 percentage points, 95 % CI 0.22, 5.80) as well as lower non-dense area (p trend = 0.02). Among women with both immunoassay and bioassay levels, there were no consistent differences in the associations with percent density between bioassay and immunoassay levels. Postmenopausal women with prolactin immunoassay levels in the highest quartile had significantly higher percent density as well as lower non-dense area compared to those in the lowest quartile. Future studies should examine the underlying biologic mechanisms, particularly for non-dense area.

  14. Dietary habits, nutrients and bone mass in Spanish premenopausal women: the contribution of fish to better bone health.

    PubMed

    Calderon-Garcia, Julian F; Moran, Jose M; Roncero-Martin, Raul; Rey-Sanchez, Purificacion; Rodriguez-Velasco, Francisco J; Pedrera-Zamorano, Juan D

    2012-12-27

    The moderate consumption of fish is recommended for a healthy diet and is also a feature of the Mediterranean diet. Fish is a major food group in diets throughout the world, and studies show that fish consumption is associated with a lower risk of a number of conditions. Spain has one of the highest annual per capita consumptions of fish worldwide. As fish is a source of high quality protein; n-3 polyunsaturated fatty acids; vitamins, such as A and D; and minerals, such as selenium, calcium, iodine, magnesium, copper and zinc, nutrients that have positive effects on bone characteristics, it has been proposed that its consumption could improve bone health. In this cross-sectional study, we have investigated the relationship between dietary habits and nutrient intake of 151 Spanish premenopausal women and analyzed the association of fish consumption on bone mass measured by quantitative ultrasound of the phalanges. A higher (P < 0.05) bone mass and vitamin D intake (P < 0.05) was observed in the group with a fish intake of 5-7 servings/week. We conclude that increased fish consumption is helpful in maintaining an adequate bone mass in Spanish premenopausal women.

  15. Dietary Habits, Nutrients and Bone Mass in Spanish Premenopausal Women: The Contribution of Fish to Better Bone Health

    PubMed Central

    Calderon-Garcia, Julian F.; Moran, Jose M.; Roncero-Martin, Raul; Rey-Sanchez, Purificacion; Rodriguez-Velasco, Francisco J.; Pedrera-Zamorano, Juan D.

    2012-01-01

    The moderate consumption of fish is recommended for a healthy diet and is also a feature of the Mediterranean diet. Fish is a major food group in diets throughout the world, and studies show that fish consumption is associated with a lower risk of a number of conditions. Spain has one of the highest annual per capita consumptions of fish worldwide. As fish is a source of high quality protein; n-3 polyunsaturated fatty acids; vitamins, such as A and D; and minerals, such as selenium, calcium, iodine, magnesium, copper and zinc, nutrients that have positive effects on bone characteristics, it has been proposed that its consumption could improve bone health. In this cross-sectional study, we have investigated the relationship between dietary habits and nutrient intake of 151 Spanish premenopausal women and analyzed the association of fish consumption on bone mass measured by quantitative ultrasound of the phalanges. A higher (P < 0.05) bone mass and vitamin D intake (P < 0.05) was observed in the group with a fish intake of 5–7 servings/week. We conclude that increased fish consumption is helpful in maintaining an adequate bone mass in Spanish premenopausal women. PMID:23271510

  16. Relationship between bone turnover biomarkers, mandibular bone mineral density, and systemic skeletal bone mineral density in premenopausal and postmenopausal Indian women.

    PubMed

    Makker, Annu; Singh, Man Mohan; Mishra, Geetanjali; Singh, Balendra Pratap; Jain, Girish Kumar; Jadhav, Satyawan

    2012-06-01

    Postmenopausal osteoporosis is one of the most common metabolic bone disorders. Osteoporosis is reported to cause bone loss in the alveolar processes of maxilla and mandible, which provide bony framework for tooth anchorage. However, the association between systemic osteoporosis and oral health remains controversial. Available evidence suggests that Indian women have lower peak bone mass than their Western/other Asian counterparts. The present study evaluated the relationship between mandibular bone mineral density (mBMD), systemic skeletal BMD, and bone metabolism in premenopausal and postmenopausal Indian women. One hundred twenty-four premenopausal and 247 postmenopausal healthy women were included in the study. The BMD of the body of mandible, radius ultradistal, total hip, femur neck, and lateral spine were measured using dual-energy x-ray absorptiometry. Serum and urine biomarkers were determined using commercial kits. Univariate regression analysis followed by stepwise multivariate regression analysis to obtain the best fit model demonstrated the BMD of radius ultradistal, serum inorganic phosphorus, estradiol, and sex hormone-binding globulin as significant predictors of mBMD in premenopausal women. The BMD of femur neck, serum ionized calcium, bone-specific alkaline phosphatase, osteocalcin, and urine total pyridinoline were significantly associated with mBMD in postmenopausal women. The significant association between mBMD and number of teeth present was observed in the whole group of premenopausal and postmenopausal women. Varied predictors of mBMD were observed in premenopausal and postmenopausal women. The results suggest that the screening for these biomarkers and serum ionized calcium should be useful (1) to assess the status of mBMD particularly in women requiring surgical dental intervention that include bone manipulation and (2) for early detection and management of women with the risk of developing osteoporosis.

  17. Young premenopausal women with breast cancer, especially estrogen receptor negative, are at significantly increased risk for subsequent ovarian cancer.

    PubMed

    Lehrer, Steven; Rheinstein, Peter H; Green, Sheryl; Rosenzweig, Kenneth E

    2016-10-01

    There is a modest risk of second cancers, among them ovarian cancer, after breast cancer. For BRCA1 and BRCA2 carriers, the risk increases substantially. We have analyzed the risk of ovarian cancer after breast cancer based on patient age and the estrogen receptor (ER) and progesterone receptor (PR) characteristics of the breast tumor. The study population was assembled using records from the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute. The SEER program statistical analysis software package (SEER*Stat, version 8.2.1) was used to identify patients diagnosed with a primary breast cancer from 1990-2010. The SEER*Stat MP-SIR (Multiple Primary-Standardized Incidence Ratio) tool was used to calculate standardized incidence ratios (SIRs) and excess risk for ovarian cancer by comparing the patients' subsequent cancer profile to the number of cancers that would be expected based on incidence rates for the general U.S. We used data from 316,801 cases of breast cancer. The overall number of ovarian cancer cases (n = 288) after ER negative PR negative breast cancer was significantly higher than expected (O/E = 1.89, p < 0.05). In premenopausal women, that is, women younger than fifty, the ovarian cancer O/E was considerably higher than expected. Analysis of latency of ovarian cancer (months) after ER negative PR negative breast cancer revealed that in the youngest women the latency was shortest (p = 0.001, linear by linear association test for trend). Young women with pre-menopausal breast cancer, especially ER negative, are at significantly increased risk for subsequent ovarian cancer; the younger they are, the higher the risk. These women should be routinely tested for BRCA1 and BRCA2 mutations, and many might benefit from measures to prevent subsequent ovarian cancer.

  18. Relationship between reproductive history, anthropometrics, lifestyle factors, and the likelihood of persistent chemotherapy-related amenorrhea in women with premenopausal breast cancer.

    PubMed

    Abusief, Mary E; Missmer, Stacey A; Ginsburg, Elizabeth S; Weeks, Jane C; Partridge, Ann H

    2012-01-01

    To determine the association between patient characteristics at diagnosis of premenopausal breast cancer, including gravidity, parity, age at menarche, age at first birth, alcohol use, smoking history, weight, height, and body mass index (BMI), with the development of persistent chemotherapy-related amenorrhea (CRA) in follow-up. Retrospective cohort study. Dana Farber Cancer Institute and Brigham and Women's Hospital. Premenopausal women with breast cancer. We identified all premenopausal women who received standard adjuvant chemotherapy during 1997-2005 for whom menstrual data were available. Multivariable logistic regression models evaluating persistent amenorrhea at ≥6 month after completion of chemotherapy were conducted. Persistent chemotherapy-related amenorrhea (CRA) at ≥6 months from completion of chemotherapy. A total of 431 women met eligibility criteria and had ≥6-months' follow-up. Women with older (>13 years) vs. younger (12-13 years) age at menarche were more than twice as likely to remain amenorrheic. Current smokers had 2.4 greater odds of CRA vs. never smokers, although this association was not statistically significant (95% confidence interval, 0.86-6.75). Few identifiable factors contribute to the variability in CRA among premenopausal women after adjuvant chemotherapy for breast cancer. Further research to improve the prediction of CRA, premature menopause, and infertility in young breast cancer survivors is warranted. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Characteristic features of ageing in Korean women's hair and scalp.

    PubMed

    Kim, S N; Lee, S Y; Choi, M H; Joo, K M; Kim, S H; Koh, J S; Park, W S

    2013-06-01

    The effect of age on hair properties has previously been investigated in white and Japanese women; however, little is known of the age-related characteristic features of hair in Korean women. To determine the ageing features of Korean women's hair by examining physical and biological factors in sufficient numbers of participants. In total, 150 healthy Korean women (aged 23-69 years) living in Seoul were allocated to five age-graded groups. Age-related changes of various features of the scalp and hair shaft were measured, including hair density, diameter, tensile strength and lustre, and grey-hair ratio. The hair-shaft compositions of minerals, amino acids and steroid hormones were analysed by high-performance liquid chromatography. Hair-loss parameters (hair density, diameter and tensile strength) and hair lustre decreased significantly with age, beginning in the subjects' 40s. The hair-whiteness value increased significantly with age, beginning in their 60s, due to an increase in the ratio of grey hair. Calcium and magnesium levels greatly exceeded the reference ranges and declined in an age-dependent manner, while potassium and phosphorus levels increased with age. No age-related change of hair-shaft amino acid content was evident. The contents of sterols and their metabolites (cholesterol, desmosterol, lanosterol and pregnenolone) increased significantly with age, but there was no correlation between the examined sex steroids and age. These results show that intrinsic ageing produces diverse changes in the hair and scalp features of Korean women from their 40s, and the ageing features of Korean women's hair could be partially different from that of women in other countries. © 2013 Amorepacific Corp. BJD © 2013 British Association of Dermatologists.

  20. Relationship of leptin, resting metabolic rate, and body composition in premenopausal hispanic and non-Hispanic White women.

    PubMed

    Deemer, Sarah E; King, George A; Dorgo, Sandor; Vella, Chantal A; Tomaka, Joe W; Thompson, Dixie L

    2010-01-01

    The purpose was to evaluate the relationships between fasting serum leptin, resting metabolic rate (RMR), and body composition in premenopausal Hispanic and non-Hispanic White (White) women. Participants were 67 Hispanic and 43 White women who arrived at the laboratory in a fasted state for measurement of RMR by indirect calorimetry, bone mineral content measured by dual-energy X-ray absorptiometry, and body density measured by hydrodensitometry. Serum leptin levels were determined by EIA. Multiple regression analysis revealed that body mass and lean body mass were the best predictors of RMR. Leptin was not a significant predictor of RMR. Further research needs to be done to examine the role of leptin on metabolism, especially in ethnic groups predisposed to development of obesity and related disorders.

  1. Anthropometric and lifestyle associations of bone mass in healthy pre-menopausal Mexican and Asian American women.

    PubMed

    Crespo, Noe C; Yoo, Eun Jung; Hawkins, Steven A

    2011-02-01

    Few studies have established the lifestyle predictors of peak bone mineral density (BMD) in Mexican-American (MA) and Asian-American (AA) women. Pre-menopausal MA (n = 48) and AA (n = 58) women aged 30-45 years old were tested for BMD, body composition, aerobic fitness, and muscle function. Socio-demographic characteristics, health status, prevalence of osteoporosis risk factors, physical activity, and diet were determined via questionnaire. Pearson's correlations and multiple linear regressions were used to test the associations between various osteoporosis risk factors and BMD. Body composition, anthropometric, and BMD differences were noted between groups. Hip, but not spine BMD, remained significantly higher for the MA compared to the AA group after adjustment for age, BMI, income, and physical activity index. Lean body mass was a significant predictor of hip BMD for both groups and this relationship was stronger for the AA group. Lean body mass may explain ethnic differences in BMD.

  2. Effect of calcium fortified milk supplementation with or without vitamin K on biochemical markers of bone turnover in premenopausal women.

    PubMed

    Kruger, Marlena C; Booth, Christine L; Coad, Jane; Schollum, Linda M; Kuhn-Sherlock, Barbara; Shearer, Martin J

    2006-01-01

    We compared the effect of supplementation with a fortified skimmed milk product (high calcium skim milk) with or without added phylloquinone (vitamin K(1)) on markers of bone formation and resorption in premenopausal women. Eighty-two women 20 to 35 y of age were randomly allocated to three groups. Two groups received two daily servings of high calcium skim milk (1000 mg/d of extra calcium) with or without added phylloquinone (80 microg/d) for 16 wk, and a third control group received no supplementation. Bone density was assessed at baseline and the bone markers, total osteocalcin, type I N-terminal procollagen peptide, and cross-linked C-telopeptide of type I collagen were measured at baseline and at weeks 2, 12, and 16. Serum phylloquinone and undercarboxylated osteocalcin were measured in the control and vitamin K-supplemented groups at weeks 0 and 16. Baseline values for age, body mass index, and bone density did not differ across groups. In vitamin K-supplemented women, mean serum phylloquinone concentrations increased from 0.27 to 0.76 microg/L (P < 0.05) and undercarboxylated osteocalcin concentrations decreased from 9.68 to 4.46 microg/L (P < 0.05) over 16 wk. Plasma cross-linked C-telopeptide of type I collagen, total osteocalcin, and type I N-terminal procollagen peptide levels decreased significantly in both supplemented groups compared with the control group over 16 wk (cross-linked C-telopeptide of type I collagen >30%, total osteocalcin and type I N-terminal procollagen peptide >15%). Fortified milk supplementation in premenopausal women reduced bone turnover significantly. Phylloquinone fortification substantially improved vitamin K status but had no demonstrable additive effect on bone turnover in this short-term study.

  3. The proliferative activity of mammary epithelial cells in normal tissue predicts breast cancer risk in premenopausal women

    PubMed Central

    Huh, Sung Jin; Oh, Hannah; Peterson, Michael A.; Almendro, Vanessa; Hu, Rong; Bowden, Michaela; Lis, Rosina L.; Cotter, Maura B.; Loda, Massimo; Barry, William T.; Polyak, Kornelia; Tamimi, Rulla M.

    2016-01-01

    The frequency and proliferative activity of tissue-specific stem and progenitor cells are suggested to correlate with cancer risk. In this study, we investigated the association between breast cancer risk and the frequency of mammary epithelial cells expressing p27, estrogen receptor (ER), and Ki67 in normal breast tissue. We performed a nested case-control study of 302 women (69 breast cancer cases, 233 controls) who had been initially diagnosed with benign breast disease according to the Nurses’ Health Studies. Immunofluorescence for p27, ER, and Ki67 was performed on tissue microarrays constructed from benign biopsies containing normal mammary epithelium and scored by computational image analysis. We found that the frequency of Ki67+ cells was positively associated with breast cancer risk among premenopausal women (odds ratio [OR]=10.1, 95% confidence interval [CI]=2.12–48.0). Conversely, the frequency of ER+ or p27+ cells was inversely, but not significantly, associated with subsequent breast cancer risk (ER+: OR=0.70, 95% CI=0.33–1.50; p27+: OR=0.89, 95% CI=0.45–1.75). Notably, high Ki67+/low p27+ and high Ki67+/low ER+ cell frequencies were significantly associated with a 5-fold higher risk of breast cancer compared to low Ki67+/low p27+ and low Ki67+/low ER+ cell frequencies, respectively, among premenopausal women (Ki67hi/p27lo: OR=5.08, 95% CI=1.43–18.1; Ki67hi/ERlo: OR=4.68, 95% CI=1.63–13.5). Taken together, our data suggest that the fraction of actively cycling cells in normal breast tissue may represent a marker for breast cancer risk assessment, which may therefore impact the frequency of screening procedures in at-risk women. PMID:26941287

  4. Circulating hormones and breast cancer risk in premenopausal women: a randomized trial of low-dose tamoxifen and fenretinide.

    PubMed

    Johansson, Harriet; Bonanni, Bernardo; Gandini, Sara; Guerrieri-Gonzaga, Aliana; Cazzaniga, Massimiliano; Serrano, Davide; Macis, Debora; Puccio, Antonella; Sandri, Maria Teresa; Gulisano, Marcella; Formelli, Franca; Decensi, Andrea

    2013-12-01

    Tamoxifen and fenretinide have been extensively studied and exhibit breast cancer-preventing activity. We aimed to assess their effect on sex hormones, sex hormone binding globulin (SHBG) and retinol, and their association with mammographic density (MD) and breast cancer events. In a double-blind, placebo-controlled trial, premenopausal women at risk for breast cancer were randomized to tamoxifen 5 mg/day, fenretinide, both agents, or placebo for 2 years. We measured MD and circulating concentrations of follicle-stimulating hormone, luteinizing hormone (LH), estradiol, progesterone, testosterone, androstenedione, dehydro-epiandrosteronesulfate, prolactin, SHBG, and retinol at baseline and on yearly intervals. The associations with breast cancer events were evaluated through competing risk and Cox regression survival models. Low-dose tamoxifen markedly and enduringly increased SHBG, whereas the increases in testosterone, estradiol, and prolactin and reduction in LH weakened after 1 year. Fenretinide increased testosterone and androstenedione and decreased retinol. MD correlated directly with SHBG and inversely with retinol. After a median follow-up of 12 years, the 10-year cumulative incidence of breast cancer events was 37 % in women with SHBG ≤ 59.3 nmol/L, 22 % in women with SHBG between 59.3 and 101 nmol/L, and 19 % in women with SHBG > 101 nmol/L (P = 0.018). The difference among SHBG tertiles remained statistically significant at multivariable analysis: HR = 2.26 (95 % CI 1.04, 4.89) for the lowest versus the highest tertile. We conclude that low-dose tamoxifen or fenretinide exhibits favorable hormonal profiles as single agents, further supporting their administration for prevention of breast cancer in premenopause. Notably, SHBG levels were inversely associated with breast neoplastic events.

  5. Luteininzing hormone releasing hormones analogs in combination with tamoxifen for the adjuvant treatment of premenopausal women with hormone receptor positive breast cancer.

    PubMed

    Conte, Benedetta; Poggio, Francesca; Del Mastro, Lucia

    2017-09-01

    The role of ovarian function suppression (OFS) through luteinizing hormone-releasing hormone agonists (LHRHa) in addition to tamoxifen has been questioned until recently. In 2015, two large clinical trials led to a paradigm shift in the adjuvant endocrine treatment of premenopausal women, introducing the use of LHRHa plus tamoxifen (or aromatase inhibitor, AI) into current clinical practice. Areas covered: The present review aims to provide an in-depth overview of the role of LHRHa+tamoxifen for the adjuvant treatment of premenopausal women with hormone receptor positive breast cancer (HR+BC). Expert opinion: The addition of LHRHa to endocrine treatment (either tamoxifen or AI) is effective in premenopausal women who are at high risk of relapse. To date, no clear recommendations are available for the choice between LHRHa+tamoxifen and LHRH+AI. Although recent data showed better DFS with LHRHa+AI, other issues should be considered: 1) approximately 20 out of 100 women do not reach complete OFS with LHRHa+AI; 2) there is no extended endocrine therapy option that can be applied to women who received 5 years of LHRHa+AI and remained premenopausal at the end of the fifth year. Long-term results of the SOFT-TEXT study are needed to establish if LHRHa+AI is superior to LHRHa+tamoxifen.

  6. A Qualitative Investigation of Korean Immigrant Women's Lives

    ERIC Educational Resources Information Center

    Yoon, Eunju; Lee, Dal Yob; Koo, Young Ran; Yoo, Sung-Kyung

    2010-01-01

    Postimmigration adjustment experiences of 10 Korean immigrant women were examined using the consensual qualitative research method. Seven domains emerged: general life conditions; gender role; changes in family dynamics; ethnic/national identity, cultural competency, and belongingness; value changes; racial relationships; and support systems and…

  7. A Qualitative Investigation of Korean Immigrant Women's Lives

    ERIC Educational Resources Information Center

    Yoon, Eunju; Lee, Dal Yob; Koo, Young Ran; Yoo, Sung-Kyung

    2010-01-01

    Postimmigration adjustment experiences of 10 Korean immigrant women were examined using the consensual qualitative research method. Seven domains emerged: general life conditions; gender role; changes in family dynamics; ethnic/national identity, cultural competency, and belongingness; value changes; racial relationships; and support systems and…

  8. Caloric restriction and calcium's effect on bone metabolism and body composition in overweight and obese premenopausal women.

    PubMed

    Radak, Tim L

    2004-12-01

    Obesity results in numerous preventable deaths and comorbidities. Unfortunately, a reduction of body weight has been correlated with a reduction in bone mass, the reasons for which have not been fully elucidated. The importance of maximizing peak bone mass during premenopausal years is well known. Most studies demonstrate a positive relationship between calcium intake and bone mass. However, during caloric restriction, which is commonly used for weight loss, calcium intake has shown mixed results. Calcium from dairy sources has received additional attention, beyond its importance to bone, for its role in regulating body weight and composition. Dairy foods are perceived as high fat, and therefore, are generally minimized or avoided during caloric restriction. The current calcium intake for premenopausal women is significantly below recommendations, and even if met during caloric restriction, may not be adequate. This review underscores the need for maintaining at least adequate intake levels of calcium, if not more, during weight loss regimens to minimize potential long-term detrimental effects on bone metabolism.

  9. Ovarian Function, Not Age, Predicts the Benefit from Ovarian Suppression or Ablation for Premenopausal Women with Breast Cancer

    PubMed Central

    Cao, Ye; Wang, Shusen; Shi, Yanxia; An, Xin; Xu, Fei; Yuan, Zhongyu

    2016-01-01

    The role of adjuvant ovarian suppression or ablation (OS/OA) in premenopausal women with hormone receptor-positive breast cancer remains controversial. The purpose of our study was to examine which patients might benefit from the addition of OS/OA to tamoxifen. We analyzed the data of 2065 premenopausal patients with hormone receptor-positive invasive ductal carcinomas who were treated at Sun Yat-Sen University Cancer Center from 2000 to 2008. The five-year disease-free survival rate (DFSR) and overall survival rate (OSR) were compared by menstrual status and treatment. Compared with patients older than forty years of age, patients younger than forty years old had significant lower DFSRs and OSRs. The addition of OS/OA to tamoxifen increased the DFSR and OSR of patients with normal menstrual cycles after chemotherapy, regardless of their age at diagnosis. Patients with normal menstrual cycles after chemotherapy are the main beneficiaries of an adjuvant OS/OA. PMID:26866810

  10. Risks factors for low bone mineral density in pre-menopausal Mexican women with systemic lupus erythematosus.

    PubMed

    Mendoza-Pinto, Claudia; García-Carrasco, Mario; Sandoval-Cruz, Hilda; Escárcega, Ricardo O; Jiménez-Hernández, Mario; Etchegaray-Morales, Ivet; Soto-Vega, Elena; Muñoz-Guarneros, Margarita; López-Colombo, Aurelio; Delezé-Hinojosa, Margarita; Cervera, Ricard

    2009-01-01

    The aim of this study was to determine the prevalence and risk factors for low bone mineral density (BMD) in women with systemic lupus erythematosus (SLE). A cross-sectional study was conducted among 100 pre-menopausal patients with SLE. Patients were evaluated using a questionnaire about the following variables: age, disease duration, disease activity, chronic disease damage, cumulative corticosteroid dose, and history of fracture. Lumbar spine and hip measurements of BMD were performed by dual absorptiometry. Univariate and multivariate statistical analyses were used to assess the relationship between risk factors and BMD. The mean age was 32.8 +/- 8.7 years, and the median duration of SLE was 73.2 +/- 65 months. The mean cumulative corticosteroid dose was 20.0 +/- 21.3 g. The mean BMD was 1.09 +/- .18 g/cm(2) in the lumbar spine and 1.0 +/- .14 g/cm(2) in the hip. Osteopenia was present in 40% of patients and osteoporosis in 5%. In the multiple regression analysis, low BMD in the lumbar spine was associated with chronic disease damage and low body mass index (BMI). Low BMD in the hip was associated with cumulative corticosteroid dose and low BMI. Chronic disease damage, low BMI, and cumulative corticosteroid dose are risks factors for low BMD in pre-menopausal SLE patients. Osteopenia was found in 40% of patients, while osteoporosis was found in only 5%.

  11. Parity and risk of death from gallbladder cancer among a cohort of premenopausal parous women in Taiwan.

    PubMed

    Chan, Te-Fu; Wu, Chen-Hsuan; Chiu, Hui-Fen; Yang, Chun-Yuh

    2015-02-05

    Little epidemiologic research has been done on the etiology of gallbladder cancer (GC). This cohort study was undertaken to examine whether there is an association between parity and risk of death from GC. The study cohort consisted of 1,292,462 women who had a first and singleton childbirth between 1 January 1978 and 31 December 1987. We tracked each woman from the time of their first childbirth to 31 December 2009, and their vital status was ascertained by linking records with the computerized mortality database. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) of death from GC associated with parity. There were 257 GC deaths during 34,980,246 person-years of follow-up. The mortality rate of GC was 0.73 cases per 100,000 person-years. As compared with women who had given birth to only one child, the adjusted HR was 1.20 (95% CI = 0.79-1.83) for women who had two children, 1.47 (95% CI = 0.95-2.29) for women who had three children, and 1.68 (95% CI = 0.99-2.85) for women with four or more births. There was a significant increasing trend in the adjusted HRs for GC with increasing parity. The findings suggested that premenopausal women of higher parity may increase the risk of death from GC.

  12. Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic

    PubMed Central

    Donnelly, L S; Evans, D G; Wiseman, J; Fox, J; Greenhalgh, R; Affen, J; Juraskova, I; Stavrinos, P; Dawe, S; Cuzick, J; Howell, A

    2014-01-01

    Background: Randomised trials of tamoxifen versus placebo indicate that tamoxifen reduces breast cancer risk by approximately 33%, yet uptake is low. Approximately 10% of women in our clinic entered the IBIS-I prevention trial. We assess the uptake of tamoxifen in a consecutive series of premenopausal women not in a trial and explore the reasons for uptake through interviews. Methods: All eligible women between 33 and 46 years at ⩾17% lifetime risk of breast cancer and undergoing annual mammography in our service were invited to take a 5-year course of tamoxifen. Reasons for accepting (n=15) or declining (n=15) were explored using semi-structured interviews. Results: Of 1279 eligible women, 136 (10.6%) decided to take tamoxifen. Women >40 years (74 out of 553 (13.4%)) and those at higher non-BRCA-associated risk were more likely to accept tamoxifen (129 out of 1109 (11.6%)). Interviews highlighted four themes surrounding decision making: perceived impact of side effects, the impact of others' experience on beliefs about tamoxifen, tamoxifen as a ‘cancer drug', and daily reminder of cancer risk. Conclusions: Tamoxifen uptake was similar to previously ascertained uptake in a randomised controlled trial (IBIS-I). Concerns were similar in women who did or did not accept tamoxifen. Decision making appeared to be embedded in the experience of significant others. PMID:24594998

  13. Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic.

    PubMed

    Donnelly, L S; Evans, D G; Wiseman, J; Fox, J; Greenhalgh, R; Affen, J; Juraskova, I; Stavrinos, P; Dawe, S; Cuzick, J; Howell, A

    2014-04-02

    Randomised trials of tamoxifen versus placebo indicate that tamoxifen reduces breast cancer risk by approximately 33%, yet uptake is low. Approximately 10% of women in our clinic entered the IBIS-I prevention trial. We assess the uptake of tamoxifen in a consecutive series of premenopausal women not in a trial and explore the reasons for uptake through interviews. All eligible women between 33 and 46 years at ≥17% lifetime risk of breast cancer and undergoing annual mammography in our service were invited to take a 5-year course of tamoxifen. Reasons for accepting (n=15) or declining (n=15) were explored using semi-structured interviews. Of 1279 eligible women, 136 (10.6%) decided to take tamoxifen. Women >40 years (74 out of 553 (13.4%)) and those at higher non-BRCA-associated risk were more likely to accept tamoxifen (129 out of 1109 (11.6%)). Interviews highlighted four themes surrounding decision making: perceived impact of side effects, the impact of others' experience on beliefs about tamoxifen, tamoxifen as a 'cancer drug', and daily reminder of cancer risk. Tamoxifen uptake was similar to previously ascertained uptake in a randomised controlled trial (IBIS-I). Concerns were similar in women who did or did not accept tamoxifen. Decision making appeared to be embedded in the experience of significant others.

  14. Bone mass and lifestyle related factors: a comparative study between Japanese and Inner Mongolian young premenopausal women.

    PubMed

    Zhang, M; Shimmura, T; Bi, L F; Nagase, H; Nishino, H; Kajita, E; Eto, M; Wang, H B; Su, X L; Chang, H; Aratani, T; Kagamimori, S

    2004-07-01

    The purpose of this study was to evaluate the ethnic difference in bone mass between Japanese and Inner Mongolian young premenopausal women and to assess the contribution of lifestyle related and anthropometric factors to bone mass. We studied 33 Japanese and 44 Inner Mongolian healthy young women, aged 20-34 years, in urban area. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI) were measured at the calcaneus using quantitative ultrasound (QUS) analysis. Age at menarche, regularity of menstruation and lifestyle related factors were estimated by a self-reported questionnaire. There were no differences between the two groups in age, height, weight, BMI, regularity of menstruation, frequency of meat intake, frequency of yellow-green vegetable intake and exercise habit. Japanese women had significantly lower age at menarche and higher proportion of milk consumption habit at junior high school, senior school and present. Before adjustment, Japanese women had significantly higher SOS and SI than Inner Mongolian women. However, after adjustment for age at menarche and milk consumption habit at junior high school, both of which were significantly different between groups, no group-differences remained in either SOS or SI. These results suggest that the differences in age at menarche and milk consumption habit at junior high school, which relate to hormonal and nutritional status during puberty, may account for the differences in bone mass between Japanese and Inner Mongolian young women.

  15. Effects of growth hormone administration for 6 months on bone turnover and bone marrow fat in obese premenopausal women.

    PubMed

    Bredella, Miriam A; Gerweck, Anu V; Barber, Lauren A; Breggia, Anne; Rosen, Clifford J; Torriani, Martin; Miller, Karen K

    2014-05-01

    Abdominal adiposity is associated with low BMD and decreased growth hormone (GH) secretion, an important regulator of bone homeostasis. The purpose of our study was to determine the effects of a short course of GH on markers of bone turnover and bone marrow fat in premenopausal women with abdominal adiposity. In a 6-month, randomized, double-blind, placebo-controlled trial we studied 79 abdominally obese premenopausal women (21-45 y) who underwent daily sc injections of GH vs. placebo. Main outcome measures were body composition by DXA and CT, bone marrow fat by proton MR spectroscopy, P1NP, CTX, 25(OH)D, hsCRP, undercarboxylated osteocalcin (ucOC), preadipocyte factor 1 (Pref 1), apolipoprotein B (ApoB), and IGF-1. GH increased IGF-1, P1NP, 25(OH)D, ucOC, bone marrow fat and lean mass, and decreased abdominal fat, hsCRP, and ApoB compared with placebo (p<0.05). There was a trend toward an increase in CTX and Pref-1. Among all participants, a 6-month increase in IGF-1 correlated with 6-month increase in P1NP (p=0.0005), suggesting that subjects with the greatest increases in IGF-1 experienced the greatest increases in bone formation. A six-month decrease in abdominal fat, hsCRP, and ApoB inversely predicted 6-month change in P1NP, and 6-month increase in lean mass and 25(OH)D positively predicted 6-month change in P1NP (p≤0.05), suggesting that subjects with greatest decreases in abdominal fat, inflammation and ApoB, and the greatest increases in lean mass and 25(OH)D experienced the greatest increases in bone formation. A six-month increase in bone marrow fat correlated with 6-month increase in P1NP (trend), suggesting that subjects with the greatest increases in bone formation experienced the greatest increases in bone marrow fat. Forward stepwise regression analysis indicated that increase in lean mass and decrease in abdominal fat were positive predictors of P1NP. When IGF-1 was added to the model, it became the only predictor of P1NP. GH replacement in

  16. Effects of growth hormone administration for 6 months on bone turnover and bone marrow fat in obese premenopausal women

    PubMed Central

    Bredella, Miriam A.; Gerweck, Anu V.; Barber, Lauren A.; Breggia, Anne; Rosen, Clifford J.; Torriani, Martin; Miller, Karen K.

    2014-01-01

    Purpose Abdominal adiposity is associated with low BMD and decreased growth hormone (GH) secretion, an important regulator of bone homeostasis. The purpose of our study was to determine the effects of a short course of GH on markers of bone turnover and bone marrow fat in premenopausal women with abdominal adiposity. Materials and Methods In a 6-month, randomized, double-blind, placebo-controlled trial we studied 79 abdominally obese premenopausal women (21–45y) who underwent daily sc injections of GH vs. placebo. Main outcome measures were body composition by DXA and CT, bone marrow fat by proton MR spectroscopy, P1NP, CTX, 25(OH)D, hsCRP, undercarboxylated osteocalcin (ucOC), preadipocyte factor 1 (Pref 1), apolipoprotein B (ApoB), and IGF-1. Results GH increased IGF-1, P1NP, 25(OH)D, ucOC, bone marrow fat and lean mass, and decreased abdominal fat, hsCRP, and ApoB compared with placebo (p<0.05). There was a trend toward an increase in CTX and Pref-1. Among all participants, 6-month increase in IGF-1 correlated with 6-month increase in P1NP (p=0.0005), suggesting that subjects with the greatest increases in IGF-1 experienced the greatest increases in bone formation. Six-month decrease in abdominal fat, hsCRP, and ApoB inversely predicted 6-month change in P1NP, and 6-month increase in lean mass and 25(OH)D positively predicted 6-month change in P1NP (p≤0.05), suggesting that subjects with greatest decreases in abdominal fat, inflammation and ApoB, and the greatest increases in lean mass and 25(OH)D experienced the greatest increases in bone formation. Six-month increase in bone marrow fat correlated with 6-month increase in P1NP (trend), suggesting that subjects with the greatest increases in bone formation experienced the greatest increases in bone marrow fat. Forward stepwise regression analysis indicated that increase in lean mass and decrease in abdominal fat were positive predictors of P1NP. When IGF-1 was added to the model, it became the only predictor

  17. Lean Mass and Body Fat Percentage Are Contradictory Predictors of Bone Mineral Density in Pre-Menopausal Pacific Island Women

    PubMed Central

    Casale, Maria; von Hurst, Pamela R.; Beck, Kathryn L.; Shultz, Sarah; Kruger, Marlena C.; O’Brien, Wendy; Conlon, Cathryn A.; Kruger, Rozanne

    2016-01-01

    Anecdotally, it is suggested that Pacific Island women have good bone mineral density (BMD) compared to other ethnicities; however, little evidence for this or for associated factors exists. This study aimed to explore associations between predictors of bone mineral density (BMD, g/cm2), in pre-menopausal Pacific Island women. Healthy pre-menopausal Pacific Island women (age 16–45 years) were recruited as part of the larger EXPLORE Study. Total body BMD and body composition were assessed using Dual X-ray Absorptiometry and air-displacement plethysmography (n = 83). A food frequency questionnaire (n = 56) and current bone-specific physical activity questionnaire (n = 59) were completed. Variables expected to be associated with BMD were applied to a hierarchical multiple regression analysis. Due to missing data, physical activity and dietary intake factors were considered only in simple correlations. Mean BMD was 1.1 ± 0.08 g/cm2. Bone-free, fat-free lean mass (LMO, 52.4 ± 6.9 kg) and age were positively associated with BMD, and percent body fat (38.4 ± 7.6) was inversely associated with BMD, explaining 37.7% of total variance. Lean mass was the strongest predictor of BMD, while many established contributors to bone health (calcium, physical activity, protein, and vitamin C) were not associated with BMD in this population, partly due to difficulty retrieving dietary data. This highlights the importance of physical activity and protein intake during any weight loss interventions to in order to minimise the loss of muscle mass, whilst maximizing loss of adipose tissue. PMID:27483314

  18. Role of Haptoglobin in Polycystic Ovary Syndrome (PCOS), Obesity and Disorders of Glucose Tolerance in Premenopausal Women

    PubMed Central

    Álvarez-Blasco, Francisco; Martínez-García, Ma Ángeles; Luque-Ramírez, Manuel; Parraza, Naiara; San Millán, José L.; Escobar-Morreale, Héctor F.

    2009-01-01

    Background Hp2 alleles of the haptoglobin α–chain polymorphism reduce the anti-oxidant properties and increase the pro-inflammatory actions of this acute-phase protein in a gene-dosage fashion. We hypothesized that the haptoglobin polymorphism might contribute to the increased oxidative stress and low-grade chronic inflammation frequently associated with polycystic ovary syndrome, obesity, and abnormalities of glucose tolerance. Methodology/Principal Findings Serum haptoglobin and the haptoglobin α–chain polymorphism were determined in 141 patients with polycystic ovary syndrome and 102 non-hyperandrogenic women. Of the whole group of 243 premenopausal women, 117 were obese and 51 showed abnormal glucose tolerance. Although serum haptoglobin concentrations were similar in PCOS patients and controls, the former presented with an increased frequency of Hp2 alleles (62% vs. 52%, P = 0.023). Circulating haptoglobin levels increased with obesity (P<0.001), yet no association was found between obesity and haptoglobin genotypes. No differences were observed in haptoglobin levels or genotype frequencies depending on glucose tolerance. Fifty percent of the variation in serum haptoglobin concentrations was explained by the variability in serum C-reactive protein concentrations, BMI, insulin sensitivity and haptoglobin genotypes. Conclusions/Significance Serum haptoglobin concentrations in premenopausal women are largely dependent on the haptoglobin polymorphism and on the presence of obesity, with insulin resistance and chronic inflammation possibly modulating this relationship. The association of polycystic ovary syndrome with Hp2 alleles suggests that the anti-oxidant and anti-inflammatory properties of haptoglobin may be reduced in these patients. PMID:19440331

  19. Estradiol effects on subcutaneous adipose tissue lipolysis in premenopausal women are adipose tissue depot specific and treatment dependent.

    PubMed

    Gavin, Kathleen M; Cooper, Elizabeth E; Raymer, Dustin K; Hickner, Robert C

    2013-06-01

    Estrogen has direct effects within adipose tissue and has been implicated in regional adiposity; however, the influence of estrogen on in vivo lipolysis is unclear. The purpose of this study was to investigate the effect of local 17β-estradiol (E(2)) on subcutaneous adipose tissue (SAT) lipolysis in premenopausal women. In vivo lipolysis (dialysate glycerol) was measured in 17 women (age 27.4 ± 2.0 yr, BMI 29.7 ± 0.5 kg/m(2)) via microdialysis of abdominal (AB) and gluteal (GL) SAT. Glycerol was measured at baseline and during acute interventions to increase lipolysis including local perfusion of isoproterenol (ISO, β-adrenergic agonist, 1.0 μmol/l), phentolamine (PHEN, α-adrenergic antagonist, 0.1 mmol/l), and submaximal exercise (60% Vo(2peak), 30 min); all with and without coperfusion of E(2) (500 nmol/l). E(2) coperfusion blunted the lipolytic response to ISO in AB (E(2) 196 ± 31%, control 258 ± 26%, P = 0.003) but not in GL (E(2) 113 ± 14%, control 111 ± 12%, P = 0.43) adipose tissue. At rest, perfusion of PHEN with ISO did not change dialysate glycerol. Submaximal exercise during ISO + PHEN increased dialysate glycerol in the AB (56 ± 9%) and GL (62 ± 12%) regions. Probes perfused with E(2) during exercise and ISO + PHEN had an increased lipolytic response in AB (90 ± 9%, P = 0.007) but a lower response in GL (35 ± 7%, P = 0.05) SAT compared with no-E(2) conditions. E(2) effects on lipolysis are region specific and may work through both adrenergic and adrenergic-independent mechanisms to potentiate and/or blunt SAT lipolysis in premenopausal women.

  20. Lean Mass and Body Fat Percentage Are Contradictory Predictors of Bone Mineral Density in Pre-Menopausal Pacific Island Women.

    PubMed

    Casale, Maria; von Hurst, Pamela R; Beck, Kathryn L; Shultz, Sarah; Kruger, Marlena C; O'Brien, Wendy; Conlon, Cathryn A; Kruger, Rozanne

    2016-07-30

    Anecdotally, it is suggested that Pacific Island women have good bone mineral density (BMD) compared to other ethnicities; however, little evidence for this or for associated factors exists. This study aimed to explore associations between predictors of bone mineral density (BMD, g/cm²), in pre-menopausal Pacific Island women. Healthy pre-menopausal Pacific Island women (age 16-45 years) were recruited as part of the larger EXPLORE Study. Total body BMD and body composition were assessed using Dual X-ray Absorptiometry and air-displacement plethysmography (n = 83). A food frequency questionnaire (n = 56) and current bone-specific physical activity questionnaire (n = 59) were completed. Variables expected to be associated with BMD were applied to a hierarchical multiple regression analysis. Due to missing data, physical activity and dietary intake factors were considered only in simple correlations. Mean BMD was 1.1 ± 0.08 g/cm². Bone-free, fat-free lean mass (LMO, 52.4 ± 6.9 kg) and age were positively associated with BMD, and percent body fat (38.4 ± 7.6) was inversely associated with BMD, explaining 37.7% of total variance. Lean mass was the strongest predictor of BMD, while many established contributors to bone health (calcium, physical activity, protein, and vitamin C) were not associated with BMD in this population, partly due to difficulty retrieving dietary data. This highlights the importance of physical activity and protein intake during any weight loss interventions to in order to minimise the loss of muscle mass, whilst maximizing loss of adipose tissue.

  1. Associations of Premenopausal Hysterectomy and Oophorectomy With Breast Cancer Among Black and White Women: The Carolina Breast Cancer Study, 1993–2001

    PubMed Central

    Robinson, Whitney R.; Nichols, Hazel B.; Tse, Chiu Kit; Olshan, Andrew F.; Troester, Melissa A.

    2016-01-01

    Black women experience higher rates of hysterectomy than other women in the United States. Although research indicates that premenopausal hysterectomy with bilateral oophorectomy decreases the risk of breast cancer in black women, it remains unclear how hysterectomy without ovary removal affects risk, whether menopausal hormone therapy use attenuates inverse associations, and whether associations vary by cancer subtype. In the population-based, case-control Carolina Breast Cancer Study of invasive breast cancer in 1,391 black (725 cases, 666 controls) and 1,727 white (939 cases, 788 controls) women in North Carolina (1993–2001), we investigated the associations of premenopausal hysterectomy and oophorectomy with breast cancer risk. Compared with no history of premenopausal surgery, bilateral oophorectomy and hysterectomy without oophorectomy were associated with lower odds of breast cancer (for bilateral oophorectomy, multivariable-adjusted odds ratios = 0.60, 95% confidence interval: 0.47, 0.77; for hysterectomy without oophorectomy, multivariable-adjusted odds ratios = 0.68, 95% confidence interval: 0.55, 0.84). Estimates did not vary by race and were similar for hormone receptor–positive and hormone receptor–negative cancers. Use of estrogen-only menopausal hormone therapy did not attenuate the associations. Premenopausal hysterectomy, even without ovary removal, may reduce the long-term risk of hormone receptor–positive and hormone receptor–negative breast cancers. Varying rates of hysterectomy are a potentially important contributor to differences in breast cancer incidence among racial/ethnic groups. PMID:27555487

  2. Physical, psychological, and menopause-related symptoms and minor psychiatric disorders in a community-based sample of Brazilian premenopausal, perimenopausal, and postmenopausal women.

    PubMed

    Oppermann, Karen; Fuchs, Sandra C; Donato, Giovana; Bastos, Carlos A; Spritzer, Poli Mara

    2012-03-01

    The aim of this study was to identify the prevalence of physical, psychological, and menopause-related symptoms and their association with minor psychiatric disorders in premenopausal, perimenopausal, and postmenopausal women. This was a nested cross-sectional study. Demographic characteristics, education, and climacteric symptoms were investigated. The 20-item Self-Reporting Questionnaire was used to screen for minor psychiatric disorders, with a score of 8 or higher indicating positive screening. We studied 324 Brazilian women aged 36 to 62 years (86 premenopausal women, 156 perimenopausal women, and 82 postmenopausal women). Mean (SD) age was 44.8 (3.6), 46.3 (4.6), and 53.3 (3.8) years, respectively (P < 0.001); 52.4% had 8 years or less of schooling (whereas 22.8% had 4 years or less). Forty-five (28.8%) perimenopausal women and 32 (39%) postmenopausal women were users of hormone therapy; 15 (17.4%) and 21 (13.5%) premenopausal and perimenopausal participants, respectively, were users of oral contraceptives. Hormone therapy and oral contraceptive users were excluded from the analysis of symptom prevalence. Hot flashes, night sweats, and vaginal dryness were more prevalent among perimenopausal women (P < 0.001). Fatigue was the most frequent complaint in all groups (61%, 81%, and 88% in premenopausal, perimenopausal, and postmenopausal women, respectively). The variables most frequently associated with positive findings during the screening for minor psychiatric disorders were very low education level and memory loss and irritability. Classic vasomotor complaints were weakly associated with nonpsychotic disease. In turn, perimenopausal women, but not postmenopausal women, were at greater risk of minor psychiatric disorders. Low education level, memory loss, irritability, and the menopausal transition represent risk factors for positive findings in a screening for minor psychiatric disorders.

  3. Effectiveness of Self Instructional Module on Coping Strategies of Tri-Dimensional Problems of Premenopausal Women – A Community Based Study

    PubMed Central

    Boro, Enu; Jamil, MD; Roy, Aakash

    2016-01-01

    Introduction Pre-menopause in women presents with diverse symptoms, encompassing the tri-dimensional spheres of physical, social and psychological domains, which requires development of appropriate coping strategies to overcome these problems. Aim To assess level of knowledge about tri-dimensional problems in pre-menopausal women and evaluate effectiveness of self instruction module on coping strategies of these problems by pre-test and post-test analysis. Materials and Methods In a cross-sectional, community based study, in pre-menopausal women aged 40-49years baseline knowledge of tridimensional problems was assessed in 300 pre-menopausal women, selected by convenient sampling after satisfying selection criteria, by a pre-formed questionnaire. This was followed by administration of a pre-tested, Self-Instructional Module (SIM). The SIM dealt with imparting knowledge about coping strategies regarding pre-menopausal problems and the participants were required to read and retain the SIM. Post-test was conducted using same questionnaire after seven days. Statistical Analysis Chi-square test/ Paired t-test was used for comparing ratios. A ‘p-value’ <0.05 was considered statistically significant. Results Baseline knowledge of tridimensional problems was adequate in 10%, moderate in 73% and inadequate in 17% women with a pre-test mean knowledge score of 8.66±2.45. The post-test mean knowledge score was higher (19.11±3.38) compared to the pre-test score. The post-test mean knowledge difference from pre-test was -10.45 with a highly significant paired t-value of -47.45 indicating that the self-instructional module was effective in increasing the knowledge score of pre- menopausal women under study. Conclusion Administration of self instructional module was shown to significantly increase the knowledge scores in all areas of pre-menopausal tri-dimensional problems. Such self-instructional module can be used as an effective educational tool in increasing the knowledge

  4. Menstruation does not cause anemia: endometrial thickness correlates positively with erythrocyte count and hemoglobin concentration in premenopausal women.

    PubMed

    Clancy, Kathryn B H; Nenko, Ilona; Jasienska, Grazyna

    2006-01-01

    Menstruation has often been cited as a risk factor for iron-deficiency anemia. This study tested whether normal, premenopausal women's luteal endometrial thickness (ET) was associated with their red blood cell count (RBC) and hemoglobin concentrations (Hg), and therefore whether a high ET put women at risk for anemia. Endometrial thickness can be considered a reasonable proxy for menstrual blood loss in normal women. Twenty-six healthy women from the Mogielica Human Ecology Study Site in Poland, aged 20-40 years (29 +/- 5.3 years, mean +/- SD), were selected. Subjects' ET was measured by transvaginal ultrasound in the luteal phase of the menstrual cycle, and their red blood cell count and hemoglobin concentrations were measured by fasting morning blood samples. Controlling for day of ET measurement, RBC and Hg were positively correlated with ET (r(2) = 0.24, P = 0.05; r(2) = 0.25, P = 0.04, respectively). We propose that, contrary to popular understanding, a thicker endometrium suggests greater iron reserves, rather than greater risk for anemia, in healthy women.

  5. The relationships among stress, coping, social support, and weight class in premenopausal African American women at risk for coronary heart disease.

    PubMed

    Strickland, Ora Lea; Giger, Joyce Newman; Nelson, Michelle A; Davis, Claudia M

    2007-01-01

    The purpose of this study was to determine the nature of the relationships among stress, coping, social support, and weight class in premenopausal African American women as risk factors for coronary heart disease. Overweight and obesity are significant problems for African American women who are at an increased risk of weight-related diseases, such as diabetes, hypertension, cardiovascular disease, and cancer. Of these women, those who are premenopausal have a significantly higher coronary heart disease mortality rate than their white counterparts. There are gaps in current knowledge concerning the role that stress and other psychosocial factors play in weight control of premenopausal African American women. Data were obtained from 178 women with eligible data sets from a larger study of 236 subjects (Genetic Predictors of Coronary Heart Disease in Premenopausal African American Women). The measures for stress, coping, and social support included the Perceived Stress Scale, the Norbeck Social Support Questionnaire, and the Jalowiec Coping Scale. The weight class of the women was determined as: normal weight-body mass index (BMI) of 18.5-24.9 kg/m, overweight-BMI of 25-29.9 kg/m, or obese-BMI > or = 30 kg/m. Statistical analysis conducted included Spearman's rho, Chi-square, and regression analysis. Confrontive coping was shown to be used more often to a "high" degree in normal-weight African American women than in overweight and obese African American women (chi = 24.024; P = .0001). Confrontive coping was the only independent predictor of weight class in a regression model that included perceived stress, life events, social support, and optimistic, self-reliant, and evasive coping strategies. Therefore, African American women who use confrontive coping to a high degree were more likely to confront problems, such as weight control issues, than those who use this coping strategy to a low or medium degree.

  6. Sexual desire, sexual arousal and hormonal differences in premenopausal US and Dutch women with and without low sexual desire.

    PubMed

    Heiman, Julia R; Rupp, Heather; Janssen, Erick; Newhouse, Sarah K; Brauer, Marieke; Laan, Ellen

    2011-05-01

    The interaction between women's hormonal condition and subjective, physiological, and behavioral indices of desire or arousal remains only partially explored, in spite of frequent reports from women about problems with a lack of sexual desire. The present study recruited premenopausal women at two sites, one in the United States and the other in the Netherlands, and incorporated various measures of acute changes in sexual desire and arousal. A sample of 46 women who met criteria for Hypoactive Sexual Desire Disorder (HSDD) was compared to 47 women who experienced no sexual problems (SF). Half of each group used oral contraceptives (OCs). The specific goal was to investigate whether there is a relationship between women's hormone levels and their genital and subjective sexual responsiveness. Background demographics and health variables, including oral contraceptive (OC) use, were recorded and hormones (total testosterone (T), free testosterone (FT), SHBG, and estradiol) were analyzed along with vaginal pulse amplitude and self-report measures of desire and arousal in response to sexual fantasy, visual sexual stimuli, and photos of men's faces. Self-reported arousal and desire were lower in the HSDD than the SF group, but only for women who were not using oral contraceptives. Relationships between hormones and sexual function differed depending on whether a woman was HSDD or not. In line with prior literature, FT was positively associated with physiological and subjective sexual arousal in the SF group. The HSDD women demonstrated the opposite pattern, in that FT was negatively associated with subjective sexual responsiveness. The findings suggest a possible alternative relationship between hormones and sexual responsiveness in women with HSDD who have characteristics similar to those in the present study.

  7. Do obesity and age effect the clinicopathological features and survival outcomes in premenopausal women with endometrial cancer?

    PubMed

    Topuz, S; Sozen, H; Vatansever, D; Iyibozkurt, A C; Ozgor, B Y; Bastu, E; Salihoglu, V; Berkman, S

    2016-01-01

    subgroups. Comorbid conditions (hypertension and diabetes mellitus) were found as statistically high in the obese patients' group (43.5%-25.8%). In contrast to comorbid conditions, nulliparity and infertility histories were observed more often within the normal weight group (55.6%-38.5%). Mean disease-free survival time was calculated as 155.81 months in the normal weight group; 114.691 months in the overweight group, and 144.677 months in the obese group. Five-year disease-free survival rate was calculated as 91%, 81%, and 87%, respectively (p = 0.452). Women with premenopausal cancers generally exhibit early and favorable histopathological symptoms. Although advanced stage endometrium cancer incidence was detected to be higher in the premenopausal endometrium cancer patients aged above 45 years compared to other age subgroups. A significant difference in terms of survival rates between these groups was not reached. In the same manner, the authors did not find a significant difference in survival rates among different weight subgroups of premenopausal endometrium cancer patients. As a secondary result, the authors discovered that diabetes mellitus and hypertension play a key role in patients with a BMI above 30 kg/m2 and nulliparity and infertility play a key role in patients with a BMI below 25 kg/m2 in the development of premenopausal endometrial cancer.

  8. Dietary Fat and Fiber Intakes Are Not Associated with Patterns of Urinary Estrogen Metabolites in Premenopausal Women123

    PubMed Central

    Oh, Hannah; Smith-Warner, Stephanie A; Tamimi, Rulla M; Wang, Molin; Xu, Xia; Hankinson, Susan E; Fuhrman, Barbara J; Ziegler, Regina G; Eliassen, A Heather

    2015-01-01

    Background: Interindividual differences in the bioavailability of potentially carcinogenic estrogen and estrogen metabolites (EMs) may play a role in the risk of breast cancer. Objective: We examined whether dietary intakes of fiber and fat influence premenopausal EM profiles through effects on estrogen synthesis, metabolism, or excretion. Methods: We conducted a cross-sectional analysis of 598 premenopausal women who participated in a reproducibility study (n = 109) or served as controls in a nested case-control study of breast cancer (n = 489) within the Nurses’ Health Study II. Dietary intakes of fiber and fat were assessed via semiquantitative food frequency questionnaires in 1995 and 1999. Midluteal urine samples were collected between 1996 and 1999 and EMs were quantified with the use of HPLC-tandem mass spectrometry. Linear mixed models were used to estimate creatinine-adjusted geometric means for individual EMs and their pathway groups across categories of dietary intake while controlling for total energy intake and potential confounders. Results: Higher total dietary fiber intake (>25 g/d vs. ≤15 g/d) was associated with significantly higher concentrations of 4-methoxyestradiol (50% difference, P-difference = 0.01, P-trend = 0.004) and lower concentrations of 17-epiestriol (−27% difference, P-difference = 0.03, P-trend = 0.03), but was not associated with any other EMs. The associations did not vary by fiber intake from different sources. Total fat intake (>35% energy vs. ≤25% energy) was suggestively positively associated with 17-epiestriol (22.6% difference, P-difference = 0.14, P-trend = 0.06); the association was significant for polyunsaturated fatty acid (37% difference, P-difference = 0.01, P-trend = 0.01) and trans fat (36.1% difference, P-difference = 0.01, P-trend = 0.01) intakes. Conclusion: Fiber and fat intakes were not strongly associated with patterns of estrogen metabolism in premenopausal women. Our data suggest estrogen metabolism

  9. Increasing Iron and Zinc in Pre-Menopausal Women and Its Effects on Mood and Cognition: A Systematic Review

    PubMed Central

    Lomagno, Karla A.; Hu, Feifei; Riddell, Lynn J.; Booth, Alison O.; Szymlek-Gay, Ewa A.; Nowson, Caryl A.; Byrne, Linda K.

    2014-01-01

    Iron and zinc are essential minerals often present in similar food sources. In addition to the adverse effects of frank iron and zinc-deficient states, iron insufficiency has been associated with impairments in mood and cognition. This paper reviews current literature on iron or zinc supplementation and its impact on mood or cognition in pre-menopausal women. Searches included MEDLINE complete, Excerpta Medica Database (EMBASE), psychINFO, psychARTICLES, pubMED, ProQuest Health and Medical Complete Academic Search complete, Scopus and ScienceDirect. Ten randomized controlled trials and one non-randomized controlled trial were found to meet the inclusion criteria. Seven studies found improvements in aspects of mood and cognition after iron supplementation. Iron supplementation appeared to improve memory and intellectual ability in participants aged between 12 and 55 years in seven studies, regardless of whether the participant was initially iron insufficient or iron-deficient with anaemia. The review also found three controlled studies providing evidence to suggest a role for zinc supplementation as a treatment for depressive symptoms, as both an adjunct to traditional antidepressant therapy for individuals with a diagnosis of major depressive disorder and as a therapy in its own right in pre-menopausal women with zinc deficiency. Overall, the current literature indicates a positive effect of improving zinc status on enhanced cognitive and emotional functioning. However, further study involving well-designed randomized controlled trials is needed to identify the impact of improving iron and zinc status on mood and cognition. PMID:25405366

  10. Comparison of the effects of two resistance training regimens on muscular and bone responses in premenopausal women.

    PubMed

    Vanni, A C; Meyer, F; da Veiga, A D R; Zanardo, V P S

    2010-09-01

    A 28-week resistance training with linear periodization was compared with an undulating model in 27 premenopausal women. In both groups, bone mineral density (BMD) was not changed but muscle strength increased, and there were changes in anthropometrical and muscle damage parameters, indicating that in this population, these models are similar concerning these variables. This study seeks to compare the effects of resistance training with undulating versus linear periodization on BMD, muscle strength, anthropometrical variables, and muscle damage parameters in premenopausal women. Twenty-seven females (39.6 +/- 0.41 years, mean +/- standard error), without osteopenia or osteoporosis and without calcium supplementation, were randomly assigned either to a linear periodization group (LPG, n = 14) or to an undulating periodization group (UPG, n = 13). The subjects were trained three times a week for 28 weeks. Lumbar spine and femoral neck BMDs were measured through dual-energy X-ray absorptiometry. Maximal and submaximal dynamic muscle strengths were measured through the 1-RM and 20-RM tests, respectively. Anthropometrical (body mass, skinfolds, and perimeters) and muscle damage parameters were assessed through serum creatine kinase (CK) and delayed-onset muscle soreness (DOMS). BMD remained unchanged in both groups, despite significant increases in maximal (LPG, 37-73%; UPG, 40-70%) and submaximal (LPG, 82-114%; UPG, 70-102%) muscle strength. The perimeter of the distal thigh was increased (about 1.7 cm) in both groups. CK and DOMS were greater in the first mesocycle than in the subsequent ones. After the 1st training session in each mesocycle, 24 and 48 h CK was increased as compared to pretraining values. The resistance training of 28 weeks increased muscle strength in both training groups with no difference in BMD or in the occurrence of muscle damage.

  11. Luteal versus follicular phase surgical oophorectomy plus tamoxifen in premenopausal women with metastatic hormone receptor positive breast cancer

    PubMed Central

    Love, Richard R.; Hossain, Syed Mozammel; Hussain, Md. Margub; Mostafa, Mohammad Golam; Laudico, Adriano V.; Siguan, Stephen Sixto S.; Adebamowo, Clement; Sun, Jing-zhong; Fei, Fei; Shao, Zhi-Ming; Yunjiang, Liu; Akram Hussain, Syed Md.; Zhang, Baoning; Lin, Cheng; Panigaro, Sonar; Walta, Fardiana; Chuan, Jiang Hong; Mirasol-Lumague, Maria Rica; Yip, Cheng-Har; Navarro, Narciso S.; Huang, Chiun-sheng; Lu, Yen-shen; Ferdousy, Tahmina; Salim, Reza; Akhter, Chameli; Nahar, Shamsun; Uy, Gemma; Young, Gregory S.; Hade, Erinn M.; Jarjoura, David

    2016-01-01

    Purpose In premenopausal women with metastatic hormone receptor positive breast cancer, hormonal therapy is the first line therapy. GnRH + tamoxifen therapies have been found to be more effective. The pattern of recurrence risk over time after primary surgery suggests that peri-operative factors impact recurrence. Secondary analyses of an adjuvant trial suggested that the luteal phase timing of surgical oophorectomy in the menstrual cycle simultaneous with primary breast surgery favorably influenced long-term outcomes. Methods 249 premenopausal women with incurable or metastatic hormone receptor positive breast cancer entered a trial in which they were randomized to historical mid-luteal or mid-follicular phase surgical oophorectomy followed by oral tamoxifen treatment. Kaplan-Meier methods, the log-rank test, and multivariable Cox regression models were used to assess overall and progression free survival in the two randomized groups and by hormone confirmed menstrual cycle phase. Results Overall survival (OS) and progression-free survival were not demonstrated to be different in the two randomized groups. In a secondary analysis, OS appeared worse in luteal phase surgery patients with progesterone levels of <2ng/ml (anovulatory patients) (adjusted hazard ratio 1.46, 95% CI: 0.89–2.41, p=0.14) compared to patients in luteal phase with progesterone 2ng/ml or higher. Median overall survival was 2.0 years (95% CI: 1.7 – 2.3) and OS at 4 years was 26%. Conclusions The history-based timing of surgical oophorectomy in the menstrual cycle did not influence outcomes in this trial of metastatic patients. ClinicalTrials.gov number NCT 00293540 PMID:27107325

  12. Relationship of Bone Mineralization Density Distribution (BMDD) in Cortical and Cancellous Bone Within the Iliac Crest of Healthy Premenopausal Women

    PubMed Central

    Dempster, D. W.; Zhou, Hua; Roschger, P.; Fratzl-Zelman, N.; Fratzl, P.; Silverberg, S. J.; Shane, E.; Cohen, A.; Stein, E.; Nickolas, T. L.; Recker, R. R.; Lappe, J.; Bilezikian, J. P.; Klaushofer, K.

    2015-01-01

    Bone mineralization density distribution (BMDD) is an important determinant of bone mechanical properties. The most available skeletal site for access to the BMDD is the iliac crest. Compared to cancellous bone much less information on BMDD is available for cortical bone. Hence, we analyzed complete transiliac crest bone biopsy samples from premenopausal women (n = 73) aged 25–48 years, clinically classified as healthy, by quantitative backscattered electron imaging for cortical (Ct.) and cancellous (Cn.) BMDD. The Ct.BMDD was characterized by the arithmetic mean of the BMDD of the cortical plates. We found correlations between Ct. and Cn. BMDD variables with correlation coefficients r between 0.42 and 0.73 (all p < 0.001). Additionally to this synchronous behavior of cortical and cancellous compartments, we found that the heterogeneity of mineralization densities (Ct.CaWidth), as well as the cortical porosity (Ct.Po) was larger for a lower average degree of mineralization (Ct.CaMean). Moreover, Ct.Po correlated negatively with the percentage of highly mineralized bone areas (Ct.CaHigh) and positively with the percentage of lowly mineralized bone areas (Ct.CaLow). In conclusion, the correlation of cortical with cancellous BMDD in the iliac crest of the study cohort suggests coordinated regulation of bone turnover between both bone compartments. Only in a few cases, there was a difference in the degree of mineralization of >1wt % between both cortices suggesting a possible modeling situation. This normative dataset of healthy premenopausal women will provide a reference standard by which disease- and treatment-specific effects can be assessed at the level of cortical bone BMDD. PMID:25134800

  13. Alcohol consumption in relation to plasma sex hormones, prolactin, and sex hormone-binding globulin in premenopausal women.

    PubMed

    Hirko, Kelly A; Spiegelman, Donna; Willett, Walter C; Hankinson, Susan E; Eliassen, A Heather

    2014-12-01

    Alcohol consumption is a consistent risk factor for breast cancer, and evidence suggests premenopausal plasma hormones are associated with breast cancer. Plasma concentrations of estradiol, estrone, estrone sulfate, testosterone, androstenedione, progesterone, prolactin, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were measured in samples collected in 1996-99. Average alcohol intake was calculated from semiquantitative food frequency questionnaires collected in 1995 and 1999. We used generalized linear models to calculate geometric mean hormone concentrations across alcohol categories and the percentage difference for the highest versus lowest category. Comparing women who consumed >20 g/d with nondrinkers, levels were 25.7% higher for luteal estrone (geometric mean, 106 vs. 84.5 pg/mL; Ptrend = 0.001), 27.2% higher for luteal estradiol (182 vs. 143 pg/mL; Ptrend = 0.006), and 16.8% higher for SHBG (85.6 vs. 73.3 nmol/L; Ptrend = 0.03); concentrations of free testosterone were 17.9% lower (0.16 vs. 0.20 ng/dL; Ptrend = 0.002). Women consuming >10 g/d compared with nondrinkers had 26.5% higher concentrations of follicular estrone sulfate (950 vs. 751 pg/mL; Ptrend = 0.04). We did not observe significant associations between alcohol and the other sex hormones evaluated. Significant positive associations were observed with beer intake, but not other alcohol types, for DHEA (Pinteraction = 0.003) and androstenedione (Pinteraction = 0.006). Alcohol consumption was significantly positively associated with plasma luteal estrogen concentrations, but not with androgen levels, nor estrone or estradiol measured in the follicular phase. Differences in premenopausal estrogen levels may contribute to the association between alcohol and breast cancer. ©2014 American Association for Cancer Research.

  14. Cost-effectiveness of cranberries vs antibiotics to prevent urinary tract infections in premenopausal women: a randomized clinical trial.

    PubMed

    Bosmans, Judith E; Beerepoot, Mariëlle A J; Prins, Jan M; ter Riet, Gerben; Geerlings, Suzanne E

    2014-01-01

    Urinary tract infections (UTIs) are common and result in an enormous economic burden. The increasing prevalence of antibiotic-resistant microorganisms has stimulated interest in non-antibiotic agents to prevent UTIs. To evaluate the cost-effectiveness of cranberry prophylaxis compared to antibiotic prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) over a 12 month period in premenopausal women with recurrent UTIs. An economic evaluation was performed alongside a randomized trial. Primary outcome was the number of UTIs during 12 months. Secondary outcomes included satisfaction and quality of life. Healthcare utilization was measured using questionnaires. Missing data were imputed using multiple imputation. Bootstrapping was used to evaluate the cost-effectiveness of the treatments. Cranberry prophylaxis was less effective than TMP-SMX prophylaxis, but the differences in clinical outcomes were not statistically significant. Costs after 12 months in the cranberry group were statistically significantly higher than in the TMP-SMX group (mean difference €249, 95% confidence interval 70 to 516). Cost-effectiveness planes and cost-effectiveness acceptability curves showed that cranberry prophylaxis to prevent UTIs is less effective and more expensive than (dominated by) TMP-SMX prophylaxis. In premenopausal women with recurrent UTIs, cranberry prophylaxis is not cost-effective compared to TMP-SMX prophylaxis. However, it was not possible to take into account costs attributed to increased antibiotic resistance within the framework of this randomized trial; modeling studies are recommended to investigate these costs. Moreover, although we based the dosage of cranberry extract on available evidence, this may not be the optimal dosage. Results may change when this optimal dosage is identified. ISRCTN.org ISRCTN50717094.

  15. Cranberries vs antibiotics to prevent urinary tract infections: a randomized double-blind noninferiority trial in premenopausal women.

    PubMed

    Beerepoot, Mariëlle A J; ter Riet, Gerben; Nys, Sita; van der Wal, Willem M; de Borgie, Corianne A J M; de Reijke, Theo M; Prins, Jan M; Koeijers, Jeanne; Verbon, Annelies; Stobberingh, Ellen; Geerlings, Suzanne E

    2011-07-25

    The increasing prevalence of uropathogens resistant to antimicrobial agents has stimulated interest in cranberries to prevent recurrent urinary tract infections (UTIs). In a double-blind, double-dummy noninferiority trial, 221 premenopausal women with recurrent UTIs were randomized to 12-month prophylaxis use of trimethoprim-sulfamethoxazole (TMP-SMX), 480 mg once daily, or cranberry capsules, 500 mg twice daily. Primary end points were the mean number of symptomatic UTIs over 12 months, the proportion of patients with at least 1 symptomatic UTI, the median time to first UTI, and development of antibiotic resistance in indigenous Escherichia coli. After 12 months, the mean number of patients with at least 1 symptomatic UTI was higher in the cranberry than in the TMP-SMX group (4.0 vs 1.8; P = .02), and the proportion of patients with at least 1 symptomatic UTI was higher in the cranberry than in the TMP-SMX group (78.2% vs 71.1%). Median time to the first symptomatic UTI was 4 months for the cranberry and 8 months for the TMP-SMX group. After 1 month, in the cranberry group, 23.7% of fecal and 28.1% of asymptomatic bacteriuria E coli isolates were TMP-SMX resistant, whereas in the TMP-SMX group, 86.3% of fecal and 90.5% of asymptomatic bacteriuria E coli isolates were TMP-SMX resistant. Similarly, we found increased resistance rates for trimethoprim, amoxicillin, and ciprofloxacin in these E coli isolates after 1 month in the TMP-SMX group. After discontinuation of TMP-SMX, resistance reached baseline levels after 3 months. Antibiotic resistance did not increase in the cranberry group. Cranberries and TMP-SMX were equally well tolerated. In premenopausal women, TMP-SMX, 480 mg once daily, is more effective than cranberry capsules, 500 mg twice daily, to prevent recurrent UTIs, at the expense of emerging antibiotic resistance. isrctn.org Identifier: ISRCTN50717094.

  16. Ethnic differences in dietary intakes, physical activity, and energy expenditure in middle-aged, premenopausal women: the Healthy Transitions Study.

    PubMed

    Lovejoy, J C; Champagne, C M; Smith, S R; de Jonge, L; Xie, H

    2001-07-01

    Menopause is a time of increased risk of obesity in women. The effect of menopause in African American women, in whom obesity is already highly prevalent, is unknown. We compared dietary intakes and energy expenditure (EE) between middle-aged, premenopausal African American and white women participating in a longitudinal study of the menopausal transition. Dietary intakes by food record, EE by triaxial accelerometer, physical activity by self-report, and body composition by dual-energy X-ray absorptiometry were compared in 97 white and 52 African American women. Twenty-four-hour and sleeping EE were measured by whole-room indirect calorimetry in 56 women. Sleeping EE (adjusted for lean and fat mass) was lower in African American than in white women (5749 +/- 155 compared with 6176 +/- 75 kJ/d; P = 0.02); however, there was no significant difference in 24-h EE between groups. Reported leisure activity over the course of a week was less in African American than in white women (556 +/- 155 compared with 1079 +/- 100 kJ/d; P = 0.02), as were the daily hours spent standing and climbing stairs. Dietary intakes of protein, fiber, calcium, magnesium, and several fatty acids were significantly less in African Americans, whereas there were no observed ethnic differences in intakes of fat or carbohydrate. Body fat within the whole group was positively correlated with total, saturated, and monounsaturated fat intakes and inversely associated with fiber and calcium intakes. Fiber was the strongest single predictor of fatness. Ethnic differences in EE and the intake of certain nutrients may influence the effect of menopausal transition on obesity in African American women.

  17. The relationship between sugar-sweetened beverages and liver enzymes among healthy premenopausal women: a prospective cohort study.

    PubMed

    Shimony, Maya K; Schliep, Karen C; Schisterman, Enrique F; Ahrens, Katherine A; Sjaarda, Lindsey A; Rotman, Yaron; Perkins, Neil J; Pollack, Anna Z; Wactawski-Wende, Jean; Mumford, Sunni L

    2016-03-01

    To prospectively assess the association between sugar-sweetened beverages (SSB), added sugar, and total fructose and serum concentrations of liver enzymes among healthy, reproductive-age women. A prospective cohort of 259 premenopausal women (average age 27.3 ± 8.2 years; BMI 24.1 ± kg/m(2)) were followed up for up to two menstrual cycles, providing up to eight fasting blood specimens/cycle and four 24-h dietary recalls/cycle. Women with a history of chronic disease were excluded. Alanine and aspartate aminotransferases (ALT and AST, respectively) were measured in serum samples. Linear mixed models estimated associations between average SSB, added sugar, and total fructose intake and log-transformed liver enzymes adjusting for age, race, body mass index, total energy and alcohol intake, and Mediterranean diet score. For every 1 cup/day increase in SSB consumption and 10 g/day increase in added sugar and total fructose, log ALT increased by 0.079 U/L (95 % CI 0.022, 0.137), 0.012 U/L (95 % CI 0.002, 0.022), and 0.031 (0.012, 0.050), respectively, and log AST increased by 0.029 U/L (-0.011, 0.069), 0.007 U/L (0.000, 0.014), and 0.017 U/L (0.004, 0.030), respectively. Women who consumed ≥1.50 cups/day (12 oz can) SSB versus less had 0.127 U/L (95 % CI 0.001, 0.254) higher ALT [percent change 13.5 % (95 % CI 0.1, 28.9)] and 0.102 (95 % CI 0.015, 0.190) higher AST [percent change 10.8 % (95 % CI 1.5, 20.9)]. Sugar-sweetened beverages were associated with higher serum ALT and AST concentrations among healthy premenopausal women, indicating that habitual consumption of even moderate SSB may elicit hepatic lipogenesis.

  18. Health concept and health promotion process among Korean migrant women.

    PubMed

    Cha, Chiyoung

    2013-01-01

    My purpose in this study was to explore the concepts of health and the health promotion process among Korean women who migrated to North America for their children's education. Interviews and surveys were analyzed using a grounded theory analysis and descriptive statistics. Women in this study established their health concept and health promotion process in accordance to their socially constructed mother role. The women established unique meanings of health and developed an altruistic motivation to be healthy that allowed them to actively pursue health promotion despite their traditional care provider roles.

  19. Whole grains are associated with serum concentrations of high sensitivity C-reactive protein among premenopausal women.

    PubMed

    Gaskins, Audrey J; Mumford, Sunni L; Rovner, Alisha J; Zhang, Cuilin; Chen, Liwei; Wactawski-Wende, Jean; Perkins, Neil J; Schisterman, Enrique F

    2010-09-01

    In premenopausal women, elevated C-reactive protein (CRP) concentrations have been associated with an increased risk of negative reproductive outcomes. Whole grain consumption has been associated with lower CRP concentrations in older women; however, less is known about this relationship in younger women. We investigated whether whole grain intake was associated with serum high sensitivity CRP (hs-CRP) concentrations in young women. BioCycle was a prospective cohort study conducted at the University of Buffalo from 2005 to 2007, which followed 259 healthy women aged 18-44 y for or= 1 serving/d had 12.3% lower hs-CRP concentrations (P = 0.02) compared with nonconsumers. Women who consumed >or= 1 serving/d of whole grain had a lower probability of having moderate (P = 0.008) or elevated (P = 0.001) hs-CRP according to the AHA criteria compared with nonconsumers. Given that elevated concentrations of hs-CRP have been linked to adverse reproductive outcomes and pregnancy complications, interventions targeting whole grain consumption may have the potential to improve health status among young women.

  20. Goserelin with chemotherapy to preserve ovarian function in pre-menopausal women with early breast cancer: menstruation and pregnancy outcomes.

    PubMed

    Wong, M; O'Neill, S; Walsh, G; Smith, I E

    2013-01-01

    Premature ovarian failure and infertility following chemotherapy in early breast cancer (EBC) are major concerns for young women. The role of gonadotrophin-releasing hormone (GnRH) agonists with chemotherapy in EBC in reducing the incidence of chemotherapy-induced early menopause remains uncertain, and long-term data on the recovery of fertility are sparse. We report an audit of our experience with the GnRH agonist, goserelin (Zoladex®), used with chemotherapy to preserve ovarian function and maintain fertility. Pre-menopausal women were given goserelin subcutaneously every 28 days during chemotherapy, starting 0-14 days before treatment. The main clinical end point was recovery of menstruation after chemotherapy. The other end points were rate of successful conception and median time to recovery of menses. About 84% of 125 women recovered menstruation with the median time to recovery of 6 months (1-43 months), including 76% of 71 patients aged over 35. Of the 42 patients who attempted pregnancy, 71% (n=30) managed to achieve pregnancies. At the time of analysis, there were 42 pregnancies and 30 healthy deliveries. The GnRH agonist, goserelin, given with chemotherapy for EBC is associated with a low risk of long-term chemotherapy-induced amenorrhoea and a high chance of pregnancy. Further randomised trials are needed.

  1. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women(∗): (∗)2016 ISSM Female Sexual Dysfunction Prize.

    PubMed

    Wåhlin-Jacobsen, Sarah; Kristensen, Ellids; Pedersen, Anette Tønnes; Laessøe, Nanna Cassandra; Cohen, Arieh S; Hougaard, David M; Lundqvist, Marika; Giraldi, Annamaria

    2017-03-01

    The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A

  2. Gene expression profiling in melasma in Korean women.

    PubMed

    Chung, Bo Young; Noh, Tai Kyung; Yang, Sang Hwa; Kim, Il Hwan; Lee, Mi Woo; Yoon, Tae Jin; Chang, Sung Eun

    2014-01-01

    There has been a paucity of data about the difference in gene expression between melasma lesional skin and normal adjacent one. Our aim was to identify novel genes involved in the pathogenesis of melasma. We performed a microarray analysis and confirmed the results on quantitative real-time polymerase chain reaction (qRT-PCR) in Korean women with melasma. There were 334 genes whose degree of expression showed a significant difference between melasma lesional skin and normal adjacent one. Of these, five were confirmed on qRT-PCR. In melasma lesional skin, there were down-regulation of genes involved in the PPAR signaling pathway and up-regulation of genes involved in neuronal component and the functions of stratum corneum barrier. This result suggests that the pathogenesis of melasma might be associated with novel genes involved in the above signaling pathway in Korean women.

  3. Dietary Patterns and Osteoporosis Risk in Postmenopausal Korean Women

    PubMed Central

    Park, Seon-Joo; Joo, Seong-Eun; Min, Haesook; Park, Jae Kyung; Kim, Yeonjung; Kim, Sung Soo; Ahn, Younjhin

    2012-01-01

    Objectives The prevalence of osteoporosis and related fractures has increased rapidly in Korean women. Proper nutrition intake is associated with the prevention of osteoporosis. We analyzed the association between dietary patterns and the risk of osteoporosis during a 4-year follow-up in postmenopausal Korean women. Methods Postmenopausal women (n = 1,725) who participated in the Korean Genome and Epidemiology Study were enrolled. Food intake was assessed using a validated semiquantitative food frequency questionnaire, and a quantitative ultrasound device was used to measure the speed of sound at the radius and tibia. Results Three major dietary patterns were identified using factor analysis based on baseline intake data: traditional (high intake of rice, kimchi, and vegetables), dairy (high intake of milk, dairy products, and green tea), and western (high intake of sugar, fat, and bread). Multivariate Cox proportional hazards models were used to estimate relative risk for osteoporosis. An inverse association was detected between the dairy dietary pattern and the osteoporosis incidence [relative risk (RR): 0.63, 95% confidence interval (CI): 0.42–0.93, p-trend=0.055 in radius; RR: 0.56, 95% CI: 0.35–0.90, p-trend=0.048 in tibia]. Individuals in the highest quintile for the traditional dietary pattern (p-trend = 0.009 in tibia) and western dietary pattern (p-trend = 0.043 in radius) demonstrated a higher risk of osteoporosis incidence than those in the lowest quintile. Conclusion These results suggested that high consumption of milk, dairy products, and green tea may reduce the risk of osteoporosis in postmenopausal Korean women. PMID:24159515

  4. Depression in non-Korean women residing in South Korea following marriage to Korean men.

    PubMed

    Kim, Hyun-Sil; Kim, Hun-Soo

    2013-06-01

    The purpose of the study was to examine the roles of acculturative stress, life satisfaction, and language literacy in depression in non-Korean women residing in South Korea following marriage to Korean men. A cross-sectional study was performed, using an anonymous, self-reporting questionnaire. A total of 173 women were selected using a proportional stratified random sampling method. The relation between acculturation, depression, language literacy, life satisfaction and socio-demographic variables and the predictors of depression among participants were analyzed. The analysis included descriptive statistics and hierarchical multiple regression. Of the participants, 9.2% had depression, which was almost twice the rate of depression found in the general Korean population. In hierarchical multiple regression analysis, acculturative stress (beta=-.325, P<.001) and life satisfaction (beta=-.282, P=.003) were significantly associated with the level of depression. This final model was statistically significant and life satisfaction, acculturative stress, language literacy accounted for 31.0% (adjusted R(2)) of the variance in the depression score (P<.001). Elevated acculturative stress and less life satisfaction were significantly associated with a higher level of depression in migrant wives in Korea. Implications for practice and research are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Premenopausal Women with a Distal Radial Fracture Have Deteriorated Trabecular Bone Density and Morphology Compared with Controls without a Fracture

    PubMed Central

    Rozental, Tamara D.; Deschamps, Laura N.; Taylor, Alexander; Earp, Brandon; Zurakowski, David; Day, Charles S.; Bouxsein, Mary L.

    2013-01-01

    Background: Measurement of bone mineral density by dual x-ray absorptiometry combined with clinical risk factors is currently the gold standard in diagnosing osteoporosis. Advanced imaging has shown that older patients with fragility fractures have poor bone microarchitecture, often independent of low bone mineral density. We hypothesized that premenopausal women with a fracture of the distal end of the radius have similar bone mineral density but altered bone microarchitecture compared with control subjects without a fracture. Methods: Forty premenopausal women with a recent distal radial fracture were prospectively recruited and matched with eighty control subjects without a fracture. Primary outcome variables included trabecular and cortical microarchitecture at the distal end of the radius and tibia by high-resolution peripheral quantitative computed tomography. Bone mineral density at the wrist, hip, and lumbar spine was also measured by dual x-ray absorptiometry. Results: The fracture and control groups did not differ with regard to age, race, or body mass index. Bone mineral density was similar at the femoral neck, lumbar spine, and distal one-third of the radius, but tended to be lower in the fracture group at the hip and ultradistal part of the radius (p = 0.06). Trabecular microarchitecture was deteriorated in the fracture group compared with the control group at both the distal end of the radius and distal end of the tibia. At the distal end of the radius, the fracture group had lower total density and lower trabecular density, number, and thickness compared with the control group (–6% to –14%; p < 0.05 for all). At the distal end of the tibia, total density, trabecular density, trabecular thickness, and cortical thickness were lower in the fracture group than in the control group (–7% to –14%; p < 0.01). Conditional logistic regression showed that trabecular density, thickness, separation, and distribution of trabecular separation remained

  6. Cancer screening behaviors among Korean-American women.

    PubMed

    Juon, H S; Choi, Y; Kim, M T

    2000-01-01

    The goals of this study were to evaluate breast and cervical cancer screening tests and to examine the correlates of cancer screening behaviors. A cross-sectional face-to-face survey of 438 Korean-American women residing in Maryland was conducted. About 50% of women age 18 and older had had a Pap smear and 46.6% of these women age 40 and older had had a mammogram in the past 2 years. In multiple logistic regression analyses, the strongest correlate of screening behaviors was having a regular medical checkup. Age and acculturation were found to be important correlates of cancer screening tests: Women less than 50 years of age were more likely to have cancer screening tests than those 50 years and older. English language proficiency was associated with having a mammogram and the proportion of life spent in the United States was associated with having a Pap smear. Employment interacted with marital status for a Pap smear, with those married and unemployed being less likely to have a Pap smear than women who were both married and employed. For strategies to increase cancer-screening tests among Korean-American women, we need to aim at developing culturally appropriate educational programs about cancer for less acculturated and recent immigrants.

  7. Teaching about the Korean Comfort Women

    ERIC Educational Resources Information Center

    Kim, Hyunduk

    2012-01-01

    During World War II, human rights violations against women took on gargantuan proportions of indescribable horror. The Japanese military engaged in the systematic abduction of women from China, Indonesia, Japan, Korea, the Philippines, Taiwan, and other nations and confined them to military installations in Japanese-occupied territories to serve…

  8. Teaching about the Korean Comfort Women

    ERIC Educational Resources Information Center

    Kim, Hyunduk

    2012-01-01

    During World War II, human rights violations against women took on gargantuan proportions of indescribable horror. The Japanese military engaged in the systematic abduction of women from China, Indonesia, Japan, Korea, the Philippines, Taiwan, and other nations and confined them to military installations in Japanese-occupied territories to serve…

  9. High intensity interval training does not impair strength gains in response to resistance training in premenopausal women.

    PubMed

    Gentil, Paulo; de Lira, Claudio Andre Barbosa; Filho, Suedi Gonçalves Cardoso; La Scala Teixeira, Cauê Vazquez; Steele, James; Fisher, James; Carneiro, Juliana Alves; Campos, Mário Hebling

    2017-06-01

    To compare the increases in upper- and lower-body muscle strength in premenopausal women performing resistance training (RT) alone or alongside concurrent high-intensity interval training (CT). Sixteen women (26-40 years) were randomly assigned into two groups that performed either RT or CT. Both groups performed the same RT program; however, CT performed additional high-intensity interval training (HIIT) on a bicycle ergometer before RT. The study lasted 8 weeks and the participants were tested for ten repetition maximum (10RM) load in elbow flexion (barbell biceps curl) and knee extension exercises pre- and post-intervention. RT was performed with 10-12 repetitions to self-determined repetition maximum in the first four weeks and then progressed to 8-10. During CT, HIIT was performed before RT with six 1-min bouts at 7-8 of perceived subjective exertion (RPE) and then progressed to eight bouts at 9-10 RPE. Analysis of variance revealed significant increases in upper and lower body strength for both the RT and CT groups. Biceps barbell curl 10RM load increased from 12.9 ± 3.2 kg to 14 ± 1.5 kg in CT (p < 0.05) and from 13 ± 1.8 kg to 15.9 ± 2.5 kg in RT (p < 0.05), with no significant between-groups differences. Knee extension 10RM increase from 31.9 ± 11.6 kg to 37.5 ± 8.5 kg for CT (p < 0.05) and from 30.6 ± 8.6 kg to 41.2 ± 7.4 kg for RT (p < 0.05). In conclusion, performing HIIT on a cycle ergometer before resistance training does not seem to impair muscle strength increases in the knee extensors or elbow flexors of pre-menopausal women. This information should be considered when prescribing exercise sessions, since both activities may be combined without negative effects in muscle strength.

  10. Relationship between serum hormone concentrations, reproductive history, alcohol consumption and genetic polymorphisms in pre-menopausal women.

    PubMed

    García-Closas, Montserrat; Herbstman, Julie; Schiffman, Mark; Glass, Andrew; Dorgan, Joanne F

    2002-11-10

    Reproductive characteristics, alcohol intake and polymorphisms in genes encoding sex-steroid metabolizing enzymes might influence the risk of hormone-related cancers by changing circulating concentrations of sex hormones. The relationship between these factors and serum concentrations of estradiol, progesterone, androstenedione, testosterone and DHEA was evaluated in a cross-sectional study of 218 pre-menopausal women from Kaiser Permanente Health Plan in Portland, Oregon. Risk factor information was obtained from questionnaires and hormone serum concentrations were determined by radioimmunoassays. Genotypes for CYP11A 5'UTR(tttta)n, CYP17 5'-UTR -34 T>C, CYP19 IVS4(ttta)n, CYP1B1 (L432V and S453N) and COMT (V158M) were determined from genomic DNA samples. Increasing number of full-term pregnancies was associated with a significant decrease in late-follicular progesterone levels (p-trend = 0.03). Increasing alcohol consumption was associated with higher estradiol levels averaged through the menstrual cycle (p-trend = 0.009) and higher progesterone levels during luteal phase (p-trend = 0.04). Androstenedione and testosterone levels were higher among light to moderate drinkers compared to non-drinkers, although we only observe a significant trend with increasing levels of alcohol consumption for androstenedione. Women heterozygous or homozygous for the CYP1B1 L432V or the S453N polymorphisms had increased luteal estradiol levels (p-value = 0.04 for L432V and 0.04 for S453N). None of the other factors evaluated was significantly associated with serum concentration of hormones. In conclusion, results from this cross-sectional study of pre-menopausal women provide support for an association between light to moderate alcohol intake and elevated levels of estrogen and androgen levels. Our data suggest that circulating levels of progesterone might be related to parity and alcohol consumption, however the biological plausibility of the observed associations is unclear. We

  11. Perceived threat predictor of calcium-rich foods in the women of premenopausal age Isfahan - Iran in 2013-2014

    PubMed Central

    Bahadoran, Parvin; Hoseini, Marjan; Kazemi, Ashraf

    2015-01-01

    Background: During women lives, frequently face the challenge of calcium reduction and absorption. Decreased calcium absorption followed by a decrease in estrogen at perimenopausal ages, low average per capita calcium intake among women, wrong nutritional behavior, household income reductions and make them more susceptible to osteoporosis and related complications. The aim of this study was to evaluate the relationship between the health belief model constructs and consuming calcium-rich foods in menopausal age women. Materials and Methods: This study was descriptive-correlation study. The questionnaires were completed by 210 menopausal women who had referred to health centers. The research data were analyzed using: Frequency distribution, mean score, Pearson correlation coefficients and multivariate regression. Significant level of P < 0/05 were considered. Results: The mean and standard deviation of the scores for perceived susceptibility and severity of the threats of consumption and complications of inadequate intake were respectively: (62.1 and 38.9, and 60.2 and 39.9) and (59.6 and 37.9 and 56.3 and 36.5). The relationship between the number of units of calcium intake with perceived susceptibility and severity calcium intake and complications caused by the inadequate intake of calcium were (P < 0.001, r = 0.581, r = 0.651) and (P < 0.001, r = 0.634, r = 0.567). Conclusions: The obtained results indicate that perceived threat is the prognostic factor for the intake of calcium-rich foods and the increase of perceived threat in the health promotion programs may be associated with the increase in the consumption of calcium-rich foods in the women of premenopausal age. PMID:26793252

  12. Health benefits of dancing activity among Korean middle-aged women

    PubMed Central

    Kim, Min Jeong; Lee, Chul Won

    2016-01-01

    The purpose of this study was to understand the health benefits of line dancing activity in Korean middle-aged women. This study explored how Korean middle-aged women perceive health benefits through lived experiences of line dancing in their leisure time. Three themes emerged related to health benefits: (1) psychological benefit, (2) physical benefit, and (3) social benefit. This finding suggested that serious leisure experience aids health enhancements in the lives of Korean middle-aged women. This study also discusses the research implication that continuous participation in leisure activity is necessary for health improvement in Korean middle-aged women. PMID:27389818

  13. Health benefits of dancing activity among Korean middle-aged women.

    PubMed

    Kim, Min Jeong; Lee, Chul Won

    2016-01-01

    The purpose of this study was to understand the health benefits of line dancing activity in Korean middle-aged women. This study explored how Korean middle-aged women perceive health benefits through lived experiences of line dancing in their leisure time. Three themes emerged related to health benefits: (1) psychological benefit, (2) physical benefit, and (3) social benefit. This finding suggested that serious leisure experience aids health enhancements in the lives of Korean middle-aged women. This study also discusses the research implication that continuous participation in leisure activity is necessary for health improvement in Korean middle-aged women.

  14. Biological and psychological predictors of visceral pain sensitivity in healthy premenopausal women.

    PubMed

    Lacourt, T E; Houtveen, J H; Doornen, L J P; Benson, S; Grigoleit, J-S; Cesko, E; Elsenbruch, S

    2014-04-01

    Factors that are associated with pain perception remain incompletely understood, especially in the visceral pain field. Therefore, the current study aimed to investigate possible psychological and biological predictors of visceral pain sensitivity in healthy subjects. In a sample of 59 healthy premenopausal female subjects on hormonal contraceptives, measures of gastrointestinal (GI) symptoms in daily life, trait and state anxiety, depression, serum cortisol concentrations and serum levels of interleukin-6 (IL-6) were obtained, followed by assessment of rectal distension pain sensitivity measures (i.e., rectal distension sensory threshold, pain threshold and pain ratings for discrete rectal distension stimuli). Regression analyses showed that more GI symptoms in daily life predicted a lower pain threshold. Higher levels of state anxiety predicted a lower pain threshold. Higher cortisol concentrations predicted lower pain ratings. IL-6 was positively related to GI symptoms but was a non-significant predictor of pain threshold in the multiple regression analysis. Similar to findings in patients with functional GI symptoms, we showed that subclinical GI symptoms predict visceral pain sensitivity. In line with somatic pain findings, state but not trait anxiety was found to predict visceral pain sensitivity. Our finding on serum cortisol as positive predictor of pain sensitivity might be interpreted in light of immunosuppressive effects of cortisol. Our finding on the role of IL-6 in GI symptoms is promising for understanding GI complaints in patients and needs further investigation. © 2013 European Pain Federation - EFIC®

  15. Fruits, vegetables, soy foods and breast cancer in pre- and postmenopausal Korean women: a case-control study.

    PubMed

    Do, Min Hee; Lee, Sang Sun; Kim, Jung Yun; Jung, Pa Jong; Lee, Min Hyuk

    2007-03-01

    We carried out a case-control study to examine the relationship between fruits, vegetables, and soy foods intake with breast cancer risk in Korean women. Incident cases (n = 359) were identified through cancer biopsies and hospital-based controls (n = 708) were selected in the same hospitals. Subjects were asked to indicate usual dietary habits, which were assessed using a semi-quantitative food frequency questionnaire (98 items). Odds ratio (OR) and 95% confidence intervals (95% CI) were calculated by unconditional logistic regression after adjustment for additional confounding factors according to the menopausal status. High grape intake showed an inverse association of breast cancer in postmenopausal women (OR = 0.59, 95% CI = 0.35-0.95; p for trend = 0.05). High tomato intake was associated with reduced breast cancer risk in premenopausal women (OR = 0.59, 95% CI = 0.38-0.89, p for trend = 0.04). In postmenopausal women, green pepper intake showed an inverse association of breast cancer risk (OR = 0.60, 95% CI = 0.43-0.96, p for trend = 0.03). High soybean intake showed an inverse association of breast cancer in postmenopausal women (OR = 0.61, 95% CI = 0.34-0.89, p for trend = 0.02). Our study suggests that high intake of some fruits, vegetables, and soybeans may be associated with a reduced breast cancer risk.

  16. Coconut oil is associated with a beneficial lipid profile in pre-menopausal women in the Philippines.

    PubMed

    Feranil, Alan B; Duazo, Paulita L; Kuzawa, Christopher W; Adair, Linda S

    2011-01-01

    Coconut oil is a common edible oil in many countries, and there is mixed evidence for its effects on lipid profiles and cardiovascular disease risk. Here we examine the association between coconut oil consumption and lipid profiles in a cohort of 1,839 Filipino women (age 35-69 years) participating in the Cebu Longitudinal Health and Nutrition Survey, a community based study in Metropolitan Cebu. Coconut oil intake was estimated using the mean of two 24-hour dietary recalls (9.5±8.9 grams). Lipid profiles were measured in morning plasma samples collected after an overnight fast. Linear regression models were used to estimate the association between coconut oil intake and each plasma lipid outcome after adjusting for total energy intake, age, body mass index (BMI), number of pregnancies, education, menopausal status, household assets and urban residency. Dietary coconut oil intake was positively associated with high density lipoprotein cholesterol especially among pre-menopausal women, suggesting that coconut oil intake is associated with beneficial lipid profiles. Coconut oil consumption was not significantly associated with low density lipoprotein cholesterol or triglyceride values. The relationship of coconut oil to cholesterol profiles needs further study in populations in which coconut oil consumption is common.

  17. Correlation between insulin resistance and breast elasticity heterogeneity measured by shear wave elastography in premenopausal women - a pilot study.

    PubMed

    Rzymski, Pawel; Wysocki, Piotr J; Kycler, Witold; Opala, Tomasz

    2011-12-31

    Recent studies have demonstrated a strong correlation between obesity, insulin resistance, increased insulin and insulin-like growth factor levels and the risk of breast cancer. Our study was aimed at exploring correlations between glucose, insulin, insulin resistance, obesity and quantitatively estimated breast elasticity in healthy women. The pilot study included 37 premenopausal women aged 22-45 years who underwent B-mode sonography and real-time shear wave elastography. Blood was collected for fasting insulin and glucose, and HOMA insulin resistance index was calculated. The mean elasticity of glandular and fatty tissue measured in both breasts was 12.5 ±3.5 kPa and 10.9 ±3.7 kPa respectively. Insulin levels did not correlate with glandular tissue elasticity (Rs=-0.23, p=0.15), but nearly correlated with fat tissue elasticity (Rs=-0.30, p=0.06), in outer quadrants significantly (Rs=-0.38, p=0.02). Interestingly, a strong correlation of insulin and insulin resistance with elasticity heterogeneity was found in fatty tissue (Rs=-0.59, p<0.001 and Rs=-0.60, p<0.001 respectively). The heterogeneity of fatty tissue but not glandular elasticity also correlated with body mass index. Insulin levels and insulin resistance correlate with breast fat tissue heterogeneity, but their role in breast pathology remains unclear.

  18. Metabolic Risk Profile and Cancer in Korean Men and Women.

    PubMed

    Ko, Seulki; Yoon, Seok-Jun; Kim, Dongwoo; Kim, A-Rim; Kim, Eun-Jung; Seo, Hye-Young

    2016-05-01

    Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.

  19. Metabolic Risk Profile and Cancer in Korean Men and Women

    PubMed Central

    Kim, A-Rim; Kim, Eun-Jung; Seo, Hye-Young

    2016-01-01

    Objectives: Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. Methods: We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. Results: A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. Conclusions: The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women. PMID:27255073

  20. Effect of office-based brief high-impact exercise on bone mineral density in healthy premenopausal women: the Sendai Bone Health Concept Study.

    PubMed

    Niu, Kaijun; Ahola, Riikka; Guo, Hui; Korpelainen, Raija; Uchimaru, Jin; Vainionpää, Aki; Sato, Kyoko; Sakai, Aiko; Salo, Sinikka; Kishimoto, Koshi; Itoi, Eiji; Komatsu, Shoko; Jämsä, Timo; Nagatomi, Ryoichi

    2010-09-01

    Although there is ample evidence supporting the effectiveness of physical activity in the prevention and treatment of osteoporosis, there are no previous studies to examine the effect of office-based brief high-impact exercise (HIE) on bone mineral density (BMD) in healthy premenopausal women. This study evaluated the effects of office-based HIE on BMD in healthy premenopausal Japanese women. Ninety-one healthy premenopausal women were randomized to receive stretching exercise (SE) or HIE (stretching, along with up to 5 × 10 vertical and versatile jumps) for 12 months. The BMD of the lumbar spine and proximal femur was measured using dual-energy X-ray absorptiometry. Several cardiovascular risk factors and leg strength also were assessed. An accelerometer-based recorder was used to measure daily impact loading in four 1-week samples. The progression of the HIE program was ensured by the accelerometer. Thirty-three women (71.7%) in the SE group and 34 (75.6%) in the HIE group completed the study. There was a significant difference in the change in the femoral neck BMD between the groups in favor of the HIE group [0.6% (95% CI: -0.4, 1.7) vs. -1.0% (95% CI: -2.2, 0.2)]. Adiponectin, LDL, HDL, and the leg strength of participants in both the groups improved during the intervention. These finding suggested that office-based brief HIE can be recommended for premenopausal women for preventing bone mineral loss.

  1. Three-dimensional ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

    PubMed

    El-Sharkawy, Mohamed; El-Mazny, Akmal; Ramadan, Wafaa; Hatem, Dina; Abdel-Hafiz, Aly; Hammam, Mohamed; Nada, Adel

    2016-03-16

    Ultrasonography has been extensively used in women suspected of having a gynecological malignancy. The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding. This cross-sectional study included 78 premenopausal women with abnormal uterine bleeding scheduled for hysteroscopy and endometrial curettage. The endometrial thickness (ET), uterine artery pulsatility index (PI) and resistance index (RI), and endometrial volume (EV) and 3D power Doppler vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were measured and compared with hysteroscopic and histopathologic findings. The ET (P <0.001), EV (P <0.001), and endometrial VI (P <0.001) and VFI (P = 0.043) were significantly increased in patients with atypical endometrial hyperplasia and endometrial carcinoma (n = 10) than those with benign endometrium (n = 68); whereas, the uterine artery PI and RI and endometrial FI were not significantly different between the two groups. The best marker for discrimination between benign and malignant endometrium was the VI with an area under the ROC curve of 0.88 at a cutoff value of 0.81%. 3D ultrasonography and power Doppler, especially endometrial VI, may be useful for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

  2. Hepcidin is a Better Predictor of Iron Stores in Premenopausal Women than Blood Loss or Dietary Intake.

    PubMed

    Lim, Karen H C; Booth, Alison O; Nowson, Caryl A; Szymlek-Gay, Ewa A; Irving, David O; Riddell, Lynn J

    2016-09-02

    The relationship between dietary intake, circulating hepcidin and iron status in free-living premenopausal women has not been explored. This cross-sectional study aimed to identify dietary determinants of iron stores after accounting for blood loss and to determine whether iron intake predicts iron stores independently of hepcidin in a sample of Australian women. Three hundred thirty eight women aged 18-50 years were recruited. Total intake and food sources of iron were determined via food frequency questionnaire; the magnitude of menstrual losses was estimated by self-report; and blood donation volume was quantified using blood donation records and self-reported donation frequency. Serum samples were analysed for ferritin, hepcidin and C-reactive protein concentrations. Linear regression was used to investigate associations. Accounting for blood loss, each 1 mg/day increase in dietary iron was associated with a 3% increase in iron stores (p = 0.027); this association was not independent of hepcidin. Hepcidin was a more influential determinant of iron stores than blood loss and dietary factors combined (R² of model including hepcidin = 0.65; R² of model excluding hepcidin = 0.17, p for difference <0.001), and increased hepcidin diminished the positive association between iron intake and iron stores. Despite not being the biggest contributor to dietary iron intake, unprocessed meat was positively associated with iron stores, and each 10% increase in consumption was associated with a 1% increase in iron stores (p = 0.006). No other dietary factors were associated with iron stores. Interventions that reduce hepcidin production combined with dietary strategies to increase iron intake may be important means of improving iron status in women with depleted iron stores.

  3. Reduction of DNA mismatch repair protein expression in airway epithelial cells of premenopausal women chronically exposed to biomass smoke.

    PubMed

    Mukherjee, Bidisha; Dutta, Anindita; Chowdhury, Saswati; Roychoudhury, Sanghita; Ray, Manas Ranjan

    2014-02-01

    Biomass burning is a major source of indoor air pollution in rural India. This study examined whether chronic inhalation of biomass smoke causes change in the DNA mismatch repair (MMR) pathway in the airway cells. For this, airway cells exfoliated in sputum were collected from 72 premenopausal nonsmoking rural women (median age 34 years) who cooked with biomass (wood, dung, crop residues) and 68 control women who cooked with cleaner fuel liquefied petroleum gas (LPG) for the past 5 years or more. The levels of particulate matters with diameters less than 10 and 2.5 μm (PM10 and PM2.5) in indoor air were measured by real-time aerosol monitor. Benzene exposure was monitored by measuring trans,trans-muconic acid (t,t-MA) in urine by high-performance liquid chromatography with ultraviolet detector. Generation of reactive oxygen species (ROS) and level of superoxide dismutase (SOD) in airway cells were measured by flow cytometry and spectrophotometry, respectively. Immunocytochemical assay revealed lower percentage of airway epithelial cells expressing MMR proteins mutL homolog 1 (MLH1) and mutS homolog 2 (MSH2) in biomass-using women compared to LPG-using controls. Women who cooked with biomass had 6.7 times higher level of urinary t,t-MA, twofold increase in ROS generation, and 31 % depletion of SOD. Indoor air of biomass-using households had three times more particulate matters than that of controls. ROS, urinary t,t-MA, and particulate pollution in biomass-using kitchen had negative correlation, while SOD showed positive correlation with MSH2 and MLH1 expression. It appears that chronic exposure to biomass smoke reduces MMR response in airway epithelial cells, and oxidative stress plays an important role in the process.

  4. Hepcidin is a Better Predictor of Iron Stores in Premenopausal Women than Blood Loss or Dietary Intake

    PubMed Central

    Lim, Karen H. C.; Booth, Alison O.; Nowson, Caryl A.; Szymlek-Gay, Ewa A.; Irving, David O.; Riddell, Lynn J.

    2016-01-01

    The relationship between dietary intake, circulating hepcidin and iron status in free-living premenopausal women has not been explored. This cross-sectional study aimed to identify dietary determinants of iron stores after accounting for blood loss and to determine whether iron intake predicts iron stores independently of hepcidin in a sample of Australian women. Three hundred thirty eight women aged 18–50 years were recruited. Total intake and food sources of iron were determined via food frequency questionnaire; the magnitude of menstrual losses was estimated by self-report; and blood donation volume was quantified using blood donation records and self-reported donation frequency. Serum samples were analysed for ferritin, hepcidin and C-reactive protein concentrations. Linear regression was used to investigate associations. Accounting for blood loss, each 1 mg/day increase in dietary iron was associated with a 3% increase in iron stores (p = 0.027); this association was not independent of hepcidin. Hepcidin was a more influential determinant of iron stores than blood loss and dietary factors combined (R2 of model including hepcidin = 0.65; R2 of model excluding hepcidin = 0.17, p for difference <0.001), and increased hepcidin diminished the positive association between iron intake and iron stores. Despite not being the biggest contributor to dietary iron intake, unprocessed meat was positively associated with iron stores, and each 10% increase in consumption was associated with a 1% increase in iron stores (p = 0.006). No other dietary factors were associated with iron stores. Interventions that reduce hepcidin production combined with dietary strategies to increase iron intake may be important means of improving iron status in women with depleted iron stores. PMID:27598194

  5. The Curves Exercise Suppresses Endotoxemia in Korean Women with Obesity

    PubMed Central

    2017-01-01

    Obesity and metabolic syndrome is a worldwide pandemic and associated with high cardiovascular risk. Metabolic endotoxemia (ME) is thought to be an underlying molecular mechanism. It triggers toll-like receptor 4-mediated inflammatory adipokines and causes a chronic low grade inflammatory status, which results in cardiovascular risk increase. Exercise is the best nonpharmacological treatment to improve prognosis. In this study, we examined the circulating endotoxin level in Korean obese women and investigated effects of exercise on it. Women over body mass index (BMI) 25 kg/m2 participated in a resistance training exercise, Curves. At baseline and after 12 weeks exercise, tests including blood samples were taken. In Korean obese women, the fasting endotoxin was 1.45 ± 0.11 EU/mL. Ingestion of a high calorie meal led to a peak level after 2 hours (postprandial 2 hours [PP2]) and a significant rise over the 4 hours (postprandial 4 hours [PP4]) in it (1.78 ± 0.15 and 1.75 ± 0.14 EU/mL for PP2 and PP4, P < 0.05 vs. fasting). After exercise, BMI and hip circumference were reduced significantly. The total cholesterol (TC) at fasting, PP2 and PP4 were decreased significantly. All levels of circulating endotoxin at fasting, PP2 and PP4 showed reduction. But, the peak change was only significant (baseline vs. 12 weeks for PP2; 1.78 ± 0.15 vs. 1.48 ± 0.06 EU/mL, P < 0.05). We report the circulating endotoxin level in Korean obese women for the first time. Also, we establish that energy intake leads to endotoxemia and exercise suppresses the peak endotoxemia after meal. It suggests an impact for a better prognosis in obese women who follow regular exercise. PMID:28049238

  6. The "Jolly Fat" Effect in Middle-Aged Korean Women.

    PubMed

    Yim, Gyeyoon; Ahn, Younjhin; Cho, Juhee; Chang, Yoosoo; Ryu, Seungho; Lim, Joong-Yeon; Park, Hyun-Young

    2017-09-18

    It has been hypothesized that depression and obesity are bi-directionally associated, and when overweight people appear to show a lower risk of depression, this supports the "Jolly Fat" hypothesis. The aim of this study was to examine the "Jolly Fat" hypothesis in middle-aged women in Korea, by different perceived stress levels. We performed a cross-sectional study of 44 to 56 aged Korean women (n = 2201) who underwent a health check-up program at the healthcare centers of Kangbuk Samsung Hospital (Seoul and Suwon centers) in Korea. General and abdominal obesity were defined as body mass index ≥25 kg/m(2) and waist circumference ≥85 cm, respectively. Depressive symptoms were measured by a Korean version of the Center for Epidemiologic Studies-Depression scale. The association between obesity and depressive symptoms was investigated by using multiple logistic regression analyses by different levels of perceived stress, with adjustment for potential confounding factors. The prevalence of general and abdominal obesity and depressive symptoms were 23.7%, 21.4%, and 16.5%, respectively. Women with general obesity were less likely to have depressive symptoms (odds ratio [OR]: 0.50; 95% confidence interval [CI]: 0.25-1.00; p-value: 0.049) in the low-stress group. We also found that women with abdominal obesity had a 60% decrease in the odds of having depressive symptoms (OR: 0.40; 95% CI: 0.18-0.87; p-value: 0.02) in the low-stress group. No significant association was found in the high-stress group. These findings indicate that the relationship between obesity and depressive symptoms in the Korean middle-aged women supports the "Jolly Fat" hypothesis. Further, our results underscore the role of stress as an important potential mediator exerting effects on the association between obesity and depressive symptoms.

  7. The Curves Exercise Suppresses Endotoxemia in Korean Women with Obesity.

    PubMed

    Jin, Seon Ah; Kim, Sun Kyeong; Seo, Hee Jung; Kim, Mijoo; Ahn, Kye Taek; Kim, Jun Hyung; Park, Jae Hyeong; Lee, Jae Hwan; Choi, Si Wan; Jeong, Jin Ok

    2017-02-01

    Obesity and metabolic syndrome is a worldwide pandemic and associated with high cardiovascular risk. Metabolic endotoxemia (ME) is thought to be an underlying molecular mechanism. It triggers toll-like receptor 4-mediated inflammatory adipokines and causes a chronic low grade inflammatory status, which results in cardiovascular risk increase. Exercise is the best nonpharmacological treatment to improve prognosis. In this study, we examined the circulating endotoxin level in Korean obese women and investigated effects of exercise on it. Women over body mass index (BMI) 25 kg/m² participated in a resistance training exercise, Curves. At baseline and after 12 weeks exercise, tests including blood samples were taken. In Korean obese women, the fasting endotoxin was 1.45 ± 0.11 EU/mL. Ingestion of a high calorie meal led to a peak level after 2 hours (postprandial 2 hours [PP2]) and a significant rise over the 4 hours (postprandial 4 hours [PP4]) in it (1.78 ± 0.15 and 1.75 ± 0.14 EU/mL for PP2 and PP4, P < 0.05 vs. fasting). After exercise, BMI and hip circumference were reduced significantly. The total cholesterol (TC) at fasting, PP2 and PP4 were decreased significantly. All levels of circulating endotoxin at fasting, PP2 and PP4 showed reduction. But, the peak change was only significant (baseline vs. 12 weeks for PP2; 1.78 ± 0.15 vs. 1.48 ± 0.06 EU/mL, P < 0.05). We report the circulating endotoxin level in Korean obese women for the first time. Also, we establish that energy intake leads to endotoxemia and exercise suppresses the peak endotoxemia after meal. It suggests an impact for a better prognosis in obese women who follow regular exercise.

  8. Reference intervals of bone turnover markers in healthy premenopausal women: results from a cross-sectional European study.

    PubMed

    Eastell, Richard; Garnero, Patrick; Audebert, Christine; Cahall, David L

    2012-05-01

    Robust validated reference intervals for bone turnover markers (BTMs) are required to assess fracture risk and effectiveness of therapy. However, there are currently limited reference intervals for BTMs in premenopausal women, especially comparing manual and automated assays. This study determined the BTM reference intervals using automated and manual assays, compared the results obtained from two different assays, and evaluated the factors that may affect BTM levels. This was a cross-sectional registry study in 194 healthy, premenopausal, European Caucasian women aged 35 to 39years from France (n=98) and Denmark (n=96). Two independent specialized laboratories, one in France (Synarc) and the other in Denmark (Nordic Bioscience), analyzed blood and urine samples from each woman for BTM levels. The type of assay used in this study significantly affected the reference intervals obtained for serum cross-linked C-terminal telopeptide of type I collagen (sCTX) and urinary cross-linked N-terminal telopeptides of type I collagen (uNTX/Cr; both P<0.001), but not for serum procollagen type I amino-terminal propeptide (PINP; P=0.28). The Serum Crosslaps® ELISA; Microtitre-plate based ELISA; Metra BAP EIA; and UniQ® PINP RIA assays yielded higher BTM reference values. The reference intervals for the BTMs, as measured with Serum β-Crosslaps, Elecsys® 2010 Systems; VITROS® ECI System; Ostase®, Access® Immunoassay System; and Total PINP, Elecsys® 2010 Systems assays, were 0.111-0.791ng/mL for sCTX, 12.3-59.7nmol BCE/mmol creatinine for uNTX/Cr, 5.8-17.5ng/mL for bone alkaline phosphatase (ALP), and 17.3-83.4ng/mL for PINP, respectively. When measured with Serum Crosslaps® ELISA, Microtitre-plate based ELISA, Metra BAP EIA, and UniQ® PINP RIA, the reference intervals were 0.177-0.862ng/mL for sCTX, 22.6-95.7nmol BCE/mmol creatinine for uNTX/Cr, 14.8-38.8U/L for bone ALP, and 19.5-75.2ng/mL for PINP, respectively. The clinical interpretation of the BTMs of a subject

  9. Effects of resistance training on regional and total bone mineral density in premenopausal women: a randomized prospective study.

    PubMed

    Lohman, T; Going, S; Pamenter, R; Hall, M; Boyden, T; Houtkooper, L; Ritenbaugh, C; Bare, L; Hill, A; Aickin, M

    1995-07-01

    This study was designed to assess the effects of 18 months of resistance exercise on regional and total bone mineral density (BMD) and soft tissue lean mass (STL) in premenopausal women aged 28-39 randomly assigned to an exercise or control group. Twenty-two exercise and 34 control subjects completed the 18-month training study. All subjects were previously inactive and untrained women. Initial, 5-, 12- and 18-month assessments were made of total and regional BMD and total and regional STL using dual energy X-ray absorptiometry. All subjects consumed a 500 mg/day elemental calcium supplement throughout the study. Initial Ca intake without supplement averaged 1,023 mg/day in total sample. Serum levels of bone osteocalcin and dietary assessments using 12 randomly assigned days of diet records were also completed. Muscular strength was assessed from both 1 repetition maximum (RM) testing of 10 weightlifting exercises and by peak torque for hip abduction/adduction and knee extension/flexion. Training increased strength by 58.1% based on 1 RM testing and by 33.8% based on isokinetic testing at 18 months versus baseline. BMD increased significantly above baseline at the lumbar spine for the exercise group at 5 months (2.8%), 12 months (2.3%), and 18 months (1.9%) as compared with controls. Femur trochanter BMD increased significantly (p < 0.05) in the exercise group at 12 months (1.8%) and 18 months (2.0%) but not at 5 months (0.7%) as compared with controls. No changes in total BMD, arm BMD, or leg BMD were found. There was a 20% increase in BGP in the exercise group as compared with controls at 5 months and this difference was maintained throughout the study. For STL, significant increases for total, arm, and leg were found at 5, 12, and 18 months for the exercise group versus control ranging from 1-6% over baseline. These results support the use of strength training for increasing STL and muscular strength with smaller but significant regional increases in BMD in the

  10. Effects of martial arts exercise on body composition, serum biomarkers and quality of life in overweight/obese premenopausal women: a pilot study

    PubMed Central

    Chyu, Ming-Chien; Zhang, Yan; Brismée, Jean-Michel; Dagda, Raul Y.; Chaung, Eugene; Von Bergen, Vera; Doctolero, Susan; Shen, Chwan-Li

    2013-01-01

    Various exercise interventions have been shown to benefit weight control and general health in different populations. However, very few studies have been conducted on martial arts exercise (MAE). The objective of this pilot study is to evaluate the efficacy of 12 weeks of MAE intervention on body composition, serum biomarkers and quality of life (QOL) in overweight/obese premenopausal women. We found that subjects in the MAE group did not lose body weight, while they significantly decreased fat-free mass and muscle mass as compared to those in the control group, who demonstrated an increase in these parameters. The MAE group demonstrated an increase in serum IGF-I concentration, but no change in others. MAE may be a feasible and effective approach to improve body composition and QOL in overweight/obese premenopausal women. Our study underscores the need for further studies using larger samples to establish possible benefits of MAE in various populations. PMID:24665215

  11. Associations of Premenopausal Hysterectomy and Oophorectomy With Breast Cancer Among Black and White Women: The Carolina Breast Cancer Study, 1993-2001.

    PubMed

    Robinson, Whitney R; Nichols, Hazel B; Tse, Chiu Kit; Olshan, Andrew F; Troester, Melissa A

    2016-09-01

    Black women experience higher rates of hysterectomy than other women in the United States. Although research indicates that premenopausal hysterectomy with bilateral oophorectomy decreases the risk of breast cancer in black women, it remains unclear how hysterectomy without ovary removal affects risk, whether menopausal hormone therapy use attenuates inverse associations, and whether associations vary by cancer subtype. In the population-based, case-control Carolina Breast Cancer Study of invasive breast cancer in 1,391 black (725 cases, 666 controls) and 1,727 white (939 cases, 788 controls) women in North Carolina (1993-2001), we investigated the associations of premenopausal hysterectomy and oophorectomy with breast cancer risk. Compared with no history of premenopausal surgery, bilateral oophorectomy and hysterectomy without oophorectomy were associated with lower odds of breast cancer (for bilateral oophorectomy, multivariable-adjusted odds ratios = 0.60, 95% confidence interval: 0.47, 0.77; for hysterectomy without oophorectomy, multivariable-adjusted odds ratios = 0.68, 95% confidence interval: 0.55, 0.84). Estimates did not vary by race and were similar for hormone receptor-positive and hormone receptor-negative cancers. Use of estrogen-only menopausal hormone therapy did not attenuate the associations. Premenopausal hysterectomy, even without ovary removal, may reduce the long-term risk of hormone receptor-positive and hormone receptor-negative breast cancers. Varying rates of hysterectomy are a potentially important contributor to differences in breast cancer incidence among racial/ethnic groups. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Prognostic effect of circulating adiponectin in a randomized 2 x 2 trial of low-dose tamoxifen and fenretinide in premenopausal women at risk for breast cancer.

    PubMed

    Macis, Debora; Gandini, Sara; Guerrieri-Gonzaga, Aliana; Johansson, Harriet; Magni, Paolo; Ruscica, Massimiliano; Lazzeroni, Matteo; Serrano, Davide; Cazzaniga, Massimiliano; Mora, Serena; Feroce, Irene; Pizzamiglio, Maria; Sandri, Maria Teresa; Gulisano, Marcella; Bonanni, Bernardo; Decensi, Andrea

    2012-01-10

    Adipokines are linked to obesity and insulin sensitivity and have recently been related to breast cancer risk and prognosis. We investigated the associations of plasma leptin and adiponectin with mammographic density and disease status and assessed their prognostic effect on recurrence-free survival in premenopausal women at risk for breast cancer. We measured circulating lipids, insulin-like growth factor 1, glucose, insulin and insulin sensitivity (calculated by homeostasis model assessment [HOMA] index), leptin, adiponectin, and leptin-to-adiponectin ratio in 235 premenopausal women with pT1mic/pT1a breast cancer (n = 21), intraepithelial neoplasia (n = 160), or 5-year Gail risk of 1.3% or greater (n = 54) who participated in a 2 × 2 trial of low-dose tamoxifen, fenretinide, both agents, or placebo over a 2-year period. At baseline, adiponectin levels were directly associated with mammographic density and HDL cholesterol and negatively associated with leptin, leptin-to-adiponectin ratio, body mass index (BMI), and HOMA index. Median adiponectin levels were lower in affected than in unaffected women (P = .006). After a median of 7.2 years and total of 57 breast neoplastic events, there was a 12% reduction in the risk of breast neoplastic events per unit increase of adiponectin (adjusted hazard ratio, 0.88; 95% CI, 0.81 to 0.96; P = .03). There was no interaction between treatment and adiponectin levels. Low adiponectin levels are associated with a history of prior intraepithelial neoplasia or pT1mic/pT1a breast cancer and higher risk of second breast neoplastic events in premenopausal women. The associations are independent of BMI, mammographic density, and treatment. Our findings support the role of adiponectin as a potential target for premenopausal breast cancer prevention and treatment.

  13. Assimilation and health service utilization of Korean immigrant women.

    PubMed

    Son, Juyeon

    2013-11-01

    In this case study, I present descriptive findings with regard to immigrant incorporation and health service utilization. Using focus groups and survey of Korean immigrant women in Wisconsin, I examine whether the ways in which they adapt to the U.S. society is relevant to their health services utilization and the alternatives they seek when available health services are less than satisfactory. The findings suggest that adherence to Korean identity appears to be associated with health service utilization. This is evident in the immigrants' evaluation of the U.S. health services as compared to those of Korea, and the consideration given by these immigrants to seeking health services in Korea instead of the United States. Such concerns on the part of these immigrants have important implications for health researchers, as they highlight the significance of immigrants' transnational experiences and their sense of personal agency in the use of health care.

  14. The volume of nipple aspirate fluid is not affected by 6 months of treatment with soy foods in premenopausal women.

    PubMed

    Maskarinec, Gertraud; Morimoto, Yukiko; Conroy, Shannon M; Pagano, Ian S; Franke, Adrian A

    2011-04-01

    Based on the hypothesis that soy food consumption may influence breast tissue activity, we examined its effect on the production of nipple aspirate fluid (NAF), a possible indicator of breast cancer risk. Of 310 premenopausal women screened, 112 (36%) produced at least 10 μL of NAF, the minimum for study participation. In a crossover design, we randomized 96 women to 2 groups who, in reverse order, consumed a high-soy diet with 2 soy servings/d (1 serving = 177 mL soy milk, 126 g tofu, or 23 g soy nuts) and a low-soy diet with <3 servings/wk of soy for 6 mo each separated by a 1-mo washout period. During each diet period, 3 NAF samples were obtained (baseline and 3 and 6 mo) using a FirstCyte Aspirator and 4 urine samples (baseline and 1, 3, and 6 mo) were analyzed for isoflavonoids by liquid chromatography tandem MS. Adherence to the study protocol according to 24-h dietary recalls and urinary isoflavonoid excretion was high. The drop-out rate was 15% (n = 14); 82 women completed the intervention. The 2 groups produced similar mean NAF volumes at baseline (P = 0.95) but differed in age and previous soy intake and in their response to the intervention (P = 0.03). In both groups, NAF volume decreased during the first 3 mo of the high-soy diet period and returned to baseline at 6 mo, but there was no effect of the high-soy diet on NAF volume (P = 0.50 for diet; P-interaction = 0.21 for diet with time). Contrary to an earlier report, soy foods in amounts consumed by Asians did not increase breast tissue activity as assessed by NAF volume.

  15. Decreased luteinizing hormone pulse frequency is associated with elevated 24-hour ghrelin after calorie restriction and exercise in premenopausal women

    PubMed Central

    Scheid, Jennifer L.; De Souza, Mary Jane; Hill, Brenna R.; Leidy, Heather J.

    2013-01-01

    Elevated ghrelin has been shown to be associated with reduced luteinizing hormone (LH) pulsatility in Rhesus monkeys, rats, men, and recently women. We previously reported that 24-h ghrelin concentrations are elevated in women following a 3-mo exercise and diet program leading to weight loss. We investigated whether the elevations in ghrelin following an ∼3-mo exercise and diet program leading to weight loss are associated with a decrease in LH pulsatility. The nonexercising control group (Control, n = 5) consumed a controlled diet that matched energy needs, whereas energy intake in the exercise group (Energy Deficit, n = 16) was reduced from baseline energy requirements and supervised exercise training occurred five times per a week. Significant decreases in body weight (−3.0 ± 0.6 kg), body fat (−2.9 ± 0.4 kg) and 24-h LH pulse frequency (−0.18 ± 0.08 pulses/h), and a significant increase in 24-h mean ghrelin were observed in only the Energy Deficit group. The pre-post change in LH pulse frequency was negatively correlated with the change in mean 24-h ghrelin (R = −0.485, P = 0.030) and the change in peak ghrelin at lunch (R = −0.518, P = 0.019). Interestingly, pre-post change in night LH pulse frequency was negatively correlated with the change in mean day ghrelin (R = −0.704, P = 0.001). Elevated total ghrelin concentrations are associated with the suppression of LH pulsatility in premenopausal women and may play a role in the suppression of reproductive function following weight loss. PMID:23115078

  16. Effect of yoga on pain, brain-derived neurotrophic factor, and serotonin in premenopausal women with chronic low back pain.

    PubMed

    Lee, Moseon; Moon, Woongjoon; Kim, Jaehee

    2014-01-01

    Background. Serotonin and brain-derived neurotrophic factor (BDNF) are known to be modulators of nociception. However, pain-related connection between yoga and those neuromodulators has not been investigated. Therefore, we aimed to evaluate the effect of yoga on pain, BDNF, and serotonin. Methods. Premenopausal women with chronic low back pain practiced yoga three times a week for 12 weeks. At baseline and after 12 weeks, back pain intensity was measured using visual analogue scale (VAS), and serum BDNF and serotonin levels were evaluated. Additionally, back flexibility and level of depression were assessed. Results. After 12-week yoga, VAS decreased in the yoga group (P < 0.001), whereas it increased (P < 0.05) in the control group. Back flexibility was improved in the yoga group (P < 0.01). Serum BDNF increased in the yoga group (P < 0.01), whereas it tended to decrease in the control group (P = 0.05). Serum serotonin maintained in the yoga group, while it reduced (P < 0.01) in the control group. The depression level maintained in the yoga group, whereas it tended to increase in the control group (P = 0.07). Conclusions. We propose that BDNF may be one of the key factors mediating beneficial effects of yoga on chronic low back pain.

  17. The Transaction Between Depression and Anxiety Symptoms and Sexual Functioning: A Prospective Study of Premenopausal, Healthy Women.

    PubMed

    Kalmbach, David A; Pillai, Vivek; Kingsberg, Sheryl A; Ciesla, Jeffrey A

    2015-08-01

    A number of studies have called attention to the problematic interplay between depression and anxiety symptoms and sexual difficulties. However, despite the bidirectional conceptualization of the association between affective and sexual problems, few studies have adequately examined temporal precedence or state-level fluctuations between these two constructs. Using Clark and Watson's (1991) tripartite model of anxiety and depression, the current study employed a repeated measures design to examine how weekly changes in affective symptoms were related to weekly changes in sexual functioning in a non-clinical sample of premenopausal women. First, we examined how general distress, anxious arousal, and anhedonia were concurrently related to various indices of sexual functioning. Next, we examined lagged effects of mood and anxiety symptoms predicting later levels of sexual functioning. Finally, we tested sexual functioning's influence on later reports of affective symptoms. Hierarchical linear modeling analyses revealed that, of the three symptom types tested, anhedonic depression was the most consistently related to sexual problems, and that these relations were more proximal than distal. The preponderance of data suggested temporal precedence of mood on sexual symptoms. These findings emphasize the importance of prospective studies in the investigation of mental and sexual health.

  18. Effect of Yoga on Pain, Brain-Derived Neurotrophic Factor, and Serotonin in Premenopausal Women with Chronic Low Back Pain

    PubMed Central

    Lee, Moseon

    2014-01-01

    Background. Serotonin and brain-derived neurotrophic factor (BDNF) are known to be modulators of nociception. However, pain-related connection between yoga and those neuromodulators has not been investigated. Therefore, we aimed to evaluate the effect of yoga on pain, BDNF, and serotonin. Methods. Premenopausal women with chronic low back pain practiced yoga three times a week for 12 weeks. At baseline and after 12 weeks, back pain intensity was measured using visual analogue scale (VAS), and serum BDNF and serotonin levels were evaluated. Additionally, back flexibility and level of depression were assessed. Results. After 12-week yoga, VAS decreased in the yoga group (P < 0.001), whereas it increased (P < 0.05) in the control group. Back flexibility was improved in the yoga group (P < 0.01). Serum BDNF increased in the yoga group (P < 0.01), whereas it tended to decrease in the control group (P = 0.05). Serum serotonin maintained in the yoga group, while it reduced (P < 0.01) in the control group. The depression level maintained in the yoga group, whereas it tended to increase in the control group (P = 0.07). Conclusions. We propose that BDNF may be one of the key factors mediating beneficial effects of yoga on chronic low back pain. PMID:25120574

  19. Korean Culture and the Reentry Motivations of University-Graduated Women

    ERIC Educational Resources Information Center

    Jang, Suh Young; Merriam, Sharan

    2004-01-01

    Well-educated Korean women are returning to higher education in unprecedented numbers. The purpose of this qualitative study was to understand the motivations of these women for returning to higher education. In-depth interviews were conducted with 13 Korean full-time housewives aged 25 to 45 who already had a bachelor's degree and who enrolled as…

  20. 25(OH) vitamin D levels in premenopausal women with polycystic ovary syndrome and/or obesity.

    PubMed

    Tsakova, Adelina D; Gateva, Antoaneta T; Kamenov, Zdravko A

    2012-12-01

    Insulin resistance, hyperinsulinemia, and obesity play an important role in development of polycystic ovary syndrome (PCOS). Current evidence suggests that vitamin D (VitD) deficiency may contribute to the disturbance in insulin metabolism and the development of the metabolic syndrome. The aim of this study was to investigate VitD levels, measured as 25(OH)D, in Bulgarian women with PCOS and/or obesity. The study included 103 women, divided into three groups - group 1 Obese (n = 33); group 2 Nonobese PCOS (n = 50), and group 3 Obese PCOS (n = 20). 25(OH)D levels were measured by electrochemiluminescence immunoassay. Almost 2/3 of the women with PCOS and/or obesity appeared to be VitD-deficient. Women with obesity, especially visceral (with or without PCOS), had significantly lower levels of 25(OH)D compared to lean PCOS subjects. Women with and without metabolic syndrome however did not differ significantly in 25(OH)D levels. Women with normal body mass index (BMI) had higher 25(OH)D levels compared to overweight and obese (p = 0.028). There was no correlation between 25(OH)D levels and indices of glucose metabolism - fasting blood glucose and immunoreactive insulin (IRI) and after OGTT and HOMA index.

  1. Augmented vagal heart rate modulation in active hypoestrogenic pre-menopausal women with functional hypothalamic amenorrhoea.

    PubMed

    O'Donnell, Emma; Goodman, Jack M; Morris, Beverly L; Floras, John S; Harvey, Paula J

    2015-11-01

    Compared with eumenorrhoeic women, exercise-trained women with functional hypothalamic amenorrhoea (ExFHA) exhibit low heart rates (HRs) and absent reflex renin-angiotensin-system activation and augmentation of their muscle sympathetic nerve response to orthostatic stress. To test the hypothesis that their autonomic HR modulation is altered concurrently, three age-matched (pooled mean, 24 ± 1 years; mean ± S.E.M.) groups of women were studied: active with either FHA (ExFHA; n=11) or eumenorrhoeic cycles (ExOv; n=17) and sedentary with eumenorrhoeic cycles (SedOv; n=17). Blood pressure (BP), HR and HR variability (HRV) in the frequency domain were determined during both supine rest and graded lower body negative pressure (LBNP; -10, -20 and -40 mmHg). Very low (VLF), low (LF) and high (HF) frequency power spectra (ms(2)) were determined and, owing to skewness, log10-transformed. LF/HF ratio and total power (VLF + LF + HF) were calculated. At baseline, HR and systolic BP (SBP) were lower (P<0.05) and HF and total power were higher (P<0.05) in ExFHA than in eumenorrhoeic women. In all groups, LBNP decreased (P<0.05) SBP, HF and total power and increased (P<0.05) HR and LF/HF ratio. However, HF and total power remained higher (P<0.05) and HR, SBP and LF/HF ratio remained lower (P<0.05) in ExFHA than in eumenorrhoeic women, in whom measures did not differ (P>0.05). At each stage, HR correlated inversely (P<0.05) with HF. In conclusion, ExFHA women demonstrate augmented vagal yet unchanged sympathetic HR modulation, both at rest and during orthostatic stress. Although the role of oestrogen deficiency is unclear, these findings are in contrast with studies reporting decreased HRV in hypoestrogenic post-menopausal women.

  2. Korean women's attitudes toward pregnancy and prenatal care.

    PubMed

    Pritham, U A; Sammons, L N

    1993-01-01

    A convenience sample of 40 native-born pregnant Korean women receiving prenatal care at a U.S. military facility in a major metropolitan area in Korea completed a questionnaire about attitudes toward pregnancy and prenatal care. Responses revealed a family life characterized by positive maternal and paternal perceptions of the pregnancy and less preference for a male child than we had anticipated. Traditional beliefs in Tae Mong, a conception dream, and Tae Kyo, rituals for safe childbirth, were followed. Food taboos, including protein sources, were reported. Attitudes toward prenatal care services, care providers, and maternal health habits are described.

  3. The impact of supervised weight loss and intentional weight regain on sex hormone binding globulin and testosterone in premenopausal women

    PubMed Central

    Aubuchon, Mira; Liu, Ying; Petroski, Gregory F.; Thomas, Tom R.; Polotsky, Alex J.

    2017-01-01

    What is the impact of intentional weight loss and regain on serum androgens in women? We conducted an ancillary analysis of prospectively collected samples from a randomized controlled trial. The trial involved supervised 10% weight loss (8.5 kg on average) with diet and exercise over 4–6 months followed by supervised intentional regain of 50% of the lost weight (4.6 kg on average) over 4–6 months. Participants were randomized prior to the partial weight regain component to either continuation or cessation of endurance exercise. Analytic sample included 30 obese premenopausal women (mean age of 40 ± 5.9 years, mean baseline body mass index (BMI) of 32.9 ± 4.2 kg/m2) with metabolic syndrome. We evaluated sex hormone binding globulin (SHBG), total testosterone (T), free androgen index (FAI), and high molecular weight adiponectin (HMWAdp). Insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI), and visceral adipose tissue (VAT) measured in the original trial were reanalyzed for the current analytic sample. Insulin, HOMA, and QUICKI improved with weight loss and were maintained despite weight regain. Log-transformed SHBG significantly increased from baseline to weight loss, and then significantly decreased with weight regain. LogFAI and logVAT decreased similarly and increased with weight loss followed by weight regain. No changes were found in logT and LogHMWAdp. There was no significant difference in any tested parameters by exercise between the groups. SHBG showed prominent sensitivity to body mass fluctuations, as reduction with controlled intentional weight regain showed an inverse relationship to VAT and occurred despite stable HMWAdp and sustained improvements with insulin resistance. FAI showed opposite changes to SHBG, while T did not change significantly with weight. Continued exercise during weight regain did not appear to impact these findings. PMID:27192090

  4. Low levels of dehydroepiandrosterone sulphate in plasma, and reduced sympathoadrenal response to hypoglycaemia in premenopausal women with rheumatoid arthritis

    PubMed Central

    Imrich, R; Rovensky, J; Malis, F; Zlnay, M; Killinger, Z; Kvetnansky, R; Huckova, M; Vigas, M; Macho, L; Koska, J

    2005-01-01

    Objectives: To evaluate the function of the hypothalamic-pituitary-adrenal axis and sympathoadrenal system in premenopausal women with rheumatoid arthritis (RA). Methods: Insulin-induced hypoglycaemia (0.1 IU/kg) was produced in 15 glucocorticoid-naive patients with long term RA with low disease activity and in 14 healthy women matched for age and body mass index. Concentrations of glucose, adrenocorticotropic hormone (ACTH), cortisol, Δ4-androstenedione (ASD), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), 17α-hydroxyprogesterone (17OHP), epinephrine (EPI), norepinephrine (NE), interleukin 6 (IL6), and tumour necrosis factor α (TNFα) were analysed in plasma. Results: Patients had comparable responses of glucose, cortisol, ACTH, ASD, and 17OHP to hypoglycaemia, without any signs of hypothalamic insufficiency. Patients had lower basal DHEAS than controls (3.03 (0.37) µmol/l v 5.1 (0.9) µmol/l, respectively; p<0.05); borderline lower basal DHEA levels (p = 0.067); while the response of DHEA to hypoglycaemia was comparable to that of controls. Patients with RA had lower EPI (p = 0.005) and NE (p<0.001) responses to hypoglycaemia. TNFα and IL6 were higher (p<0.05) in patients with RA (TNFα 8 (2.8) pg/ml in RA v 1.1 (0.5) pg/ml in controls and IL6 15.1 (6.7) pg/ml v 1.4 (0.7) pg/ml). Conclusions: Lower basal DHEAS levels, without concomitant differences or changes in DHEA, ASD, 17OHP, and cortisol responses to hypoglycaemia in patients with RA, indicate an isolated decrease in adrenal androgen production. Significantly lower responses of EPI and NE to hypoglycaemia may suggest sympathoadrenal hyporeactivity in patients with RA. PMID:15647427

  5. The impact of supervised weight loss and intentional weight regain on sex hormone binding globulin and testosterone in premenopausal women.

    PubMed

    Aubuchon, Mira; Liu, Ying; Petroski, Gregory F; Thomas, Tom R; Polotsky, Alex J

    2016-08-01

    What is the impact of intentional weight loss and regain on serum androgens in women? We conducted an ancillary analysis of prospectively collected samples from a randomized controlled trial. The trial involved supervised 10% weight loss (8.5 kg on average) with diet and exercise over 4-6 months followed by supervised intentional regain of 50% of the lost weight (4.6 kg on average) over 4-6 months. Participants were randomized prior to the partial weight regain component to either continuation or cessation of endurance exercise. Analytic sample included 30 obese premenopausal women (mean age of 40 ± 5.9 years, mean baseline body mass index (BMI) of 32.9 ± 4.2 kg/m(2)) with metabolic syndrome. We evaluated sex hormone binding globulin (SHBG), total testosterone (T), free androgen index (FAI), and high molecular weight adiponectin (HMWAdp). Insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI), and visceral adipose tissue (VAT) measured in the original trial were reanalyzed for the current analytic sample. Insulin, HOMA, and QUICKI improved with weight loss and were maintained despite weight regain. Log-transformed SHBG significantly increased from baseline to weight loss, and then significantly decreased with weight regain. LogFAI and logVAT decreased similarly and increased with weight loss followed by weight regain. No changes were found in logT and LogHMWAdp. There was no significant difference in any tested parameters by exercise between the groups. SHBG showed prominent sensitivity to body mass fluctuations, as reduction with controlled intentional weight regain showed an inverse relationship to VAT and occurred despite stable HMWAdp and sustained improvements with insulin resistance. FAI showed opposite changes to SHBG, while T did not change significantly with weight. Continued exercise during weight regain did not appear to impact these findings.

  6. Correlates of leisure-time physical activity in Korean immigrant women.

    PubMed

    Choi, Jiwon; Wilbur, Joellen; Miller, Arlene; Szalacha, Laura; McAuley, Edward

    2008-08-01

    This study describes the physical activity behavior of Korean immigrant women and examines the relationships among leisure-time physical activity (LTPA) behavior, background, and intrapersonal correlates of behavior in Korean immigrant women in the United States using a cross-sectional survey design. A convenience sample of Midwestern Korean immigrant women completed the long form of the International Physical Activity Questionnaire in Korean. Among the participants, 78% were physically active, meeting the Healthy People 2010 goal for physical activity when all physical activity behaviors were considered, whereas 23% met the goal when only LTPA was considered. Women who were older, did not have a child younger than 5, used environmental resources for physical activity, had lower depressive symptoms, and had higher confidence for overcoming exercise barriers were spent more time in LTPA. Accommodating those with young children, enhancing environmental resource use, and improving exercise self-efficacy are important considerations for interventions aimed at increasing LTPA in Korean immigrant women.

  7. Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

    PubMed Central

    Laban, Mohamed; Eisa, Marwa M.

    2016-01-01

    The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB. PMID:28003825

  8. Prevalence of Sarcopenia in Healthy Korean Elderly Women

    PubMed Central

    Lee, Eun Sil

    2015-01-01

    Background We evaluated the prevalence of sarcopenia, presarcopenia, and severe sarcopenia in healthy Korean elderly women. Methods We measured the muscle mass and muscle function of 196 ambulatory women over the age of 65 years who visited the University Hospital Menopause Clinic. Appendicular skeletal muscle mass was measured by dual energy X-ray absorptiometry to measure skeletal muscle mass index (SMI). Assessment of hand grip strength (HGS) of the dominant hand was performed to measure the muscle strength, and 4-m straight on-way path was used to measure gait speed for physical performance. The values used to define the presarcopenia, sarcopenia, and severe sarcopenia were based on the cutoff values proposed by the Asian Working Group for Sarcopenia (AWGS). Results The mean age of women was 71.2 years, and the mean SMI in 196 women was 5.94 kg/m2. The average HGS was 20.3 kg, and the mean gait speed was 1.08 m/sec. In 41 out of the 196 women (20.9%), the SMI was reduced to less than 5.4 kg/m2. Fifty-nine women (30.1%) had HGS of less than 18 kg, and gait speed was less than 0.8 m/sec in 12 women (6.1%). Twenty-six women (13.3%) were classified into the presarcopenia stage, and 15 women (7.6%) were classified into the sarcopenia stage. There was no case of severe sarcopenia. Conclusions One out of five relatively healthy women aged more than 65 years showed a decrease in muscle mass, and 7.6% of women showed a decrease in muscle mass and strength. The sarcopenia stage was also intensified with aging. PMID:26713310

  9. NSAIDS and the Osteogenic Response to Mechanical Stress in Premenopausal Women

    DTIC Science & Technology

    2007-04-01

    Participants take either ibuprofen (400mg) or placebo capsules before and after each exercise session. Women are randomized to three treatment arms: 1...Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT: This is a study of the effects of ibuprofen , a non-steroidal...Exercise, stress fracture, ibuprofen , prostaglandins, bone mineral density, estrogen 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT

  10. Neutrophilic inflammatory response and oxidative stress in premenopausal women chronically exposed to indoor air pollution from biomass burning.

    PubMed

    Banerjee, Anirban; Mondal, Nandan Kumar; Das, Debangshu; Ray, Manas Ranjan

    2012-04-01

    The possibility of inflammation and neutrophil activation in response to indoor air pollution (IAP) from biomass fuel use has been investigated. For this, 142 premenopausal, never-smoking women (median age, 34 years) who cook exclusively with biomass (wood, dung, crop wastes) and 126 age-matched control women who cook with cleaner fuel liquefied petroleum gas (LPG) were enrolled. The neutrophil count in blood and sputum was significantly higher (p < 0.05) in biomass users than the control group. Flow cytometric analysis revealed marked increase in the surface expression of CD35 (complement receptor-1), CD16 (F(C)γ receptor III), and β(2) Mac-1 integrin (CD11b/CD18) on circulating neutrophils of biomass users. Besides, enzyme-linked immunosorbent assay showed that they had 72%, 67%, and 54% higher plasma levels of the proinflammatory cytokines tumor necrosis factor-alpha, interleukin-6, and interleukin-12, respectively, and doubled neutrophil chemoattractant interleukin-8. Immunocytochemical study revealed significantly higher percentage of airway neutrophils expressing inducible nitric oxide synthase, while the serum level of nitric oxide was doubled in women who cooked with biomass. Spectrophotometric analysis documented higher myeloperoxidase activity in circulating neutrophils of biomass users, suggesting neutrophil activation. Flow cytometry showed excess generation of reactive oxygen species (ROS) by leukocytes of biomass-using women, whereas their erythrocytes contained a depleted level of antioxidant enzyme superoxide dismutase (SOD). Indoor air of biomass-using households had two to four times more particulate matter with diameters of <10 μm (PM(10)) and <2.5 μm (PM(2.5)) as measured by real-time laser photometer. After controlling potential confounders, rise in proinflammatory mediators among biomass users were positively associated with PM(10) and PM(2.5) in indoor air, suggesting a close relationship between IAP and neutrophil activation. Besides

  11. Body size across the life course and risk of premenopausal and postmenopausal breast cancer in Black women, the Carolina Breast Cancer Study, 1993–2001

    PubMed Central

    Robinson, Whitney R.; Tse, Chiu Kit; Olshan, Andrew F.; Troester, Melissa A.

    2014-01-01

    It is believed that greater adiposity is associated with reduced risk of breast cancer in premenopausal but increased risk in postmenopausal women. However, few studies have evaluated these relationships among Black women or examined anthropometric measures other than near-diagnosis body mass index (BMI). PURPOSE This study investigated associations between measures of body size across the life course and breast cancer risk among Black and White women living in the U.S. South. METHODS We used data from the Carolina Breast Cancer Study, a population-based case-control study of invasive breast cancer in North Carolina women aged 20–74 years. We assessed nine body size variables, including age 10 relative weight; age 18 BMI; adult weight gain; “reference” BMI 1 year before interview; and post-diagnosis measured BMI and abdominal obesity measures. RESULTS Among premenopausal Whites, heavier childhood relative weight was associated with decreased cancer risk (odds ratio [OR]=0.48 [95% confidence interval (CI)=0.33–0.70]). Among premenopausal Blacks, greater adult waist circumference and waist-to-hip ratio (WHR) were associated with increased risk (waist OR=1.40 [1.00–1.97] and high tertile WHR OR=2.03 [1.29–3.19]), with associations for WHR in a similar direction in Whites. Among postmenopausal women, recalled body size was not associated with risk, except for increased risk associated with adult weight gain among White non-hormone therapy users. ER/PR status and hormone therapy use also modified other associations. DISCUSSION In this population, greater adult BMI was not associated with increased breast cancer risk, but some measures of early-life body size and abdominal obesity were associated with risk. PMID:24924530

  12. Effects of Herbal vX on libido and sexual activity in premenopausal and postmenopausal women.

    PubMed

    Waynberg, J; Brewer, S

    2000-01-01

    This study investigated the possibility of an alternative to chemical medication in the treatment of sexual dysfunction in healthy women. The efficacy of a unique herbal formulation of Muira puama and Ginkgo biloba (Herbal vX) was assessed in 202 healthy women complaining of low sex drive. Various aspects of their sex life were rated before and after 1 month of treatment. Responses to self-assessment questionnaires showed significantly higher average total scores from baseline in 65% of the sample after taking the supplement. Statistically significant improvements occurred in frequency of sexual desires, sexual intercourse, and sexual fantasies, as well as in satisfaction with sex life, intensity of sexual desires, excitement of fantasies, ability to reach orgasm, and intensity of orgasm. Reported compliance and tolerability were good. These initial findings support the strong anecdotal evidence for the benefits of Herbal vX on the female sex drive. A double-blind study is planned to further research these results.

  13. Cooking with biomass increases the risk of depression in pre-menopausal women in India.

    PubMed

    Banerjee, Madhuchhanda; Siddique, Shabana; Dutta, Anindita; Mukherjee, Bidisha; Ranjan Ray, Manas

    2012-08-01

    Cooking with biomass fuel, a common practice in rural India, is associated with a high level of indoor air pollution (IAP). The aim of this study was to investigate whether IAP from biomass burning increases the risk of depression. For this cross-sectional study, we enrolled a group of 952 women (median age 37 years) who cooked regularly with biomass and a control group of 804 age-matched women who cooked with cleaner fuel (liquefied petroleum gas). Depression was assessed using the second edition of Beck's depression inventory (BDI-II). Platelet P-selectin expression was assessed by flow cytometry and platelet serotonin was measured by ELISA. Particulate matter having diameter of less than 10 and 2.5 μm (PM(10) and PM(2.5), respectively) in indoor air was measured by real-time aerosol monitor. Carbon monoxide (CO) in exhaled breath was measured by CO monitor. Compared with the control group, women who cooked with biomass had a higher prevalence of depression and depleted platelet serotonin, suggesting altered serotonergic activity in the brain. In addition, P-selectin expression on platelet surface was up-regulated implying platelet hyperactivity and consequent risk of cardiovascular disease. Biomass-using households had increased levels of PM(10) and PM(2.5), and biomass users had elevated levels of CO in expired air. Controlling potential confounders, cooking with biomass was found to be an independent and strong risk factor for depression. IAP from cooking with biomass is a risk for depression among rural women in their child-bearing age. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. NSAIDS and the Osteogenic Response to Mechanical Stress in Premenopausal Women

    DTIC Science & Technology

    2006-10-01

    Participants take either ibuprofen (400mg) or placebo capsules before and after each exercise session. Women are randomized to three treatment arms...Original contains colored plates: ALL DTIC reproductions will be in black and white. 14. ABSTRACT This is a study of the effects of ibuprofen , a non...TERMS Exercise, stress fracture, ibuprofen , prostaglandins, bone mineral density, estrogen 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF

  15. Validation of Different Instruments for Caffeine Measurement Among Premenopausal Women in the BioCycle Study

    PubMed Central

    Schliep, Karen C.; Schisterman, Enrique F.; Mumford, Sunni L.; Perkins, Neil J.; Ye, Aijun; Pollack, Anna Z.; Zhang, Cuilin; Porucznik, Christina A.; VanDerslice, James A.; Stanford, Joseph B.; Wactawski-Wende, Jean

    2013-01-01

    Effects of caffeine on women's health are inconclusive, in part because of inadequate exposure assessment. In this study we determined 1) validity of a food frequency questionnaire compared with multiple 24-hour dietary recalls (24HDRs) for measuring monthly caffeine and caffeinated beverage intakes; and 2) validity of the 24HDR compared with the prior day's diary record for measuring daily caffeinated coffee intake. BioCycle Study (2005–2007) participants, women (n = 259) aged 18–44 years from western New York State, were followed for 2 menstrual cycles. Participants completed a food frequency questionnaire at the end of each cycle, four 24HDRs per cycle, and daily diaries. Caffeine intakes reported for the food frequency questionnaires were greater than those reported for the 24HDRs (mean = 114.1 vs. 92.6mg/day, P = 0.01) but showed high correlation (r = 0.73, P < 0.001) and moderate agreement (К = 0.51, 95% confidence interval: 0.43, 0.57). Women reported less caffeinated coffee intake in their 24HDRs compared with their corresponding diary days (mean = 0.51 vs. 0.80 cups/day, P < 0.001) (1 cup = 237 mL). Although caffeine and coffee exposures were highly correlated, absolute intakes differed significantly between measurement tools. These results highlight the importance of considering potential misclassification of caffeine exposure. PMID:23462965

  16. Sex hormones and adipokines in healthy pre-menopausal, post-menopausal and elderly women, and in age-matched men: data from the Brisighella Heart study.

    PubMed

    Cicero, A F G; Magni, P; Lentini, P; Ruscica, M; Dozio, E; Strollo, F; Borghi, C

    2011-01-01

    Sex hormones and adipokines seem to differently interact in both genders at different ages. To comparatively evaluate the serum level of adipokines and sex hormones in healthy non-pharmacologically treated premenopausal women, post-menopausal women, and elderly women, and in age-matched men. From the historical cohort of the Brisighella Heart Study we selected 199 adult healthy subjects (males: 89; females: 110), aged 62.5±12.4 yr. Men and women included in the age-class subgroups were matched for body mass index (BMI), waist circumference, blood pressure, heart rate, fasting plasma glucose, plasma lipids. Leptin did not differ among various age classes in men, while pre-menopausal women displayed significantly lower serum leptin than post-menopausal women (-6.7 ± 2.2 pg/ml, p=0.036). Post-menopausal women had significantly greater serum leptin when compared with age-matched men (+13.1 ± 2.0 pg/ml, p<0.001); the same was observed for elderly women when compared with elderly men (+11.2 ± 2.3 pg/ml, p<0.001). At any age, women had significantly lower serum testosterone/estrone ratio than age-matched men (p<0.01). Serum DHEAS was inversely proportional to age in both genders. The main predictors of adiponectin level are age in men (p=0.027) and BMI in women (p=0.003). The main predictors of leptin level are BMI and the testosterone/estrone ratio in both sexes (p<0.05). The testosterone/estrone ratio is also the main predictor of ghrelin levels in women (p=0.006). Sex hormones and adipokines show specific interactions in the two genders and in different age-classes in a representative sample of adult healthy subjects.

  17. Estrogen and androgen receptor expression in surface epithelium and inclusion cyst in the ovary of premenopausal and postmenopausal women

    PubMed Central

    2013-01-01

    Background The importance of surface epithelium and epithelial inclusion cysts in the ovary arises from studies demonstrating that these structures are susceptible to epithelial ovarian cancer development. The expression of estrogen receptor alpha (ER alpha), androgen receptor (AR), in epithelial cells of the ovary from premenopausal and postmenopausal women is interesting because sexual steroid hormones are involved in cell growth and differentiation. Methods The presence of ER alpha, AR, and the orphan G protein-coupled receptor 30 (GPR30) was demonstrated by immunofluorescence in ovaries obtained from 79 pre and postmenopausal patients, undergoing histero-salpingo-oophorectomy for proliferative gynecological diseases. The proportion of patients that displayed positive reaction for estrogen and androgen receptors in epithelial cells of the ovary was evaluated according to menopausal status and associated pathology. Results The proportion of patients that displayed a positive receptor expression in the epithelial cells of the ovarian surface and cortical inclusion cysts shows that ER alpha is present in 20 of 79 patients (0.25), AR in 33 of 79 (0.42) and GPR30 in 38 of 55 (0.69). There are no differences in ER alpha, AR, and GPR30 expression between pre and postmenopausal patients and considering the associated pathology, proportions for ER alpha and GPR30 are similar. The patients with cervical cancer show a higher proportion of AR expression in epithelial cells of the ovary, which is statistically significant (P < 0.01) compared with patients with other proliferative diseases. Conclusions The presence of ER alpha, AR, and GPR30 in the surface epithelial ovarian cells and its derivatives are observed with a proportion that is specific for each receptor. The proportion of expression for these receptors in the epithelial cells of the ovary does not change after menopause. The proportion of ovaries with AR positive epithelial cells in patients with cervical

  18. Enterolignan Producing Phenotypes are Associated with Increased Gut Microbial Diversity and Altered Composition in Premenopausal Women in the United States

    PubMed Central

    Hullar, Meredith A. J.; Lancaster, Samuel M.; Li, Fei; Tseng, Elizabeth; Beer, Karlyn; Atkinson, Charlotte; Wähälä, Kristiina; Copeland, Wade K.; Randolph, Timothy W.; Newton, Katherine M.; Lampe, Johanna W.

    2014-01-01

    Background Lignans in plant foods are metabolized by gut bacteria to the enterolignans, enterodiol (END) and enterolactone (ENL). Enterolignans have biologic activities important to the prevention of cancer and chronic diseases. We examined the composition of the gut microbial community (GMC) as a contributor to human enterolignan exposure. Methods We evaluated the association between the GMC in stool, urinary enterolignan excretion, and diet from a 3-day food record in 115 premenopausal (ages 40–45 y) women in the United States. Urinary enterolignans were measured using GC/MS. The GMC was evaluated using 454 pyrosequencing of the 16S rRNA gene. Sequences were aligned in SILVA (www.arb-silva.de). Operational taxonomic units (OTU) were identified at 97% sequence similarity. Taxonomic classification was performed and alpha and beta diversity in relationship to ENL production were assessed. Multivariate analysis and regression were used to model the association between enterolignan excretion and the GMC. Bacteria associated with ENL production were identified using univariate analysis and ridge regression. Results After adjusting for dietary fiber intake and adiposity, we found a significant positive association between ENL excretion and either the GMC (p=0.0007), or the diversity of the GMC (p=0.01). The GMC associated with high ENL production was distinct (UNIFRAC, p<0.003, MRPP) and enriched in Moryella spp., Acetanaerobacterium spp., Fastidiosipila spp., and Streptobacillus spp. Conclusion Diversity and composition of the GMC are associated with increased human exposure to enterolignans. Impact Differences in gut microbial diversity and composition explain variation in gut metabolic processes that impact environmental exposures and influences human health. PMID:25542830

  19. Imaging in breast cancer: diffuse optics in breast cancer: detecting tumors in pre-menopausal women and monitoring neoadjuvant chemotherapy.

    PubMed

    Tromberg, Bruce J; Cerussi, Albert; Shah, Natasha; Compton, Montana; Durkin, Amanda; Hsiang, David; Butler, John; Mehta, Rita

    2005-01-01

    Diffuse optical spectroscopy (DOS) and diffuse optical imaging (DOI) are non-invasive diagnostic techniques that employ near-infrared (NIR) light to quantitatively characterize the optical properties of centimeter-thick, multiple-scattering tissues. Although NIR was first applied to breast diaphanography more than 70 years ago, quantitative optical methods employing time- or frequency-domain 'photon migration' technologies have only recently been used for breast imaging. Because their performance is not limited by mammographic density, optical methods can provide new insight regarding tissue functional changes associated with the appearance, progression, and treatment of breast cancer, particularly for younger women and high-risk subjects who may not benefit from conventional imaging methods. This paper reviews the principles of diffuse optics and describes the development of broadband DOS for quantitatively measuring the optical and physiological properties of thick tissues. Clinical results are shown highlighting the sensitivity of diffuse optics to malignant breast tumors in 12 pre-menopausal subjects ranging in age from 30 to 39 years and a patient undergoing neoadjuvant chemotherapy for locally advanced breast cancer. Significant contrast was observed between normal and tumor regions of tissue for deoxy-hemoglobin (p = 0.005), oxy-hemoglobin (p = 0.002), water (p = 0.014), and lipids (p = 0.0003). Tissue hemoglobin saturation was not found to be a reliable parameter for distinguishing between tumor and normal tissues. Optical data were converted into a tissue optical index that decreased 50% within 1 week in response to neoadjuvant chemotherapy. These results suggest a potential role for diffuse optics as a bedside monitoring tool that could aid the development of new strategies for individualized patient care.

  20. Dairy Food Intake Is Associated with Reproductive Hormones and Sporadic Anovulation among Healthy Premenopausal Women.

    PubMed

    Kim, Keewan; Wactawski-Wende, Jean; Michels, Kara A; Plowden, Torie C; Chaljub, Ellen N; Sjaarda, Lindsey A; Mumford, Sunni L

    2017-02-01

    Dairy food intake has been associated with infertility; however, little is known with regard to associations with reproductive hormones or anovulation. We investigated whether intakes of dairy foods and specific nutrients were associated with reproductive hormone concentrations across the cycle and the risk of sporadic anovulation among healthy women. We prospectively measured serum reproductive hormones ≤8 times/menstrual cycle for 2 cycles from 259 regularly menstruating women (mean age: 27.3 y). Dairy food intake was assessed via 24-h dietary recalls 4 times/cycle. Dairy food intakes were assessed by 1) total and low- and high-fat dairy products; 2) dairy nutrients, including fat, lactose, calcium, and phosphorus; and 3) dairy foods, including milk, cheese, butter, cream, yogurt, and ice cream categories. Weighted linear mixed models were used to evaluate associations between dairy nutrients or food intakes and hormone concentrations. Modified Poisson regression models with robust error variance were used to evaluate anovulation. Models were adjusted for age, body mass index, race, physical activity, Mediterranean diet score, total energy, protein, fiber, caffeine, and other hormones. Each serving increase in total and low- and high-fat dairy foods and all increases in amounts of all dairy nutrients tested were associated with an ∼5% reduction in serum estradiol concentrations but were not associated with anovulation. Total and high-fat dairy food intakes were positively associated with serum luteinizing hormone concentrations. We observed associations between intakes of >0 servings of yogurt (RR: 2.1; 95% CI: 1.2, 3.7) and cream (RR: 1.8; 95% CI: 1.0, 3.2) and a higher risk of sporadic anovulation compared with no intake. Our study showed associations between increasing dairy food and nutrient intakes and decreasing estradiol concentrations as well as between cream and yogurt intakes and the risk of sporadic anovulation. These results highlight the

  1. Effect of a Low-Fat or Low-Carbohydrate Weight-Loss Diet on Markers of Cardiovascular Risk Among Premenopausal Women: A Randomized Trial

    PubMed Central

    Pennell, Michael; Sprangers, Peter; Vitolins, Mara Z.; DeGraffinreid, Cecilia; Paskett, Electra D.

    2014-01-01

    Abstract Background: Low-fat and low-carbohydrate weight-loss diets can have a beneficial effect on longitudinal measures of blood pressure and blood lipids. We aimed to assess longitudinal changes in blood pressure and blood lipids in a population of premenopausal women. We hypothesized that results may differ by level of adherence to the respective diet protocol and baseline presence of hypertension or hyperlipidemia. Methods: Overweight or obese premenopausal women were randomized to a low-fat (n=41) or low-carbohydrate (n=38) diet. As part of the 52-week Lifestyle Eating and Fitness (LEAF) intervention trial, we fit linear mixed models to determine whether a change in outcome differed by treatment arm. Results: Within-group trends in blood pressure and blood lipids did not differ (p>0.30). Across study arms, there was a significant decrease in systolic blood pressure (SBP, 3 mm Hg, p=0.01) over time, but diastolic blood pressure (DBP) did not change significantly over the course of the study. Blood lipids (total cholesterol [TC], low-density lipoproteins [LDL], and high-density lipoproteins [HDL]) all exhibited nonlinear trends over time (p<0.01); each decreased initially but returned to levels comparable to baseline by study conclusion (p>0.20). We observed a decline in SBP among women who were hypertensive at baseline (p<0.01), but hypercholesterolemia at baseline did not affect trends in blood lipids (p>0.40). Conclusions: Our results support that dietary interventions may be efficacious for lowering blood pressure and blood lipids among overweight or obese premenopausal women. However, a decrease in SBP was the only favorable change that was sustained in this study population. These changes can be maintained over the course of a 1-year intervention, yet changes in blood lipids may be less sustainable. PMID:25029619

  2. Postoperative Quality of Life and Sexual Function in Premenopausal Women Undergoing Laparoscopic Myomectomy for Symptomatic Fibroids: A Prospective Observational Cohort Study

    PubMed Central

    Radosa, Julia Caroline; Radosa, Christoph Georg; Mavrova, Russalina; Wagenpfeil, Stefan; Hamza, Amr; Joukhadar, Ralf; Baum, Sascha; Karsten, Maria; Juhasz-Boess, Ingolf; Solomayer, Erich-Franz; Radosa, Marc Philipp

    2016-01-01

    Introduction Uterine leiomyomas are the most common benign gynecologic tumors. To date laparoscopy myomectomy is the gold standard for treatment of symptomatic fibroids in reproductive-aged women. Detailed counseling about the effects of this procedure on postoperative sexuality and quality of life is important in these patients. However, available data on these subjects are limited and contradictory. The aim of this study was to assess sexual function and quality of life in premenopausal women undergoing laparoscopic myomectomy for symptomatic uterine fibroids. Material and Methods All premenopausal women who underwent laparoscopic myomectomy for symptomatic fibroids between April 2012 and August 2014 at a tertiary university center were enrolled in this prospective observational cohort study. Sexual function and quality of life were assessed for the pre- and postoperative (six months post-operatively) state using two validated questionnaires, the Female Sexual Function Index (FSFI) and the European Quality of Life Five-Dimension Scale (EQ-5D). Results Ninety-five of the 115 (83%) eligible patients completed the study. Overall a significant improvement in quality of life and sexual function was observed in the study cohort: Median FSFI (28 (18.7–35.2)) and EQ-5D scores (1 (0.61–1) after laparoscopic myomectomy were significantly higher than preoperative scores (21.2 (5.2–33.5); 0.9 (0.2–1); p ≤ 0.01). The number, position and localization of the largest fibroids were not correlated with pre- or postoperative sexual function or quality of life. Conclusion Laparoscopic myomectomy might have positive short-term effects on postoperative quality of life and sexual function in premenopausal women suffering from symptomatic fibroids. PMID:27898669

  3. Effect of a low-fat or low-carbohydrate weight-loss diet on markers of cardiovascular risk among premenopausal women: a randomized trial.

    PubMed

    Foraker, Randi E; Pennell, Michael; Sprangers, Peter; Vitolins, Mara Z; DeGraffinreid, Cecilia; Paskett, Electra D

    2014-08-01

    Low-fat and low-carbohydrate weight-loss diets can have a beneficial effect on longitudinal measures of blood pressure and blood lipids. We aimed to assess longitudinal changes in blood pressure and blood lipids in a population of premenopausal women. We hypothesized that results may differ by level of adherence to the respective diet protocol and baseline presence of hypertension or hyperlipidemia. Overweight or obese premenopausal women were randomized to a low-fat (n=41) or low-carbohydrate (n=38) diet. As part of the 52-week Lifestyle Eating and Fitness (LEAF) intervention trial, we fit linear mixed models to determine whether a change in outcome differed by treatment arm. Within-group trends in blood pressure and blood lipids did not differ (p>0.30). Across study arms, there was a significant decrease in systolic blood pressure (SBP, 3 mm Hg, p=0.01) over time, but diastolic blood pressure (DBP) did not change significantly over the course of the study. Blood lipids (total cholesterol [TC], low-density lipoproteins [LDL], and high-density lipoproteins [HDL]) all exhibited nonlinear trends over time (p<0.01); each decreased initially but returned to levels comparable to baseline by study conclusion (p>0.20). We observed a decline in SBP among women who were hypertensive at baseline (p<0.01), but hypercholesterolemia at baseline did not affect trends in blood lipids (p>0.40). Our results support that dietary interventions may be efficacious for lowering blood pressure and blood lipids among overweight or obese premenopausal women. However, a decrease in SBP was the only favorable change that was sustained in this study population. These changes can be maintained over the course of a 1-year intervention, yet changes in blood lipids may be less sustainable.

  4. Esophageal temperature threshold for sweating decreases before ovulation in premenopausal women.

    PubMed

    Stephenson, L A; Kolka, M A

    1999-01-01

    The purpose of this study was to test the hypothesis that regulated body temperature is decreased in the preovulatory phase in eumenorrheic women. Six women were studied in both the preovulatory phase (Preov-2; days 9-12), which was 1-2 days before predicted ovulation when 17beta-estradiol (E2) was estimated to peak, and in the follicular phase (F; days 2-6). The subjects walked on a treadmill ( approximately 225 W x m-2) in a warm chamber (ambient temperature = 30 degreesC; dew-point temperature = 11.5 degreesC) while heavily clothed. E2, esophageal temperature (Tes), local skin temperatures, and local sweating rate were measured. The estimate of when the E2 surge would occur was correct for four of six subjects. In these four subjects, E2 increased (P

  5. Failure to Consider the Menstrual Cycle Phase May Cause Misinterpretation of Clinical and Research Findings of Cardiometabolic Biomarkers in Premenopausal Women

    PubMed Central

    Schisterman, Enrique F.; Mumford, Sunni L.; Sjaarda, Lindsey A.

    2014-01-01

    Biomarker assessment plays a critical role in the study and prevention of disease. However, variation in biomarkers attributable to the menstrual cycle in premenopausal women may impair understanding the role of certain biomarkers in disease development and progression. Thus, in light of the recently increasing evidence of menstrual cycle variability in multiple cardiometabolic biomarkers, a reexamination of approaches for appropriately studying and diagnosing cardiovascular disease in premenopausal women is warranted. We reviewed studies (from 1934 through 2012) evaluating changes in cardiometabolic biomarkers across phases of the menstrual cycle, including markers of oxidative stress, lipids, insulin sensitivity, and systemic inflammation. Each was observed to vary significantly during the menstrual cycle. For example, nearly twice as many women had elevated cholesterol levels warranting therapy (≥200 mg/dL) during the follicular phase compared with the luteal phase (14.3% vs. 7.9%), with only 3% having consistently high levels during all phases of the cycle. Similarly, nearly twice as many women were classified as being at an elevated risk of cardiovascular disease (high sensitivity C-reactive protein >3 mg/L) during menses compared with other phases (12.3% vs. 7.4%). Menstrual cycle–associated variability in cardiometabolic biomarkers is an important source of variability that should be accounted for in both research and clinical settings. PMID:24042431

  6. Absolute Benefit of Adjuvant Endocrine Therapies for Premenopausal Women With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Early Breast Cancer: TEXT and SOFT Trials.

    PubMed

    Regan, Meredith M; Francis, Prudence A; Pagani, Olivia; Fleming, Gini F; Walley, Barbara A; Viale, Giuseppe; Colleoni, Marco; Láng, István; Gómez, Henry L; Tondini, Carlo; Pinotti, Graziella; Price, Karen N; Coates, Alan S; Goldhirsch, Aron; Gelber, Richard D

    2016-07-01

    Risk of recurrence is the primary consideration in breast cancer adjuvant therapy recommendations. The TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial) trials investigated adjuvant endocrine therapies for premenopausal women with hormone receptor-positive breast cancer, testing exemestane plus ovarian function suppression (OFS), tamoxifen plus OFS, and tamoxifen alone. We examined absolute treatment effect across a continuum of recurrence risk to individualize endocrine therapy decision making for premenopausal women with human epidermal growth factor receptor 2 (HER2) -negative disease. The TEXT and SOFT hormone receptor-positive, HER2-negative analysis population included 4,891 women. The end point was breast cancer-free interval (BCFI), defined as time from random assignment to first occurrence of invasive locoregional, distant, or contralateral breast cancer. A continuous, composite measure of recurrence risk for each patient was determined from a Cox model incorporating age, nodal status, tumor size and grade, and estrogen receptor, progesterone receptor, and Ki-67 expression levels. Subpopulation treatment effect pattern plot methodology revealed differential treatment effects on 5-year BCFI according to composite risk. SOFT patients who remained premenopausal after chemotherapy experienced absolute improvement of 5% or more in 5-year BCFI with exemestane plus OFS versus tamoxifen plus OFS or tamoxifen alone, reaching 10% to 15% at intermediate to high composite risk; the benefit of tamoxifen plus OFS versus tamoxifen alone was apparent at the highest composite risk. The SOFT no-chemotherapy cohort-for whom composite risk was lowest on average-did well with all endocrine therapies. For TEXT patients, the benefit of exemestane plus OFS versus tamoxifen plus OFS in 5-year BCFI ranged from 5% to 15%; patients not receiving chemotherapy and with lowest composite risk did well with both treatments. Premenopausal women with

  7. CYP1A1 and CYP1B1 polymorphisms and their association with estradiol and estrogen metabolites in women who are premenopausal and perimenopausal.

    PubMed

    Sowers, MaryFran R; Wilson, Angela L; Kardia, Sharon R; Chu, Jian; McConnell, Daniel S

    2006-09-01

    The purpose of this study was to relate measured concentrations of estradiol (E2) and the urinary estrogen metabolites 2-hydroxyestrone (2-OHE1) and 16alpha-hydroxyestrone (16alpha-OHE1) to single nucleotide polymorphisms (SNPs) from CYP1A1 and CYP1B1, the primary genes involved in estrogen catabolism. We investigated the association of 4 CYP1A1 SNPs (CYP1A1 rs4646903, CYP1A1 rs1531163, CYP1A1 rs2606345, and CYP1A1 rs1048943) and 2 CYP1B1 SNPs (CYP1B1 rs162555 and CYP1B1 rs1056836) to circulating serum E2 concentrations and the urinary estrogen metabolites 2-OHE1 and 16alpha-OHE1. The associations were evaluated in 1,340 participants of 4 racial/ethnic groups from the Study of Women's Health Across the Nation (SWAN) who were premenopausal and perimenopausal. There was substantial variation in the allele frequencies of the SNPs for African American and Caucasian women. There was, however, remarkable comparability between Chinese and Japanese women; their CYP1A1 and CYP1B1 allele frequencies differed by only < or =11%. There was significant variation in E2 concentrations by genotype within racial/ethnic group for CYP1A1 rs2606345. In particular, Japanese women with the CC genotype had lower E2 concentrations than did Japanese women with the AC genotype. Chinese women with the CC genotype had higher 2-OHE1 concentrations than did Chinese women with the AC genotype. Further, African American women with the CC genotype had higher 16alpha-OHE1 concentrations than did those with other genotypes. CYP1A1 rs2606345 may play an important role in estrogen metabolism in women who are premenopausal and perimenopausal.

  8. A measurement-specific quality-of-life satisfaction during premenopause, perimenopause and postmenopause in Arabian Qatari women

    PubMed Central

    Bener, Abdulbari; Falah, Anas

    2014-01-01

    Objective: The aim of this study was to use an instrument, the menopause-specific quality-of-life satisfaction in the state of Qatar for the premenopausal, menopause and postmenopausal period. Design: A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian Gulf women. Measurement-specific quality-of-life satisfaction questionnaires and face-to-face interviews were performed. Setting: Primary Health Care (PHC) Centers in Qatar. Materials and Methods: A multistage sampling design was used and a representative sample of 1,500 women aged 40-60 years were included during July 2012 and November 2013, and 1,158 women agreed to participate (77.2%) and responded to the study. Results: The mean age and standard deviation of the subjects was 50.9 ± 6.1. The median age of natural menopause in the present study was 49 years [mean and standard deviation 49.9 ± 2.7]. The rate of consanguineous marriages in the sample was found to be 30.3%. There were statistically significance differences between menopausal stages with regard to ethnicity, education level, occupation, type of housing condition, and consanguinity. There were statistically significance differences between menopausal stages concerning BMI groups, Systolic BP, Diastolic BP, physical activity, parity, and sheesha smoking habits. Meanwhile, the present study revealed that the most common disease was found to be diabetes mellitus (11.4%), followed by hypertension (6.6%), asthma (5.6%) and CHD (2.5%), and the majority of subjects (69.5%) had no specific disease. The most frequent symptom was aches in the back and neck (49.2%), night sweat (37.2%), low backache (35.7%), feeling nervous (35.4%) followed by aches in the muscles/joints (34.6%), hot flashes (33.3%), decreased social activities (28.3%), decreased leisure activities (47.6%), difficulty sleeping (28.9%), mood swings (25.4%), and decreased concentration (28.3%), sexual activity (24.1%) and total energy level (26

  9. Association of genetic polymorphisms with serum estrogens measured multiple times during a 2-year period in premenopausal women.

    PubMed

    Lurie, Galina; Maskarinec, Gertraud; Kaaks, Rudolf; Stanczyk, Frank Z; Le Marchand, Loïc

    2005-06-01

    There is evidence that circulating estrogens are associated with breast cancer risk. In this study of premenopausal women, we explored the association of polymorphisms in genes in the estrogen synthesis and metabolism pathways with serum and urinary levels of estrone (E1) and estradiol (E2) and with the urinary ratio of 2-hydroxyestrone (2-OHE1)/16alpha-hydroxyestrone (16alpha-OHE1). This analysis included 220 women, who were participants in a 2-year randomized soy intervention. Blood specimens were collected in the luteal phase of the menstrual cycle an average of 4.4 times over 2 years. Overnight urinary specimens were collected on the same cycle day, only at baseline. Levels of E1, E2, 2-OHE1, and 16alpha-OHE1 were measured by enzyme immunoassays. The DNA samples were analyzed by PCR/RFLP for the COMT Val158Met, CYP1A1*2A, CYP1A1*2B, CYP1A2*1F, CYP1B1 Val432Leu, and CYP17 T27C polymorphisms. We applied mixed models to investigate the relations between genotypes and repeated serum hormone measurements and generalized linear models to assess associations between genotypes and urinary estrogen metabolites. The CYP1A2 C allele was significantly associated with lower serum E2 levels; in CC genotype carriers, serum E2 levels were 26.3% lower than in homo- and heterozygous common allele carriers combined (P = 0.01). CYP1A2*1F also affected the urinary 2-OHE1/16alpha-OHE1 ratio; carriers of the variant C allele had a markedly lower ratio than individuals with the AA genotype (1.37 versus 1.76; P = 0.002). These data suggest that CYP1A2*1F is associated with lower circulating levels of E2, and that it may be a susceptibility locus for breast cancer.

  10. Adjuvant Endocrine Therapy in Breast Cancer: Evolving Paradigms in Premenopausal Women.

    PubMed

    Rossi, Lorenzo; Pagani, Olivia

    2017-05-01

    In the last few years, new adjuvant endocrine treatment options have become available in young women with early breast cancer, such as the addition of ovarian function suppression to tamoxifen or aromatase inhibitors. Treatment duration has been also adapted in the latest guidelines based on the individual risk of recurrence. The oncologist is therefore challenged to precisely assess the risk of recurrence according to currently available predictive and prognostic factors in order to offer the most appropriate therapeutic option to the individual patient, considering also potential side effects, quality of life, pregnancy planning and patients' preferences. The adjuvant treatment planning should always be discussed and agreed in a multidisciplinary context. Tamoxifen remains the standard of care in low-risk patients or in case of intolerance to combined treatment with pharmacological ovarian function suppression or aromatase inhibitors. Combination treatment is indicated in intermediate high-risk disease. The patient should always be considered an active partner in the treatment decision process, to improve treatment motivation and adherence. Finally, the therapeutic choice should take into account drug availability and pharmacoeconomic issues, which unfortunately may prevent, in many low-income countries, the provision of such effective treatments.

  11. Coconut oil predicts a beneficial lipid profile in pre-menopausal women in the Philippines

    PubMed Central

    Feranil, Alan B.; Duazo, Paulita L.; Kuzawa, Christopher W.; Adair, Linda S.

    2011-01-01

    Coconut oil is a common edible oil in many countries, and there is mixed evidence for its effects on lipid profiles and cardiovascular disease risk. Here we examine the association between coconut oil consumption and lipid profiles in a cohort of 1,839 Filipino women (age 35–69 years) participating in the Cebu Longitudinal Health and Nutrition Survey, a community based study in Metropolitan Cebu City. Coconut oil intake was measured as individual coconut oil intake calculated using two 24-hour dietary recalls (9.54 ± 8.92 grams). Cholesterol profiles were measured in plasma samples collected after an overnight fast. Mean lipid values in this sample were total cholesterol (TC) (186.52 ± 38.86 mg/dL), high density lipoprotein cholesterol (HDL-c) (40.85 ± 10.30 mg/dL), low density lipoprotein cholesterol (LDL-c) (119.42 ± 33.21 mg/dL), triglycerides (130.75 ± 85.29 mg/dL) and the TC/HDL ratio (4.80 ± 1.41). Linear regression models were used to estimate the association between coconut oil intake and each plasma lipid outcome after adjusting for total energy intake, age, body mass index (BMI), number of pregnancies, education, menopausal status, household assets and urban residency. Dietary coconut oil intake was positively associated with HDL-c levels. PMID:21669587

  12. Sacral nervous function, hormonal levels and sexuality in premenopausal women before and after hysterectomy.

    PubMed

    Helström, L; Bäckström, T; Sörbom, D; Lundberg, P O

    1994-08-01

    To investigate the predictive value of sacral nervous function, result of pelvic examination and hormonal status on sexuality before and after subtotal hysterectomy. One hundred and four women were examined and interviewed one month before and one year after hysterectomy for non-malignant diseases. Genital examination, sacral nervous function testing including vibrotactility were performed, and sex hormone levels were estimated at each occasion. The results were evaluated and compared using multivariate analyses. Postoperative experience of multiple orgasm was negatively correlated to three out of five measured factors for pelvic sacral function: i.e. vibrotactility of the clitoris, the external anal reflex and the levator muscle strength. No correlations were found between tests for sacral nervous function and a latent factor for sexuality before and after the operation. Preoperative uterine size did not show correlation to either preoperative or postoperative sexual parameters nor did uterine pain during vaginal examination. The preoperative sex hormone levels, and the result of histopathological examination showed no correlation to sexual variables. Preoperative somatic findings including sacral nervous function and pelvic muscular strength cannot be used as predictors for sexuality after subtotal hysterectomy.

  13. Adjuvant!© Online estimation of chemotherapy effectiveness when added to ovarian function suppression plus tamoxifen for premenopausal women with estrogen-receptor-positive breast cancer

    PubMed Central

    Paridaens, Robert J.; Gelber, Shari; Cole, Bernard F.; Gelber, Richard D.; Thürlimann, Beat; Price, Karen N.; Holmberg, Stig B.; Crivellari, Diana; Coates, Alan S.; Goldhirsch, Aron

    2013-01-01

    Purpose Adjuvant! © Online (Adjuvant!) is a user-friendly, web-based tool that provides estimates of adjuvant therapy outcomes for individual patients. While reliable evidence underpins estimates for most patient cohorts, there is a paucity of data on the effect of adding chemotherapy to complete estrogen blockade for premenopausal women with estrogen-receptor positive breast cancer. Methods International Breast Cancer Study Group (IBCSG) Trial 11-93 enrolled 174 premenopausal women with estrogen-receptor positive, node-positive breast cancer. Fifty-five percent of patients had 1 positive axillary lymph node and 97% had 3 or fewer positive nodes. Patients were randomized to receive ovarian function suppression plus five years of tamoxifen with or without anthracycline-based chemotherapy. Estimated hazard rates and corresponding 10-year relapse-free survival percents obtained from Trial 11-93 data were compared with those predicted using Adjuvant!. Results The 10-year relapse-free survival percents predicted from Adjuvant! were 64.4% (95% CI, 61.9% to 67.2%) for endocrine therapy alone and 74.9% (95% CI, 73.1% to 76.8%) for chemoendocrine therapy. By contrast, these estimates in Trial 11-93 were 76.4% (95% CI, 65.8% to 84.0%) for endocrine therapy alone and 74.9% (95% CI, 64.5% to 82.7%) for chemoendocrine therapy. The Adjuvant! estimate for the endocrine alone control group is lower than that observed in Trial 11-93 (p=0.03), while the estimates for the two chemoendocrine therapy groups are similar. Conclusions Adjuvant! appears to underestimate the effectiveness of adjuvant endocrine therapy alone for premenopausal women with endocrine responsive breast cancer, thus overestimating the added benefit, if any, from chemotherapy for this patient population. PMID:20195744

  14. Soy foods and urinary isoprostanes: results from a randomized study in premenopausal women.

    PubMed

    Sen, Cherisse; Morimoto, Yukiko; Heak, Sreang; Cooney, Robert V; Franke, Adrian A; Maskarinec, Gertraud

    2012-05-01

    In addition to their antiestrogenic effects, soy isoflavones may protect against cancer through alternate biological actions, for example, antioxidant properties. This randomized crossover study explored the relationship between dietary isoflavone intake through common soy foods and oxidative stress quantified by urinary isoprostane levels. Eighty-two women aged 39.2 ± 6.1 years were randomly selected to receive a high soy diet of 2 soy food servings per day and a low soy diet of <3 servings per week for 6 months each, separated by a 1-month washout period. Urine samples were collected at baseline and at the end of each dietary period. Urinary isoprostane levels were measured using enzyme-linked immunosorbent assays (ELISA) and adjusted for creatinine levels. Mixed models using log-transformed values were applied to evaluate the effect of the high soy diet. Unadjusted isoprostane excretion levels were lower during the high rather than the low soy diet, but this effect was not statistically significant (p = 0.81). After adjustment for urinary creatinine, isoprostane excretion was slightly higher during the high soy diet (p = 0.02), an observation that was confirmed in a regression analysis between urinary isoflavones and isoprostanes during the high soy diet. The original association remained significant when restricted to adherent participants, however this effect disappeared after exclusion of three extreme values. In agreement with several previous reports, these findings do not support the hypothesis that soy exerts antioxidant effects, as measured by urinary isoprostane excretions, but additional markers of oxidative stress need to be investigated in future studies.

  15. Soy Foods and Urinary Isoprostanes: Results from a Randomized Study in Premenopausal Women

    PubMed Central

    Sen, Cherisse; Morimoto, Yukiko; Heak, Sreang; Cooney, Robert V.; Franke, Adrian A.; Maskarinec, Gertraud

    2013-01-01

    In addition to their antiestrogenic effects, soy isoflavones may protect against cancer through alternate biologic actions including antioxidant properties. This randomized, crossover study explored the relation between dietary isoflavone intake through common soy foods and oxidative stress quantified by urinary isoprostane levels. Eighty-two women aged 39.2±6.1 years were randomized to a high soy diet of 2 soy food servings per day and a low soy diet of <3 servings per week for 6 months each, separated by a 1 month washout period. Urine samples were collected at baseline and at the end of each dietary period. Urinary isoprostane levels were measured using enzyme-linked immunosorbent assays (ELISA) and adjusted for creatinine levels. Mixed models using log-transformed values were applied to evaluate the effect of the high soy diet. Unadjusted isoprostane excretion levels were lower during the high than the low soy diet, but this effect was not statistically significant (p=0.81). After adjustment for urinary creatinine, isoprostane excretion was slightly higher during the high soy diet (p=0.02), an observation that was confirmed in a regression analysis between urinary isoflavones and isoprostanes during the high soy diet. The original association remained significant when restricted to adherent participants; however, this effect disappeared after exclusion of three extreme values. In agreement with several previous reports, these findings do not support the hypothesis that soy exerts antioxidant effects as measured by urinary isoprostane excretions, but additional markers of oxidative stress need to be investigated in future studies. PMID:22331037

  16. "Thank You, Sorry, Love" (TSL) Therapy with North Korean Refugee Women: A Pilot Study

    ERIC Educational Resources Information Center

    Kim, Hee Jin; Kim, Jae Yop; Kim, Dong Goo

    2016-01-01

    Objectives: This study was designed to evaluate the effectiveness of The "Thank You, Sorry, Love" (TSL) family therapy program in potentially improving the marital relationships and health of North Korean refugee women. Methods: The participants included 12 married North Korean female refugees in their 20s to 40s. Using a blinded…

  17. Group Work for Korean Expatriate Women in the United States: An Exploratory Study

    ERIC Educational Resources Information Center

    Suh, Suhyun; Lee, Myoung-Suk

    2006-01-01

    This paper presents the results of exploratory research with a group of seven Korean expatriate women. The study employed a modified Reality Therapy approach over eight meetings conducted by two professionally qualified leaders who also speak Korean. Qualitative research methods were used to analyze and describe the participants' experiences.…

  18. "Thank You, Sorry, Love" (TSL) Therapy with North Korean Refugee Women: A Pilot Study

    ERIC Educational Resources Information Center

    Kim, Hee Jin; Kim, Jae Yop; Kim, Dong Goo

    2016-01-01

    Objectives: This study was designed to evaluate the effectiveness of The "Thank You, Sorry, Love" (TSL) family therapy program in potentially improving the marital relationships and health of North Korean refugee women. Methods: The participants included 12 married North Korean female refugees in their 20s to 40s. Using a blinded…

  19. Group Work for Korean Expatriate Women in the United States: An Exploratory Study

    ERIC Educational Resources Information Center

    Suh, Suhyun; Lee, Myoung-Suk

    2006-01-01

    This paper presents the results of exploratory research with a group of seven Korean expatriate women. The study employed a modified Reality Therapy approach over eight meetings conducted by two professionally qualified leaders who also speak Korean. Qualitative research methods were used to analyze and describe the participants' experiences.…

  20. Effects of an isoflavone-free soy diet on ovarian hormones in premenopausal women.

    PubMed

    Lu, L J; Anderson, K E; Grady, J J; Nagamani, M

    2001-07-01

    Soy intakes have been associated with reduced rates of breast cancer in some Asian populations. The isoflavones daidzein and genistein and other components of soybeans may modulate endocrine function and lead to beneficial health effects. This study determined the effects of a soy diet containing minimum amounts of isoflavones on circulating levels of ovarian hormones and gonadotropins. Nine healthy, regularly cycling women consumed a constant soya-containing diet on a metabolic unit starting on day 2 of a menstrual cycle until day 2 of the next cycle. The soy diet was calculated to maintain constant body weight and included a 36-oz portion of soymilk that provided 334 kilocalories and less than 5 mg/day of total isoflavones. The energy distribution of the soy diet was 35.9% fat, 14.0% protein, and 49.8% carbohydrate whereas the home diets averaged 39% fat, 16.6% protein, and 42.5% carbohydrate. For the group, the soya diet provided more carbohydrate (P = 0.002) and less protein (P = 0.005) than the home diets. Daily consumption of the soya diet reduced daily circulating levels of 17beta-estradiol over the entire menstrual cycle by 20% (P < 0.01, paired t test, two-tailed) and progesterone by 33% (P < 0.0001) compared with levels during the home diet period, but had no effect on LH, FSH, or sex hormone-binding globulin. The decreases in follicular phase 17beta-estradiol during the soy diet can be accounted for by changes in energy intakes, nutrient density, and fiber intake, whereas changes in luteal phase 17beta-estradiol were most strongly associated with differences in fiber intake. Changes in progesterone levels were most strongly associated with changes in protein intake and much less with other nutrients. Isoflavones were not detectable in plasma and urine during either the soy or home diet periods. These results suggest that at least under the conditions of this study, a soy diet with low levels of isoflavones and low energy intake from protein can reduce

  1. Serum carotenoid interactions in premenopausal women reveal α-carotene is negatively impacted by body fat.

    PubMed

    Nuss, Emily Taylor; Valentine, Ashley R; Zhang, Zhumin; Lai, HuiChuan Jennifer; Tanumihardjo, Sherry A

    2017-01-01

    Increasing body mass indices (BMIs) across the globe reflect pandemic shifts towards habitual positive energy imbalances. Excess body fat in individuals is often associated with high-energy and high-fat diets scanty in fresh produce. Carotenoids are fat-soluble pigments plentiful in many fruits and vegetables. They are well-known for provitamin A and antioxidant functions, but little research has been done related to carotenoid-body mass interactions. Serum carotenoids were analyzed relative to body fat to determine correlations between major serum carotenoids, retinol, BMI, fat mass, and lean mass. Healthy women ( n = 76), 19-50 years old, were categorized into two comparison groups determined by percent body fat measured by air displacement plethysomography (BOD POD®), i.e. <31% and ≥31% fat mass. Anthropometric and three-day diet records were completed for BMI and nutrient intake calculations, respectively. Serum α-carotene concentrations were strongly inversely associated with all measures of body composition ( P < 0.001 α-carotene) controlling for dietary intake and age, while β-carotene, lutein, and lycopene were not ( P > 0.05). Dietary intake between groups did not differ, including carrot consumption (a high dietary source of α-carotene). These results confirm previous carotenoid-health research and propose the need for further investigation of potential protective roles that α-carotene may perform for optimal health. Serum α-carotene may provide a deeper and clinically relevant purpose, beyond previous suggestions for its use as a biomarker for fruit and vegetable consumption, in that α-carotene may be a biomarker for chronic disease risk frequently linked with obesity. Impact statement Carotenoids are important pigments in fruit and vegetables and found in human serum. This study isolated a negative relationship between serum α-carotene and body fatness. As humans begin to live over a century, determining biomarkers of ultimate

  2. Daily environmental differences in blood pressure and heart rate variability in healthy premenopausal women.

    PubMed

    James, Gary D; Bovbjerg, Dana H; Hill, Leah A

    2015-01-01

    As daily environments change, behavior and activity also change and as blood pressure (BP) and heart rate (HR) are allostatically tied to these factors, one might expect that environments that elicit the greatest behavioral/activity variation should also evince the highest BP and HR variability [standard deviation (SD) or coefficient of variation (CV)]. The purpose of this study was to evaluate this premise. Two hundred and six women (age = 37.6 ± 9.1 years) wore an ambulatory BP monitor on a midweek workday. All worked in clerical, technical, or professional positions. Ambulatory BP and HR Means, SDs and CVs at work (11 AM-3 PM), home (∼6-10 PM) and during sleep (∼10 PM-6 AM) were compared using repeated measures ANCOVA. Mean BP and HR decreased from work and home to sleep [121 ± 11, 120 ± 11 vs. 107 ± 12 systolic; 82 ± 10, 80 ± 11 vs. 66 ± 11 diastolic; 79 ± 12, 80 ± 12 vs. 68 ± 11 HR (all P < 0.001)], while the CV of systolic and diastolic BP increased [0.06 ± 0.02, 0.07 ± 0.02 vs. 0.08 ± 0.03 systolic; 0.09 ± 0.03, 0.10 ± 0.04 vs. 0.12 ± 0.05 diastolic (P < 0.001)]. The HR SD decreased during sleep [8.1 ± 3.8, 8.2 ± 3.8 vs. 6.9 ± 3.2 (P < 0.001)]. HR variability follows the expected variability pattern with behavior and activity, whereas BP does not. © 2014 Wiley Periodicals, Inc.

  3. Health care seeking behavior of Korean women with lymphedema.

    PubMed

    Cho, Myoung Ok

    2004-06-01

    The present biocultural study aimed to describe the health care use patterns of women with lymphedema. Data came from interviews and participant observations with eight key informants between February 2000 and February 2002. Analyzing the process of seeking health care, this paper explored how Korean women with lymphedema make use of all the available resources in the three sectors of the health care system: professional, folk and popular health. In these three sectors of the health care system, informants showed different patterns of behavior. In the professional health care sector, they behave based on scientific Western medicine and holistic herbal medical frameworks. Informants want scientific technological treatment from a Westernized doctor and perfect humanistic and holistic treatment from a herbal doctor. In the folk sector, informants' behavior is ruled by a pragmatic and supernatural framework. Informants seek religious healers who have strong spirituality and non-religious healers who have experience and skills. Informants complied with these healer's remedies based on efficacy and empirical healing evidence. In the popular sector of the health care system, informants behave based on their concept of illness and rules of daily life. They believe lymphedema comes from poor blood circulation and they want to be regarded as members of society, not as patients with lymphedema. Therefore, informants practised popular remedies that they believed were good for promoting blood circulation and keeping their social network active. This description about health care seeking behaviors being embedded in Korean socio-medical culture can serve to understand patients with other chronic health problems. With these results, we can put a bridge over the river of cultural conflict between health professionals and patients.

  4. Primary antiphospholipid syndrome in premenopausal women: low vitamin D, high fat mass and maintained bone mineral mass.

    PubMed

    Paupitz, J A; Freire de Carvalho, J; Caparbo, V F; Klack, K; Pereira, R M R

    2010-10-01

    The aim of this study was to analyze vitamin D levels and their association with bone mineral density and body composition in primary antiphospholipid syndrome. For this cross-sectional study 23 premenopausal women with primary antiphospholipid syndrome (Sapporo criteria) and 23 age- and race-matched healthy controls were enrolled. Demographic, anthropometric, clinical and laboratorial data were collected using clinical interview and chart review. Serum 25-hydroxyvitamin D levels, parathormone, calcium and 24-hour urinary calcium were evaluated in all subjects. Bone mineral density and body composition were studied by dual X-ray absorptiometry. The mean age of patients and controls was 33 years. Weight (75.61 [20.73] vs. 63.14 [7.34] kg, p = 0.009), body mass index (29.57 [7.17] vs. 25.35 [3.37] kg, p = 0.014) and caloric ingestion (2493 [1005.6] vs. 1990 [384.1] kcal/day, p = 0.03) were higher in PAPS than controls. All PAPS were under oral anticoagulant with INR within therapeutic range. Interestingly, biochemical bone parameters revealed lower levels of 25-hydroxyvitamin D [21.64 (11.26) vs. 28.59 (10.67) mg/dl, p = 0.039], serum calcium [9.04 (0.46) vs. 9.3 (0.46) mg/dl, p = 0.013] and 24-hour urinary calcium [106.55 (83.71) vs. 172.92 (119.05) mg/d, p = 0.027] in patients than in controls. Supporting these findings, parathormone levels were higher in primary antiphospholipid syndrome than in controls [64.82 (37.83) vs. 44.53 (19.62) pg/ml, p = 0.028]. The analysis of osteoporosis risk factors revealed that the two groups were comparable (p > 0.05). Lumbar spine, femoral neck, total femur and whole body bone mineral density were similar in both groups (p > 0.05). Higher fat mass [28.51 (12.93) vs. 20.01 (4.68) kg, p = 0.005] and higher percentage of fat [36.08 (7.37) vs. 31.23 (4.64)%, p = 0.010] were observed in PAPS in comparison with controls; although no difference was seen regarding lean mass. In summary, low vitamin D in primary antiphospholipid syndrome

  5. Validity of bioelectrical impedance analysis to estimate body composition changes after bariatric surgery in premenopausal morbidly women.

    PubMed

    Savastano, Silvia; Belfiore, Annamaria; Di Somma, Carolina; Mauriello, Concetta; Rossi, Annalisa; Pizza, Genoveffa; De Rosa, Annalba; Prestieri, Giovanni; Angrisani, Luigi; Colao, Annamaria

    2010-03-01

    In obese patients, subtle variations of the hydration of soft tissues can propagate errors in bioelectrical impedance analysis (BIA) measures of body composition. Bioelectrical impedance vector analysis (BIVA) is a useful method to evaluate tissue hydration. Laparoscopic adjustable gastric banding (LAGB) is a purely restrictive bariatric surgical procedure resulting in lower fat-free mass (FFM) loss than other malabsorptive or mixed intervention. The aim of this study was to evaluate the 6- and 12-month changes in body composition in a homogeneous group of premenopausal morbidly obese women treated by LAGB by comparing the results of conventional BIA and BIVA with dual-energy X-ray absorptiometry (DXA) method. Forty-five consecutive morbidly obese patients (mean age, 35.3 +/- 9.1 years; body mass index, 34.5-48.7 kg/m(2)) were prospectively evaluated at the Endocrinology Unit of the Department of Molecular and Clinical Endocrinology and Oncology. The LAGB device (Lap-Band System; Inamed Health, Santa Barbara, CA, USA) was inserted laparoscopically. Soft tissue hydration was evaluated by BIVA; fat mass (FM) and FFM were evaluated by BIA (BIA 101 RJL, Akern Bioresearch, Firenze, Italy) and by DXA (Hologic QDR 4500A S/N 45622; Hologic Inc., Bedford, MA, USA). Pre- and postoperative BIVA vectors indicated a normal hydration in all patients. Postoperatively, the excess of body weight loss was mainly due to a decrease in FM. The regression analysis of BIA and DXA methods at baseline and at the 6- and 12-month follow-up for FM r (2) values were 0.98, 0.94, and 0.99, respectively (p < 0.001); FM% r (2) values were 0.91, 0.89, and 0.98, respectively (p < 0.001); and FFM r (2) values were 0.87, 0.82, 0.99, respectively (p < 0.001). BIA and DXA measurements of body composition exhibit a high relative agreement in the study group of normo-hydrated obese subjects. BIA tends to overestimate FFM, but this effect is reduced along with the weight loss during the follow-up. Under

  6. Modulation of Breast Cancer Risk Biomarkers by High Dose Omega-3 Fatty Acids: Phase II Pilot Study in Pre-menopausal Women

    PubMed Central

    Fabian, Carol J; Kimler, Bruce F.; Phillips, Teresa A.; Box, Jessica A.; Kreutzjans, Amy L.; Carlson, Susan E.; Hidaka, Brandon H.; Metheny, Trina; Zalles, Carola M.; Mills, Gordon B.; Powers, Kandy R.; Sullivan, Debra K.; Petroff, Brian K.; Hensing, Whitney L.; Fridley, Brooke L.; Hursting, Stephen D

    2015-01-01

    Higher intakes of the omega-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) relative to the omega-6 arachidonic acid (AA) have been variably associated with reduced risk of premenopausal breast cancer. The purpose of this pilot trial was to assess feasibility and explore effects of high dose EPA and DHA on blood and benign breast tissue risk biomarkers prior to design of a placebo controlled Phase IIB trial. Premenopausal women with evidence of hyperplasia +/- atypia by baseline random periareolar fine needle aspiration (RPFNA) were given 1860 mg of EPA + 1500 mg of DHA ethyl esters daily for 6 months. Blood and benign breast tissue were sampled during the same menstrual cycle phase pre-study and a median of 3 weeks after last dose. Additional blood was obtained within 24 hours of last dose. Feasibility which was pre-defined as 50% uptake, 85% retention and 70% compliance, was demonstrated with 46% uptake, 94% completion, and 85% compliance. Cytologic atypia decreased from 77 to 38% (p=0.002), and Ki-67 from a median of 2.1 to 1.0 % (p=0.021) with an increase in the ratio of EPA + DHA to AA in erythrocyte phospholipids but no change in blood hormones, adipokines, or cytokines. Exploratory breast proteomics assessment showed decreases in several proteins involved in hormone and cytokine signaling with mixed effects on those in the AKT/mTOR pathways. Further investigation of EPA plus DHA for breast cancer prevention in a placebo controlled trial in premenopausal women is warranted. PMID:26276744

  7. Modulation of Breast Cancer Risk Biomarkers by High-Dose Omega-3 Fatty Acids: Phase II Pilot Study in Premenopausal Women.

    PubMed

    Fabian, Carol J; Kimler, Bruce F; Phillips, Teresa A; Box, Jessica A; Kreutzjans, Amy L; Carlson, Susan E; Hidaka, Brandon H; Metheny, Trina; Zalles, Carola M; Mills, Gordon B; Powers, Kandy R; Sullivan, Debra K; Petroff, Brian K; Hensing, Whitney L; Fridley, Brooke L; Hursting, Stephen D

    2015-10-01

    Higher intakes of the omega-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) relative to the omega-6 arachidonic acid (AA) have been variably associated with reduced risk of premenopausal breast cancer. The purpose of this pilot trial was to assess feasibility and explore the effects of high-dose EPA and DHA on blood and benign breast tissue risk biomarkers before design of a placebo-controlled phase IIB trial. Premenopausal women with evidence of hyperplasia ± atypia by baseline random periareolar fine needle aspiration were given 1860 mg of EPA + 1500 mg of DHA ethyl esters daily for 6 months. Blood and benign breast tissue were sampled during the same menstrual cycle phase prestudy and a median of 3 weeks after last dose. Additional blood was obtained within 24 hours of last dose. Feasibility, which was predefined as 50% uptake, 85% retention, and 70% compliance, was demonstrated with 46% uptake, 94% completion, and 85% compliance. Cytologic atypia decreased from 77% to 38% (P = 0.002), and Ki-67 from a median of 2.1% to 1.0% (P = 0.021) with an increase in the ratio of EPA + DHA to AA in erythrocyte phospholipids but no change in blood hormones, adipokines, or cytokines. Exploratory breast proteomics assessment showed decreases in several proteins involved in hormone and cytokine signaling with mixed effects on those in the AKT/mTOR pathways. Further investigation of EPA plus DHA for breast cancer prevention in a placebo-controlled trial in premenopausal women is warranted. ©2015 American Association for Cancer Research.

  8. Responses to Overdiagnosis in Thyroid Cancer Screening among Korean Women.

    PubMed

    Lee, Sangeun; Lee, Yoon Young; Yoon, Hyo Joong; Choi, Eunji; Suh, Mina; Park, Boyoung; Jun, Jae Kwan; Kim, Yeol; Choi, Kui Son

    2016-07-01

    Communicating the harms and benefits of thyroid screening is necessary to help individuals decide on whether or not to undergo thyroid cancer screening. This study was conducted to assess changes in thyroid cancer screening intention in response to receiving information about overdiagnosis and to determine factors with the greatest influence thereon. Data were acquired from subjects included in the 2013 Korean National Cancer Screening Survey (KNCSS), a nationwide, population-based, cross-sectional survey. Of the 4,100 respondents in the 2013 KNCSS, women were randomly subsampled and an additional face-to-face interview was conducted. Finally, a total of 586 female subjects were included in this study. Intention to undergo thyroid cancer screening was assessed before and after receiving information on overdiagnosis. Prior awareness of overdiagnosis in thyroid cancer screening was 27.8%. The majority of subjects intended to undergo thyroid cancer screening before and after receiving information on overdiagnosis (87% and 74%, respectively). Only a small number of subjects changed their intention to undergo thyroid cancer screening from positive to negative after receiving information on overdiagnosis. Women of higher education level and Medical Aid Program recipients reported being significantly more likely to change their intention to undergo thyroid cancer screening afterreceiving information on overdiagnosis,whilewomen with stronger beliefs on the efficacy of cancer screening were less likely to change their intention. Women in Korea appeared to be less concerned about overdiagnosis when deciding whether or not to undergo thyroid cancer screening.

  9. Alternative view of health behavior: the experience of older Korean women.

    PubMed

    Yang, Jin Hyang; Yang, Bok Sun

    2011-03-01

    In this study we explored the perspectives of older Korean women on the principles and meanings of health behavior. Participants were 12 women age 65 and older, with no serious illnesses requiring hospitalization, who were living independently. We used an interpretative phenomenological approach for data collection and analysis. Seven themes emerged: (a) eating well in accordance with one's physical requirements; (b) maintaining one's inherited health; (c) controlling one's illness properly; (d) maintaining good relationships with close relatives and friends; (e) being modest and free from greed; (f) staying in harmony with nature; and (g) regaining energy and vitality. These experiences were mainly based on the traditional Korean concept of health promotion, "food is medicine," rather than on Western concepts of health promotion. In providing optimal geriatric nursing care for Korean older women, the results will be significant because they are based on older women's traditional Korean perspectives of health promotion rather than existing perspectives of Western medicine.

  10. Progressive high-intensity resistance training and bone mineral density changes among premenopausal women: evidence of discordant site-specific skeletal effects.

    PubMed

    Martyn-St James, Marrissa; Carroll, Sean

    2006-01-01

    Regular weight-bearing physical activity has been widely recommended for adult women and may be beneficial in preserving bone mineral density (BMD). However, there is conflicting evidence regarding the effects of resistance training on BMD in premenopausal women. Novel systematic review and meta-analysis evidence is presented on the effects of progressive high-intensity resistance training on BMD in premenopausal women. Structured computer searches of MEDLINE, EMBASE, PubMed, Web of Science, SportDiscus and Evidence Based Medicine Reviews Multifile were undertaken along with hand-searching of key journals and reference lists to locate relevant studies published up to September 2004. Criteria for included studies were published controlled studies and randomised controlled trials (RCTs) evaluating the effects of progressive, high-intensity resistance training studies on BMD in premenopausal women. Two authors reached consensus on all included and excluded studies. Study outcomes for analysis were radiographic BMD assessment from first follow-up at lumbar spine and femoral neck. Primary outcomes for analysis were absolute changes in BMD g/cm(2) at lumbar spine and femoral neck. Relative changes (percentage change) in BMD at lumbar spine were also assessed. Data were extracted from studies including study design, participant characteristics and treatment mode, intensity and duration, using electronic data extraction forms. Where necessary, relevant information was obtained by contacting study authors. Methodological quality of studies was assessed using a well recognised three-question instrument designed to assess bias. Informal assessment for small sample study effects and potential bias was undertaken through visual inspection of funnel plots. The weighted mean difference method (inverse of the variances) was used for combining study group estimates. Quantification of the effect of heterogeneity among study outcomes was assessed using the I(2) statistic. Random

  11. Expression of cyclooxygenase-1 and cyclooxygenase-2, syndecan-1 and connective tissue growth factor in benign and malignant breast tissue from premenopausal women.

    PubMed

    Fahlén, M; Zhang, H; Löfgren, L; Masironi, B; von Schoultz, E; von Schoultz, B; Sahlin, L

    2017-02-21

    Stromal factors have been identified as important for tumorigenesis and metastases of breast cancer. From 49 premenopausal women, samples were collected from benign or malignant tumors and the seemingly normal tissue adjacent to the tumor. The factors studied, with real-time polymerase chain reaction (PCR) and immunohistochemistry, were cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and COX-2), syndecan-1 (S-1) and connective tissue growth factor (CTGF). COX-1 and S-1 mRNA levels were higher in the malignant tumors than in normal and benign tissues. The COX-2 mRNA level was lower in the malignant tumor than in the normal tissue, while CTGF mRNA did not differ between the groups. COX-1 immunostaining was higher in stroma from malignant tumors than in benign tissues, whereas COX-2 immunostaining was higher in the malignant tissue. Glandular S-1 immunostaining was lower in malignant tumors compared to benign and normal tissues, and the opposite was found in stroma. Conclusively, mRNA levels of COX-1 and COX-2 were oppositely regulated, with COX-1 being increased in the malignant tumor while COX-2 was decreased. S-1 protein localization switched from glandular to stromal cells in malignant tissues. Thus, these markers are, in premenopausal women, localized and regulated differently in normal/benign breast tissue as compared to the malignant tumor.

  12. C-reactive protein, waist circumference, and family history of heart attack are independent predictors of body iron stores in apparently healthy premenopausal women.

    PubMed

    Suárez-Ortegón, M F; Arbeláez, A; Mosquera, M; Méndez, F; Aguilar-de Plata, C

    2012-08-01

    Ferritin levels have been associated with metabolic syndrome and insulin resistance. The aim of the present study was to evaluate the prediction of ferritin levels by variables related to cardiometabolic disease risk in a multivariate analysis. For this aim, 123 healthy women (72 premenopausal and 51 posmenopausal) were recruited. Data were collected through procedures of anthropometric measurements, questionnaires for personal/familial antecedents, and dietary intake (24-h recall), and biochemical determinations (ferritin, C reactive protein (CRP), glucose, insulin, and lipid profile) in blood serum samples obtained. Multiple linear regression analysis was used and variables with no normal distribution were log-transformed for this analysis. In premenopausal women, a model to explain log-ferritin levels was found with log-CRP levels, heart attack familial history, and waist circumference as independent predictors. Ferritin behaves as other cardiovascular markers in terms of prediction of its levels by documented predictors of cardiometabolic disease and related disorders. This is the first report of a relationship between heart attack familial history and ferritin levels. Further research is required to evaluate the mechanism to explain the relationship of central body fat and heart attack familial history with body iron stores values.

  13. Association analysis of genetic polymorphisms and potential interaction of the osteocalcin (BGP) and ER-α genes with body mass index (BMI) in premenopausal Chinese women

    PubMed Central

    Xu, Hong; Xiao, Wen; Luo, Dan; Liu, Yong-ming; Zou, Lin; Kuang, Hai-bin

    2010-01-01

    Aim: To investigate whether estrogen receptor α (ER-α) PvuII and osteocalcin (also known as bone Gla protein, or BGP) HindIII genetic polymorphisms and their potential interactions are associated with body mass index (BMI) variation. Methods: Data on BMI and ER-α PvuII and BGP HindIII genotypes were obtained from 328 healthy premenopausal Chinese women in east China. The study subjects were unrelated, at least 21 years old (mean age of 33.2±5.9 years), and had an average BMI of 21.58±2.59. All subjects were genotyped at the ER-α PvuII and BGP HindIII loci using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). Results: The BGP HindIII genotypes were significantly associated with BMI (P=0.003). Carriers of the HH and Hh genotypes had approximately 2.73% and 1.27% higher BMI than those of the hh genotype, respectively. In contrast, the ER-α PvuII polymorphism was not significantly associated with BMI (P=0.454). In addition, there was no evidence of potential interactions between the ER-α and BGP genes in our subjects (P≥0.013). Conclusion: The HindIII polymorphism of the BGP gene, but not the PvuII polymorphism of the ER-α gene or their potential interaction, was associated with BMI in premenopausal Chinese women. PMID:20305683

  14. Association analysis of genetic polymorphisms and potential interaction of the osteocalcin (BGP) and ER-alpha genes with body mass index (BMI) in premenopausal Chinese women.

    PubMed

    Xu, Hong; Xiao, Wen; Luo, Dan; Liu, Yong-ming; Zou, Lin; Kuang, Hai-bin

    2010-04-01

    To investigate whether estrogen receptor alpha (ER-alpha) PvuII and osteocalcin (also known as bone Gla protein, or BGP) HindIII genetic polymorphisms and their potential interactions are associated with body mass index (BMI) variation. Data on BMI and ER-alpha PvuII and BGP HindIII genotypes were obtained from 328 healthy premenopausal Chinese women in east China. The study subjects were unrelated, at least 21 years old (mean age of 33.2+/-5.9 years), and had an average BMI of 21.58+/-2.59. All subjects were genotyped at the ER-alpha PvuII and BGP HindIII loci using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). The BGP HindIII genotypes were significantly associated with BMI (P=0.003). Carriers of the HH and Hh genotypes had approximately 2.73% and 1.27% higher BMI than those of the hh genotype, respectively. In contrast, the ER-alpha PvuII polymorphism was not significantly associated with BMI (P=0.454). In addition, there was no evidence of potential interactions between the ER-alpha and BGP genes in our subjects (P>or=0.013). The HindIII polymorphism of the BGP gene, but not the PvuII polymorphism of the ER-alpha gene or their potential interaction, was associated with BMI in premenopausal Chinese women.

  15. The Role of Leisure Engagement for Health Benefits Among Korean Older Women.

    PubMed

    Kim, Junhyoung; Irwin, Lori; Kim, May; Chin, Seungtae; Kim, Jun

    2015-01-01

    This qualitative study was designed to examine the benefits of leisure to older Korean women. Using a constructive grounded theory methodology, in this study we identified three categories of benefits from leisure activities: (a) developing social connections, (b) enhancing psychological well-being, and (c) improving physical health. The findings of this study demonstrate that involvement in leisure activities offers substantial physical, psychological, and social benefits for older Korean women. The results also suggest that these benefits can provide an opportunity for older Korean adults to improve their health and well-being, which, in turn, may help promote successful aging.

  16. Cardiovascular disease risk factors and depression in Korean women: results from the fourth Korean National Health and Nutrition Examination Survey.

    PubMed

    Park, Jong Eun; Lee, Jung Eun

    2011-12-30

    Depression is the fourth leading factor of disease burden for the global female population, but while increasing evidence has supported a contributing role of depression in cardiovascular disease, little is known about this association within the female population of Korea. We examined the association in a study of 5658 Korean women who participated in the fourth Korean National Health and Nutrition Examination Survey. A logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 279 cases of depression were included. Cardiovascular disease risk factors were associated with higher odds of depression: ORs (95% CIs) were 3.99 (2.25-7.05) for current smokers with <5 pack-years vs. never-smokers, 1.97 (1.18-3.30) for ≥28 vs. <20kg/m(2) of body mass index, 1.42 (1.03-1.95) for 100-125 vs. <100mg/dL of fasting serum glucose levels, and 2.10 (1.46-3.03) for a history of hyperlipidemia. Women with a history of two or three comorbid disorders (diabetes, hypertension, and cardiovascular disease) had a 1.63-fold higher OR for depression than women without any of these diseases. Korean women with depression had a greater prevalence of major risk factors for cardiovascular disease than women without depression.

  17. A weight-loss program adapted to the menstrual cycle increases weight loss in healthy, overweight, premenopausal women: a 6-mo randomized controlled trial.

    PubMed

    Geiker, Nina Rw; Ritz, Christian; Pedersen, Sue D; Larsen, Thomas M; Hill, James O; Astrup, Arne

    2016-07-01

    Hormonal fluctuations during the menstrual cycle influence energy intake and expenditure as well as eating preferences and behavior. We examined the effect in healthy, overweight, premenopausal women of a diet and exercise weight-loss program that was designed to target and moderate the effects of the menstrual cycle compared with the effect of simple energy restriction. A total of 60 healthy, overweight, premenopausal women were included in a 6-mo weight-loss program in which each subject consumed a diet of 1600 kcal/d. Subjects were randomly assigned to either a combined diet and exercise program that was tailored to metabolic changes of the menstrual cycle (Menstralean) or to undergo simple energy restriction (control). Thirty-one women (19 Menstralean and 12 control women) completed the study [mean ± SD body mass index (in kg/m(2)): 32.0 ± 5.2]. Both groups lost weight during the study. In an intention-to-treat analysis, the Menstralean group did not achieve a clinically significant weight loss compared with that of the control group (P = 0.61). In per-protocol analyses, a more-pronounced weight loss of 4.3 ± 1.4 kg (P = 0.002) was shown in adherent Menstralean subjects than in the control group. A differentiated diet and exercise program that is tailored to counteract food cravings and metabolic changes throughout the menstrual cycle may increase weight loss above that achieved with a traditional diet and exercise program in women who can comply with the program. This trial was registered at clinicaltrials.gov as NCT01622114. © 2016 American Society for Nutrition.

  18. Gender-Specific Differences in the Kinetics of Nonfasting TRL, IDL, and LDL Apolipoprotein B-100 in Men and Premenopausal Women

    PubMed Central

    Matthan, Nirupa R.; Jalbert, Susan M.; Barrett, P. Hugh R.; Dolnikowski, Gregory G.; Schaefer, Ernst J.; Lichtenstein, Alice H.

    2010-01-01

    Objective To investigate mechanisms underlying gender differences in serum lipoprotein concentrations, the kinetic behavior of apoB-100 was assessed. Methods and Results Twenty subjects (<50 years; 12 men and 8 premenopausal women) were provided a Western diet for 4 to 6 weeks, after which the kinetics of apoB-100 in triglyceride-rich, intermediate-density, and low-density lipoprotein (TRL, IDL, and LDL) were determined in the fed state. Nonfasting plasma TC, LDL-C, and triglyceride concentrations were 23%, 34%, and 57% lower, respectively, in the women compared with men. Plasma TRL and LDL apoB 100 pool sizes were lower by 40% and 30%, respectively. These differences were accounted for by higher TRL and LDL apoB 100 fractional catabolic rates (FCR), rather than differences in production rates (PR). Plasma TRL-C and LDL-C were positively correlated with TRL and LDL apoB 100 concentrations and pool size, and negatively correlated with TRL and LDL apoB 100 FCR (women: r=−0.59, P<0.01 and r=−0.54, P<0.04, and men: r=−0.43, P<0.05 and r=−0.44, P<0.05). No significant associations were observed between plasma TRL-C and LDL-C and PR. Conclusions These data suggest the mechanism for lower TRL-C and LDL-C concentrations in women was determined predominantly by higher TRL and LDL FCR rather than lower PR. This could explain, in part, the lower CVD risk in premenopausal women relative to men. PMID:18658047

  19. Social and cultural construction of urinary incontinence among Korean American elderly women.

    PubMed

    Kang, Youngmi; Crogan, Neva L

    2008-01-01

    The purpose of this article is to describe the social and cultural constructions that influence help-seeking for urinary incontinence (UI) among Korean American elderly women. Many Korean American elder women do not perceive UI as a problem worthy of attention. The reason may lie in its social and cultural construction. The social construction is rooted in the collectivist nature of Korean culture, which makes UI a family, rather than an individual, problem. The cultural construction is related to Confucianism, which directs conceptions about ageism, shame, and fatalism. This article will help the gerontological nurse to better understand Korean American elderly women's sociocultural background related to UI care and could lead to appropriate family centered interventions to manage or treat UI in this population.

  20. Regulation of small dense LDL concentration in Korean and Scottish men and women.

    PubMed

    Cho, Hong Keun; Shin, Gilja; Ryu, Sung Kee; Jang, Yangsoo; Day, Stephen P; Stewart, Grace; Packard, Chris J; Shepherd, James; Caslake, Muriel J

    2002-09-01

    Small dense LDL is now emerging as an important risk factor for coronary artery disease. The amount of the LDL III has been reported to differ between ethnic groups. To investigate differences in the distribution of LDL subfractions between Korean and Scottish populations, we measured the plasma concentration and percent distribution of three major LDL subfractions in age-and sex-matched, middle aged, healthy 124 Korean and Scottish subjects (32 Korean men vs. 32 Scottish men; 30 Korean women vs. 30 Scottish women). Body mass index and waist circumference did not differ between the two ethnic groups. Total cholesterol and LDL cholesterol concentrations were higher in Scottish men compared with Korean men (P<0.01), while plasma triglyceride concentration was higher in Korean men and women (P<0.01 in men, P<0.05 in women). HDL cholesterol concentrations in both Korean men and women were lower than that of their Scottish counterparts (P<0.05 in men; P<0.001 in women). Korean men had lower concentrations of total LDL (242+/-65 vs. 325+/-122 mg/dl, P<0.01), LDL I (24+/-18 vs. 60+/-36 mg/dl, P<0.001) and LDL II (110+/-56 vs. 196+/-78 mg/dl, P<0.001). In contrast, LDL III concentration was markedly higher in Korean men (108+/-75 vs. 70+/-65 mg/dl, P<0.05). Likewise, the percent of LDL I (10.0+/-7.3 vs. 19.1+/-10.1%, P<0.001) and LDL II (47.2+/-20.7 vs. 60.1+/-10.9%, P<0.01) were lower in Korean men, while that of LDL III was higher (42.8+/-24.9 vs. 20.8+/-15.0%, P<0.001). In the female population, there were no differences in total LDL and LDL I concentrations between Korean and Scottish. LDL II concentration was lower in Korean women (106+/-53 vs. 151+/-57 mg/dl, P<0.01). Korean women showed a higher percent of LDL III (24.8+/-24.7 vs. 14.2+/-5.9%, P<0.05) and a lower LDL II (47.8+/-19.1 vs. 61.0+/-10.0%, P<0.01). Multiple linear regression revealed that plasma triglyceride concentration was the most important determinant of the LDL III subfraction concentration in

  1. The stranded individualizer under compressed modernity: South Korean women in individualization without individualism.

    PubMed

    Kyung-Sup, Chang; Min-Young, Song

    2010-09-01

    South Korean families have functioned as a highly effective receptacle for the country's highly compressed conditions of modernity and late modernity. It is as much due to the success of South Korean families as an engine of compressed modernity as due to their failure that they have become functionally overloaded and socially risk-ridden. Such familial burdens and risks are particularly onerous to South Korean women because of the fundamentally gender-based structure of family relations and duties that has in part been recycled from the Confucian past and in part manufactured under industrial capitalism. Under these complicated conditions, South Korean women have had to dramatically restructure their family relations and duties as well as their individual life choices. Furthermore, under the most recent condition of what Beck calls second modernity, other institutions of modernity, such as the state, industrial economy, firms, unions, schools, and welfare systems, have become increasingly ineffective in helping to alleviate such (gender-based) familial burdens and dilemmas. As a result South Korean women have experienced dramatic changes in marriage patterns, fertility, family relations, etc. South Korean women's individualization has thereby taken place primarily as a matter of practicality rather than ideational change. A brief analysis of the situation in the neighbouring societies of Japan and Taiwan reinforces the conclusion that individualization without individualism, particularly among women, is a region-wide phenomenon in East Asia.

  2. Influence of number of deliveries and total breast-feeding time on bone mineral density in premenopausal and young postmenopausal women.

    PubMed

    Tsvetov, Gloria; Levy, Sigal; Benbassat, Carlos; Shraga-Slutzky, Ilana; Hirsch, Dania

    2014-03-01

    Pregnancy and lactation have been associated with decline in bone mineral density (BMD). It is not clear if there is a full recovery of BMD to baseline. This study sought to determine if pregnancy or breast-feeding or both have a cumulative effect on BMD in premenopausal and early postmenopausal women. We performed single-center cohort analysis. Five hundred women aged 35-55 years underwent routine BMD screening from February to July 2011 at a tertiary medical center. Patients were questioned about number of total full-term deliveries and duration of breast-feeding and completed a background questionnaire on menarche and menopause, smoking, dairy product consumption, and weekly physical exercise. Weight and height were measured. Dual-energy X-ray absorptiometry was used to measure spinal, dual femoral neck, and total hip BMD. Associations between background characteristics and BMD values were analyzed. Sixty percent of the women were premenopausal. Mean number of deliveries was 2.5 and mean duration of breast-feeding was 9.12 months. On univariate analysis, BMD values were negatively correlated with patient age (p=0.006) and number of births (p=0.013), and positively correlated with body mass index (p<0.001). On multiple (adjusted) logistic regression analysis, prolonged breast-feeding duration, but not number of deliveries, was significantly correlated to a low BMD (p=0.008). An effect was noted only in postmenopausal women. The spine was the most common site of BMD decrease. Prolonged breast-feeding may have a deleterious long-term effect on BMD and may contribute to increased risk of osteoporosis later in life. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. The association between subjective assessment of menstrual bleeding and measures of iron deficiency anemia in premenopausal African-American women: a cross-sectional study.

    PubMed

    Bernardi, Lia A; Ghant, Marissa S; Andrade, Carolina; Recht, Hannah; Marsh, Erica E

    2016-08-15

    Both iron deficiency and iron deficiency anemia are common in the United States with a prevalence amongst women of 12 % and 4 % respectively. These numbers are even higher in African-American women (AAW) and are often a result of heavy menstrual bleeding (HMB). The primary objective of this study was to determine if perceived assessment of menstrual bleeding was associated with objective and subjective measures of anemia in AAW. Quantitative cross-sectional pilot study with surveys and venipuncture. 44 premenopausal AAW (mean age 37.9 years ± 9. 4) participated in the study. Iron deficiency was present in 68.2 % of the participants and 18.2 % were anemic. Almost half of the participants reported that their menses were heavy or very heavy, and there was a relationship between perceived heaviness of menstrual flow and anemia (P = 0.021). Of the individuals who reported that their menses were heavy or very heavy, 35.0 % were anemic. AAW who reported heavy or very heavy menses had significantly lower hemoglobin (P = 0.015), hematocrit (P = 0.003), and ferritin (P = 0.012) levels, as well as more general (P = 0.006) and menses-associated symptoms of anemia (P = 0.015) than those who reported normal or light menses. This pilot study of premenopausal AAW found that a significant percentage of women who report HMB are not only iron deficient, but also anemic. AAW should be educated on the consequences of HMB and counseled to seek care with a women's health provider when they perceive HMB. More importantly, providers should be aware that when AAW report HMB, evaluation for iron deficiency and anemia are essential.

  4. Effect of vitamin D supplementation on cardiometabolic risks and health-related quality of life among urban premenopausal women in a tropical country--a randomized controlled trial.

    PubMed

    Ramly, Mazliza; Ming, Moy Foong; Chinna, Karuthan; Suboh, Suhaili; Pendek, Rokiah

    2014-01-01

    Many observational studies linked vitamin D to cardiometabolic risks besides its pivotal role in musculoskeletal diseases, but evidence from trials is lacking and inconsistent. To determine whether Vitamin D supplementation in urban premenopausal women with vitamin D deficiency can improve cardiometabolic risks and health-related quality of life (HRQOL). A double-blind randomized controlled trial was conducted in Kuala Lumpur, Malaysia. A total of 192 vitamin D deficient (<50 nmol/l) premenopausal women were randomized to receive either vitamin D 50,000 IU or placebo once a week for 2 months and then monthly for 10 months. Primary outcomes were serum 25(OH)D, serum lipid profiles, blood pressure and HOMA-IR measured at baseline, 6 months and 12 months. HRQOL was assessed with SF-36 at baseline and 12 months. Ninety three and ninety-nine women were randomised into intervention and placebo groups respectively. After 12 months, there were significant differences in the serum 25(OH)D concentration (mean difference: 49.54; 95% CI: 43.94 to 55.14) nmol/l) and PTH levels (mean difference: -1.02; 95% CI: -1.67 to -0.38 pmol/l) in the intervention group compared to placebo group. There was significant difference between treatment group in both serum 25(OH)D and PTH. There was no effect of supplementation on HOMA-IR, serum lipid profiles and blood pressure (all p>0.05) between two groups. There was a small but significant improvement in HRQOL in the components of vitality (mean difference: 5.041; 95% CI: 0.709 to 9.374) and mental component score (mean difference: 2.951; 95% CI: 0.573 to 5.329) in the intervention group compared to placebo group. Large and less frequent dosage vitamin D supplementation was safe and effective in the achievement of vitamin D sufficiency. However, there was no improvement in measured cardiometabolic risk factors in premenopausal women. Conversely vitamin D supplementation improves some components of HRQOL. Australian New Zealand Clinical Trial

  5. Body composition, cardiometabolic risk factors, physical activity, and inflammatory markers in premenopausal women after a 10-year follow-up: a MONET study.

    PubMed

    Razmjou, Sahar; Abdulnour, Joseph; Bastard, Jean-Philippe; Fellahi, Soraya; Doucet, Éric; Brochu, Martin; Lavoie, Jean-Marc; Rabasa-Lhoret, Rémi; Prud'homme, Denis

    2017-07-31

    Menopausal transition and postmenopause are usually associated with changes in body composition and a decrease in physical activity energy expenditure (PAEE). This study investigated body composition, cardiometabolic risk factors, PAEE, and inflammatory markers in premenopausal women after a 10-year follow-up. In all, 102 premenopausal women participated in the 5-year observational longitudinal Montreal Ottawa New Emerging Team (MONET) study. This present substudy included 48 participants (age: 60.0 ± 1.7 years; body mass index: 23.2 ± 2.2 kg/m) 6.0 ± 0.3 years after completion of the initial MONET study. Measures included body composition, waist circumference (WC), fasting glucose and insulin levels, insulin sensitivity (QUICKI model), plasma lipid levels, PAEE, and inflammatory markers. Compared with baseline measures of the MONET study, analyses revealed no significant increase in body weight, although there were significant increases in WC, fat mass (FM), % FM, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, haptoglobin, apolipoprotein B, ferritin, adiponectin, and soluble cluster of differentiation 14 (all P < 0.001) after the 10-year follow-up. However, significant decreases were observed for fat-free mass, PAEE, fasting glucose levels, interleukin-8 levels, and soluble tumor necrosis factor receptors 1 and 2 (sTNFR-1 and sTNFR-2) levels (all P < 0.05). To determine the effect of postmenopausal years, data were restructured based on final menstrual period (FMP), and one-way analyses of variance were performed.Waist circumference, % FM, total cholesterol, high-density lipoprotein cholesterol, apolipoprotein B, ferritin, adiponectin, and soluble cluster of differentiation 14 were higher in early and late postmenopausal periods in these women. sTNFR-1 and sTNFR-2 levels were higher at the FMP and early postmenopausal years as compared with the late postmenopausal periods. Finally

  6. Effect of Vitamin D Supplementation on Cardiometabolic Risks and Health-Related Quality of Life among Urban Premenopausal Women in a Tropical Country – A Randomized Controlled Trial

    PubMed Central

    Ramly, Mazliza; Ming, Moy Foong; Chinna, Karuthan; Suboh, Suhaili; Pendek, Rokiah

    2014-01-01

    Background Many observational studies linked vitamin D to cardiometabolic risks besides its pivotal role in musculoskeletal diseases, but evidence from trials is lacking and inconsistent. Aim To determine whether Vitamin D supplementation in urban premenopausal women with vitamin D deficiency can improve cardiometabolic risks and health-related quality of life (HRQOL). Design A double-blind randomized controlled trial was conducted in Kuala Lumpur, Malaysia. A total of 192 vitamin D deficient (<50 nmol/l) premenopausal women were randomized to receive either vitamin D 50,000 IU or placebo once a week for 2 months and then monthly for 10 months. Primary outcomes were serum 25(OH)D, serum lipid profiles, blood pressure and HOMA-IR measured at baseline, 6 months and 12 months. HRQOL was assessed with SF-36 at baseline and 12 months. Results Ninety three and ninety-nine women were randomised into intervention and placebo groups respectively. After 12 months, there were significant differences in the serum 25(OH)D concentration (mean difference: 49.54; 95% CI: 43.94 to 55.14) nmol/l) and PTH levels (mean difference: −1.02; 95% CI: −1.67 to −0.38 pmol/l) in the intervention group compared to placebo group. There was significant difference between treatment group in both serum 25(OH)D and PTH. There was no effect of supplementation on HOMA-IR, serum lipid profiles and blood pressure (all p>0.05) between two groups. There was a small but significant improvement in HRQOL in the components of vitality (mean difference: 5.041; 95% CI: 0.709 to 9.374) and mental component score (mean difference: 2.951; 95% CI: 0.573 to 5.329) in the intervention group compared to placebo group. Conclusion Large and less frequent dosage vitamin D supplementation was safe and effective in the achievement of vitamin D sufficiency. However, there was no improvement in measured cardiometabolic risk factors in premenopausal women. Conversely vitamin D supplementation improves some components

  7. Dietary Patterns and Risk for Metabolic Syndrome in Korean Women

    PubMed Central

    Choi, Jeong-Hwa; Woo, Hae Dong; Lee, Jeong-Hee; Kim, Jeongseon

    2015-01-01

    Abstract Dietary patterns are a risk factor for metabolic syndrome (MetS). The prevalence of MetS has increased in Korea, and this condition has become a public health issue. Therefore, the present cross-sectional study aimed to identify the associations between dietary patterns and the risk of MetS among Korean women. The data of 5189 participants were analyzed to determine dietary intake and lifestyle. A principal components analysis was employed to determine participant dietary patterns with regard to 106 food items. MetS was diagnosed using the National Cholesterol Education Program, Adult Treatment Panel III. Logistic regression analyses were applied to evaluate the associations between dietary pattern quintiles and MetS and to generate odds ratios (ORs) and 95% confidence intervals (CIs) after adjusting for potential confounders. Three dietary patterns were identified: “traditional,” “western,” and “prudent.” The “prudent” dietary pattern consisted of a high intake of fruits and fruit products as well as nuts, dairy, and a low consumption of grains; this pattern was negatively associated with the risk of MetS. The highest quintile of the “prudent” dietary pattern was significantly less likely to develop MetS (OR: 0.5, 95% CI: 0.36–0.68, P for trend <0.001) compared with the lowest quintile. This pattern was also negatively associated with all of the MetS diagnostic criteria: abdominal obesity (OR: 0.52, 95% CI: 0.41–0.65), blood pressure (OR: 0.72, 95% CI: 0.59–0.87), triglycerides (OR: 0.67, 95% CI: 0.52–0.85), fasting glucose (OR: 0.64, 95% CI: 0.43–0.95), and high-density lipoprotein cholesterol (OR: 0.53, 95% CI: 0.42–0.68). However, the “traditional” and “western” dietary patterns were not associated with the risk of MetS. The “prudent” dietary pattern was negatively associated with the risk of developing MetS among Korean women. PMID:26313795

  8. Korean immigrant women's lived experience of childbirth in the United States.

    PubMed

    Seo, Jin Young; Kim, Wooksoo; Dickerson, Suzanne S

    2014-01-01

    To understand Korean immigrant women's common experiences and practices of utilizing health care services in the United States during childbirth. A qualitative interpretive phenomenological research design. Recruitment was conducted through advertisement on the MissyUSA.com website, which is the largest online community for married Korean women who live in North America. A purposive sample of 15 Korean immigrant women who experienced childbirth in the United States within the past 5 years was recruited. Data were collected using semistructured telephone interviews and were analyzed using the Heideggerian hermeneutical methodology. During childbirth in the United States, participants faced multifaceted barriers in unfamiliar sociocultural contexts yet maintained their own cultural heritages. They navigated the unfamiliar health care system and developed their own strategies to overcome barriers to health care access. Korean immigrant women actively sought health information on the Internet and through social networking during childbirth. Korean immigrant women selectively accepted new cultural beliefs with some modifications from their own cultural contexts and developed their own distinct birth cultures. Understanding a particular culture and respecting women's traditions, beliefs, and practices about their childbirth could help nurses to provide culturally sensitive care. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  9. A Randomized Double-Blind Placebo-Controlled Trial of the Effect of Vitamin D3 Supplementation on Breast Density in Premenopausal Women.

    PubMed

    Brisson, Jacques; Bérubé, Sylvie; Diorio, Caroline; Mâsse, Benoît; Lemieux, Julie; Duchesne, Thierry; Delvin, Edgar; Vieth, Reinhold; Yaffe, Martin J; Chiquette, Jocelyne

    2017-08-01

    Background: This double-blind, placebo-controlled parallel group trial assessed whether oral supplementation with 1,000, 2,000, or 3,000 IU/day vitamin D3 over one year reduces percent mammographic breast density in premenopausal women.Methods: The trial was conducted between October 2012 and June 2015, among premenopausal female volunteers from Quebec City (Quebec, Canada). Women were randomized with ratio 1:1:1:1 to one of four study arms (1,000, 2,000, or 3,000 IU/day vitamin D3 or placebo). The primary outcome was mean change in percent mammographic breast density. Participants and research team were blinded to study arm assignment.Results: Participants (n = 405) were randomized to receive 1,000 (n = 101), 2,000 (n = 104), or 3,000 IU/day (n = 101) vitamin D3, or a placebo (n = 99). The primary analysis included 391 participants (96, 99, 100, and 96, respectively). After the one-year intervention, mean ± SE change in percent breast density in the arms 1,000 IU/day (-5.5% ± 0.5%) and 2,000 IU/day (-5.9% ± 0.5%) vitamin D3 was similar to that in the placebo arm (-5.7% ± 0.5%) (P values = 1.0). In the 3,000 IU/day vitamin D3 arm, percent breast density also declined but slightly less (-3.8% ± 0.5%) compared with placebo arm (P = 0.03). Adherence to intervention was excellent (92.8%), and reporting of health problems was comparable among study arms (P ≥ 0.95). All participants had normal serum calcium.Conclusions: In premenopausal women, one-year supplementation with 1,000, 2,000, or 3,000 IU/day vitamin D3 resulted in a reduction of percent breast density no greater than that seen with the placebo.Impact: At doses of 1,000-3,000 IU/day, vitamin D supplementation will not reduce breast cancer risk through changes in breast density. Cancer Epidemiol Biomarkers Prev; 26(8); 1233-41. ©2017 AACR. ©2017 American Association for Cancer Research.

  10. Study protocol: the effect of vitamin D supplements on cardiometabolic risk factors among urban premenopausal women in a tropical country - a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Besides its classical role in musculoskeletal diseases, vitamin D deficiency has recently been found to be associated with cardiometabolic risks such as hypertension, diabetes mellitus and hypercholesterolemia. Although Malaysia is a sunshine-abundant country, recent studies found that vitamin D deficiency prevalence was significantly high. However, few published studies that measured its effect on cardiometabolic risk factors were found in Malaysia. There are also limited clinical trials carried out globally that tried to establish the causality of vitamin D and cardiometabolic risks. Therefore, a double blind, parallel, randomized controlled trial on vitamin D and cardiometabolic risks is planned to be carried out. The objective of this study is to investigate whether vitamin D supplements can reduce the cardiometabolic risk and improve the quality of life in urban premenopausal women with vitamin D deficiency. Methods/design Three hundred and twenty premenopausal women working in a public university in Kuala Lumpur, Malaysia will be randomized to receive either vitamin D supplement (50,000 IU weekly for 8 weeks and 50,000 IU monthly for 10 months) or placebo for 12 months. At baseline, all participants are vitamin D deficient (≤ 20 ng/ml or 50 nmol/l). Both participants and researchers will be blinded. The serum vitamin D levels of all participants collected at various time points will only be analysed at the end of the trial. Outcome measures such as 25(OH) D3, HOMA-IR, blood pressure, full lipid profiles will be taken at baseline, 6 months and 12 months. Health related quality of life will be measured at baseline and 12 months. The placebo group will be given delayed treatment for six months after the trial. Discussion This trial will be the first study investigating the effect of vitamin D supplements on both the cardiometabolic risk and quality of life among urban premenopausal women in Malaysia. Our findings will contribute to the growing body

  11. Study protocol: the effect of vitamin D supplements on cardiometabolic risk factors among urban premenopausal women in a tropical country -- a randomized controlled trial.

    PubMed

    Ramly, Mazliza; Moy, Foong Ming; Pendek, Rokiah; Suboh, Suhaili; Tan Tong Boon, Alexander

    2013-05-01

    Besides its classical role in musculoskeletal diseases, vitamin D deficiency has recently been found to be associated with cardiometabolic risks such as hypertension, diabetes mellitus and hypercholesterolemia. Although Malaysia is a sunshine-abundant country, recent studies found that vitamin D deficiency prevalence was significantly high. However, few published studies that measured its effect on cardiometabolic risk factors were found in Malaysia. There are also limited clinical trials carried out globally that tried to establish the causality of vitamin D and cardiometabolic risks. Therefore, a double blind, parallel, randomized controlled trial on vitamin D and cardiometabolic risks is planned to be carried out.The objective of this study is to investigate whether vitamin D supplements can reduce the cardiometabolic risk and improve the quality of life in urban premenopausal women with vitamin D deficiency. Three hundred and twenty premenopausal women working in a public university in Kuala Lumpur, Malaysia will be randomized to receive either vitamin D supplement (50,000 IU weekly for 8 weeks and 50,000 IU monthly for 10 months) or placebo for 12 months. At baseline, all participants are vitamin D deficient (≤ 20 ng/ml or 50 nmol/l). Both participants and researchers will be blinded. The serum vitamin D levels of all participants collected at various time points will only be analysed at the end of the trial. Outcome measures such as 25(OH) D3, HOMA-IR, blood pressure, full lipid profiles will be taken at baseline, 6 months and 12 months. Health related quality of life will be measured at baseline and 12 months. The placebo group will be given delayed treatment for six months after the trial. This trial will be the first study investigating the effect of vitamin D supplements on both the cardiometabolic risk and quality of life among urban premenopausal women in Malaysia. Our findings will contribute to the growing body of knowledge in the role of vitamin D

  12. IGF-1 Receptor Expression on Circulating Osteoblast Progenitor Cells Predicts Tissue-Based Bone Formation Rate and Response to Teriparatide in Premenopausal Women With Idiopathic Osteoporosis.

    PubMed

    Cohen, Adi; Kousteni, Stavroula; Bisikirska, Brygida; Shah, Jayesh G; Manavalan, J Sanil; Recker, Robert R; Lappe, Joan; Dempster, David W; Zhou, Hua; McMahon, Donald J; Bucovsky, Mariana; Kamanda-Kosseh, Mafo; Stubby, Julie; Shane, Elizabeth

    2017-06-01

    We have previously reported that premenopausal women with idiopathic osteoporosis (IOP) have profound microarchitectural deficiencies and heterogeneous bone remodeling. Those with the lowest bone formation rate have higher baseline serum insulin-like growth factor-1 (IGF-1) levels and less robust response to teriparatide. Because IGF-1 stimulates bone formation and is critical for teriparatide action on osteoblasts, these findings suggest a state of IGF-1 resistance in some IOP women. To further investigate the hypothesis that osteoblast and IGF-1-related mechanisms mediate differential responsiveness to teriparatide in IOP, we studied circulating osteoblast progenitor (COP) cells and their IGF-1 receptor (IGF-1R) expression. In premenopausal women with IOP, peripheral blood mononuclear cells (PBMCs) were obtained at baseline (n = 25) and over 24 months of teriparatide treatment (n = 11). Flow cytometry was used to identify and quantify COPs (non-hematopoetic lineage cells expressing osteocalcin and RUNX2) and to quantify IGF-1R expression levels. At baseline, both the percent of PBMCs that were COPs (%COP) and COP cell-surface IGF-1R expression correlated directly with several histomorphometric indices of bone formation in tetracycline-labeled transiliac biopsies. In treated subjects, both %COP and IGF-1R expression increased promptly after teriparatide, returning toward baseline by 18 months. Although neither baseline %COP nor increase in %COP after 3 months predicted the bone mineral density (BMD) response to teriparatide, the percent increase in IGF-1R expression on COPs at 3 months correlated directly with the BMD response to teriparatide. Additionally, lower IGF-1R expression after teriparatide was associated with higher body fat, suggesting links between teriparatide resistance, body composition, and the GH/IGF-1 axis. In conclusion, these assays may be useful to characterize bone remodeling noninvasively and may serve to predict early response to

  13. Effects of an 8-Month Ashtanga-Based Yoga Intervention on Bone Metabolism in Middle-Aged Premenopausal Women: A Randomized Controlled Study

    PubMed Central

    Kim, SoJung; Bemben, Michael G.; Knehans, Allen W.; Bemben, Debra A.

    2015-01-01

    Although Yoga has the potential to be an alternative physical activity to enhance bone health, there is a lack of high quality evidence for this type of intervention. The purpose of this randomized controlled trial was to examine the effects of a progressive 8-month Ashtanga-based Yoga program on bone turnover markers (BTM), areal bone mineral density (aBMD) and volumetric bone characteristics in premenopausal women. Thirty-four premenopausal women (35-50 years) were randomly assigned either to a Yoga group (YE, n = 16) or a control group (CON, n = 18). Participants in YE group performed 60 minutes of an Ashtanga-based Yoga series 2 times/week with one day between sessions for 8 months, and the session intensity was progressively increased by adding the number of sun salutations (SS). Participants in CON were encouraged to maintain their normal daily lifestyles monitored by the bone specific physical activity questionnaire (BPAQ) at 2 month intervals for 8 months. Body composition was measured by dual energy x-ray absorptiometry (DXA). Bone formation (bone alkaline phosphatase, Bone ALP) and bone resorption (Tartrate-Resistant Acid Phosphatase-5b, TRAP5b) markers were assessed at baseline and after 8 months. aBMD of total body, lumbar spine and dual proximal femur and tibia bone characteristics were measured using DXA and peripheral Quantitative Computed Tomography (pQCT), respectively. We found that the serum Bone ALP concentrations were maintained in YE, but significantly (p = 0.005) decreased in CON after the 8 month intervention, and there were significant (p = 0.002) group differences in Bone ALP percent changes (YE 9.1 ± 4.0% vs. CON -7.1 ± 2.3%). No changes in TRAP5b were found in either group. The 8-month Yoga program did not increase aBMD or tibia bone strength variables. Body composition results showed no changes in weight, fat mass, or % fat, but small significant increases in bone free lean body mass occurred in both groups. The findings of this study

  14. Effects of an 8-Month Ashtanga-Based Yoga Intervention on Bone Metabolism in Middle-Aged Premenopausal Women: A Randomized Controlled Study.

    PubMed

    Kim, SoJung; Bemben, Michael G; Knehans, Allen W; Bemben, Debra A

    2015-12-01

    Although Yoga has the potential to be an alternative physical activity to enhance bone health, there is a lack of high quality evidence for this type of intervention. The purpose of this randomized controlled trial was to examine the effects of a progressive 8-month Ashtanga-based Yoga program on bone turnover markers (BTM), areal bone mineral density (aBMD) and volumetric bone characteristics in premenopausal women. Thirty-four premenopausal women (35-50 years) were randomly assigned either to a Yoga group (YE, n = 16) or a control group (CON, n = 18). Participants in YE group performed 60 minutes of an Ashtanga-based Yoga series 2 times/week with one day between sessions for 8 months, and the session intensity was progressively increased by adding the number of sun salutations (SS). Participants in CON were encouraged to maintain their normal daily lifestyles monitored by the bone specific physical activity questionnaire (BPAQ) at 2 month intervals for 8 months. Body composition was measured by dual energy x-ray absorptiometry (DXA). Bone formation (bone alkaline phosphatase, Bone ALP) and bone resorption (Tartrate-Resistant Acid Phosphatase-5b, TRAP5b) markers were assessed at baseline and after 8 months. aBMD of total body, lumbar spine and dual proximal femur and tibia bone characteristics were measured using DXA and peripheral Quantitative Computed Tomography (pQCT), respectively. We found that the serum Bone ALP concentrations were maintained in YE, but significantly (p = 0.005) decreased in CON after the 8 month intervention, and there were significant (p = 0.002) group differences in Bone ALP percent changes (YE 9.1 ± 4.0% vs. CON -7.1 ± 2.3%). No changes in TRAP5b were found in either group. The 8-month Yoga program did not increase aBMD or tibia bone strength variables. Body composition results showed no changes in weight, fat mass, or % fat, but small significant increases in bone free lean body mass occurred in both groups. The findings of this study

  15. Factors influencing the life satisfaction in the older Korean women living alone.

    PubMed

    Kim, Sook-Young; Sok, Sohyune R

    2013-04-01

    The population of Korea is aging rapidly. The older population varies in characteristics in accordance with a wide-range of circumstances; therefore, categorizing the overall older population as a homogeneous group, could misrepresent their issues. For that reason, the study of older people should be focused on the diversity of characteristics among the older population. The aims of this study were to examine and identify the factors related to life satisfaction in older Korean women living alone. This study was a cross-sectional survey design. The participants comprised of 243 older women over the age of 65, who met eligibility criteria. Measures were a demographic characteristics form, the Health Self-Rating Scale, the Self-Esteem Scale (RSES), the Korean Geriatric Depression Scale Short Form, and the Life Satisfaction Instrument. Degrees of the perceived health status, self-esteem, and depression were higher than the median. Life satisfaction was lower than the median. Predictors that determine life satisfaction in older Korean women living alone were depression, perceived health status, self-esteem, and monthly allowance. All these predictors, or factors, had an explanatory power of 48.2% for life satisfaction among older Korean women living alone. Of all these predictor factors, depression had the largest impact. The major factor influencing the life satisfaction in older Korean women living alone was depression. These findings suggest that there is a need to develop nursing strategies aimed at decreasing depression in order to increase life satisfaction in older women living alone.

  16. Measuring health literacy among immigrants with a phonetic primary language: a case of Korean American women.

    PubMed

    Han, Hae-Ra; Kim, Jiyun; Kim, Miyong T; Kim, Kim B

    2011-04-01

    While the need for understanding the issue of health literacy among ethnic minority groups with limited English skills is rapidly increasing in the US, it is difficult to find valid and useful health literacy tools for certain linguistic minorities. This study was designed to validate the Korean translation of Rapid Estimate of Adult Literacy in Medicine (REALM) and Test of Functional Health Literacy in Adults-Short form (S-TOFHLA). Korean REALM and S-TOFHLA were administered to 98 Korean American women, together with REALM-English. Participants were first-generation immigrants who were educated in Korea. Both Korean REALM and S-TOFHLA resulted in a negatively-skewed distribution. REALM-English yielded well-distributed groups with significant correlations with Korean REALM and S-TOFHLA (Spearman's rho = 0.30, P = 0.003 and 0.22, P = 0.03, respectively). Educational level was significantly correlated with REALM-English and Korean S-TOFHLA (Spearman's rho = 0.39, P = 0.000 and 0.25, P = 0.014), but not with REALM-Korean. The translation of REALM and S-TOFHLA into the Korean language did not lead to a valid assessment of health literacy. A more systematic approach is needed to assess health literacy in immigrants with limited English skills, particularly those with a phonetic primary language. Meanwhile, REALM-English could be used as a crude health literacy test for individuals with some English skills.

  17. HR+/Her2- breast cancer in pre-menopausal women: The impact of younger age on clinical characteristics at diagnosis, disease management and survival.

    PubMed

    De Camargo Cancela, Marianna; Comber, Harry; Sharp, Linda

    2016-12-01

    Young women (20-39 years-old) with breast cancer are diagnosed with more aggressive tumours and consequently have poorer survival. However, there is an evidence gap as to whether age has an independent effect on survival of pre-menopausal women diagnosed with HR+/Her2- tumours. The aim of this population-based study was to compare characteristics at diagnosis, determinants of treatment and survival in women aged 20-39 and 40-49 years diagnosed with HR+/Her2- tumours. From the National Cancer Registry Ireland, we identified women aged 20-49 diagnosed with a first invasive HR+/Her2- breast cancer during 2002-2008. Women aged 20-39 were compared to those aged 40-49 years. Poisson regression with robust error variance was used to explore the impact of age on treatment receipt. Associations between age and survival from all causes was investigated using Cox models. In multivariate models, women aged 20-39 significantly more often having no cancer-directed surgery (IRR=1.49, 95%CI 1.07, 2.08). In those having surgery, younger age was associated with significantly higher likelihood of receiving chemotherapy; age was not associated with receipt of adjuvant radiotherapy or endocrine therapy. Women aged 20-39 undergoing surgery were significantly more likely to die than women aged 40-49 (HR=1.84, 95%CI: 1.31, 2.59). Age is an independent prognostic factor in younger women diagnosed with HR+/Her2- breast cancer, supporting the hypothesis that breast cancer in women under 40 has more aggressive behaviour, even within HR+/Her2- tumours. Future research should explore the reasons for poorer survival in order to inform strategies to improve outcomes in this age group.

  18. Associations among Organochlorine Pesticides, Methanobacteriales, and Obesity in Korean Women

    PubMed Central

    Lee, Hae-Sook; Lee, Je-Chul; Lee, In-Kyu; Moon, Hyo-Bang; Chang, Yoon-Seok; Jacobs, David R.; Lee, Duk-Hee

    2011-01-01

    Background Although Methanobacteriales in the gut has recently been linked to obesity, no study has examined the hypothesis that waist circumference, a marker of visceral obesity, are positively associated with Methanobacteriales in the general population. Since Methanobacteriales increase in a petroleum-contaminated environment to biodegrade petroleum as one way of autopurification, we also hypothesized that high body burden of highly lipophilic petroleum-based chemicals like organochlorine pesticides (OCPs) is associated with higher levels of Methanobacteriales in the gut. Methodology/Principal Findings Among 83 Korean women who visited a community health service center for a routine health checkup, quantitative real-time PCR (qPCR) based on 16S rDNA was used to quantify Methanobacteriales in feces. Nine OCPs were measured in both serum and feces of 16 subjects. Methanobacteriales were detected in 32.5% (27/83 women). Both BMI and waist circumference among women with Methanobacteriales were significantly higher than in women without Methanobacteriales (P = 0.04 and P = 0.01, respectively). Also, Methanobacteriales levels in feces were positively associated with BMI and waist circumference (r = +0.23 and P = 0.03 for both). Furthermore, there were significant correlations between feces Methanobacteriales levels and serum concentrations of most OCPs, including with cis-nonachlor (r = +0.53, P<0.05), oxychlordane (r = +0.46, P<0.1), and trans-nonachlor (r = +0.43, P<0.1). Despite high correlations of serum and feces concentrations of most OCPs, feces OCP concentrations were not clearly associated with feces Methanobacteriales levels. Conclusion/Significance In this cross-sectional study, the levels of Methanobacteriales in the human gut were associated with higher body weight and waist circumference. In addition, serum OCP concentrations were positively correlated with levels of Methanobacteriales. There may be a meaningful link among

  19. [Menstrual disturbances and alternations in hypophyseal gonadal axis in end-stage premenopausal women undergoing hemodialysis: a multi-center study].

    PubMed

    Matuszkiewicz-Rowińska, Joanna; Skórzewska, Katarzyna; Radowicki, Stanisław; Niemczyk, Stanisław; Przedlacki, Jerzy; Sokalski, Antoni; Wardyn, Kazimierz; Puka, Janusz; Switalski, Marek; Grochowski, Janusz; Ostrowski, Kazimierz

    2003-06-01

    The results of the studies of hypophyseal-gonadal axis in dialysis women are not uniform. Mostly the increased serum concentrations of prolactine and pituitary gonadotropins are observed; the data about ovarian secretion are much more scanty and contradictory. The aim of this crossectional study was to assess changes in sexual hormones secretion and their associations with menstrual disturbations in premenopausal women with end-stage renal failure undergoing hemodialysis. Sixty three women from six mazovian dialysis units, aged 18-45 years (mean 35 +/- 7 years) were enrolled into the study. They were divided into four groups according to their menstrual pattern: I--eumenorrhoea (n = 17), II--polymenorrhoea (n = 9), III--oligomenorrhoea (n = 16) i IV--amenorrhoea n = 21). There were no differences between both groups in respect to age, age of menarche, time on hemodialysis, and body mass index. In all subjects gynecological examination was performed and serum prolactin, FSH, LH, estradiol, progesterone and testosterone concentrations were assayed. In 49% women high serum prolactin concentrations were noted (the highest in group IV--1699 +/- 1022 vs 441 +/- 205 microIU/ml in group I; p < 0.05). Mean serum FSH and LH were increased in group IV only (33 +/- 59 and 22 +/- 31 mIU/ml); no significant differences among groups examined were seen. Serum estradiol was increased in groups I-III (95 +/- 46, 72 +/- 33, and 83 +/- 55 pg/ml, respectively) and decreased in group IV (27 +/- 22 pg/ml; p < 0.001 in respect to remaining groups). Mean serum progesterone and testosterone concentrations were normal in all four groups, but serum progesterone was significantly lower in groups II-IV than in group I (p < 0.05). No differences in hormonal status between patients receiving and not receiving rHuEpo were observed. Menstrual disturbances are common (73%) in premenopausal women with end-stage renal failure, with amenorrhea constituting a half of them. Hyperprolactinemia is the most

  20. Face consciousness among South Korean women: a culture-specific extension of objectification theory.

    PubMed

    Kim, Si Yeon; Seo, Young Seok; Baek, Keun Young

    2014-01-01

    This study tested key tenets of objectification theory with South Korean women and explored the roles of sexually objectifying media and culture-specific standards of beauty in body image and eating disorder symptoms. Two pilot studies with South Korean college women (n = 40, n = 30) revealed that facial characteristics such as size and shape represent a discrete variable among culture-specific standards of beauty for South Korean women. Results with a sample of 562 South Korean college women indicated that media exposure had significant positive indirect relations with body shame and eating disorder symptoms through the mediating roles of internalization, body surveillance, and face surveillance. Internalization of cultural standards of beauty had significant positive direct relations with body surveillance and face surveillance and had both direct and indirect relations with body shame and eating disorder symptoms. Body and face surveillances had significant positive direct relations with body shame and had indirect relations with eating disorder symptoms. Finally, body shame mediated the links from internalization and surveillance variables to eating disorder symptoms. The results support the applicability of objectification theory as it relates to South Korean women and point to the significance of culture-specific standards of beauty within that framework. These findings could contribute to the broader field of multicultural body image research, with potential implications for therapist practices and training. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  1. The effect of 8-week different-intensity walking exercises on serum hepcidin, IL-6, and iron metabolism in pre-menopausal women.

    PubMed

    Buyukyazi, G; Ulman, C; Çelik, A; Çetinkaya, C; Şişman, A R; Çimrin, D; Doğru, Y; Kaya, D

    2017-03-01

    Objective Hepcidin may be an important mediator in exercise-induced iron deficiency. Despite the studies investigating acute exercise effects on hepcidin and markers of iron metabolism, we found no studies examining the chronic effects of walking exercises (WE) on hepcidin and markers of iron metabolism in premenopausal women. The chronic effects of two 8-week different-intensity WE on hepcidin, interleukin 6 (IL-6), and markers of iron metabolism in pre-menopausal women were examined. Methods Exercise groups (EG) [moderate tempo walking group (MTWG), n = 11; brisk walking group (BWG), n = 11] walked 3 days/week, starting from 30 to 51 min. Control group (CG; n = 8) did not perform any exercises. BWG walked at ∼70%-75%; MTWG at ∼50%-55% of HRRmax. VO2max, hepcidin, IL-6, and iron metabolism markers were determined before and after the intervention. Results VO2max increased in both EGs, favoring the BWG. Hepcidin increased in the BWG (p < 0.01) and CG (p < 0.05). IL-6 decreased in the BWG and the MTWG (p < 0.05; p < 0.01). While iron, ferritin, transferrin, and transferrin saturation levels did not change in any group, total iron binding capacity (p < 0.05), red blood cells (p < 0.05), and hematocrit (p < 0.01) increased only in the BWG. Conclusion Both WE types may be useful to prevent inflammation. However, brisk walking is advisable due to the positive changes in VO2max and some iron metabolism parameters, which may contribute to prevent iron deficiency. The increase in hepcidin levels remains unclear and necessitates further studies.

  2. Effect of short-term upper-body resistance training on muscular strength, bone metabolic markers, and BMD in premenopausal women

    PubMed Central

    Liang, Michael TC; Quezada, Lorena; Lau, WY Jamie; Sokmen, Bulent; Spalding, Thomas W

    2012-01-01

    To examine the effect of a 10-week upper-body resistance training program on bone turnover markers and site-specific bone mineral density (BMD) in the wrist and distal half of the ulna and radius in untrained and healthy young premenopausal women. Methods Twenty-two subjects (aged 22.1 ± 1.8 years) were randomly assigned to a resistance training (n = 12) or no training control (n = 10) group. The following outcome variables were measured before and after 10 weeks of resistance training: (1) bone formation biomarker osteocalcin, and bone resorption biomarker tartrate-resistant acid phosphatase isoform 5b; (2) BMD in the wrist and distal half of the ulna and radius; (3) isokinetic strength of the elbow and knee extensors and flexors; (4) dynamic strength of the arm extensors and flexors; and (5) maximum number of push-ups. Results The 10-week upper body resistance training intervention resulted in improved strength performance in push-ups (resistance training versus control: P < 0.05), chest presses (P < 0.05), and pulldowns (P < 0.05). However, there was no improvement in the BMD of the wrist (P > 0.05), BMD of the distal half of the ulna and radius (P > 0.05), and metabolic biomarkers osteocalcin (P > 0.05) and tartrate-resistant acid phosphatase isoform 5b (P > 0.05), except for the osteocalcin/tartrate-resistant acid phosphatase isoform 5b ratio. Also, no improvement in the resistance training group was observed for isokinetic strength of the knee and elbow flexion/extension. Conclusion Upper-body muscular strength performance, but not bone metabolic markers and BMD of the wrist, can be improved with a 10-week upper body resistance training program of the nonweight-bearing limbs in untrained young premenopausal women. PMID:24198603

  3. Genetic association analyses of fast plasma glucose level in pre-menopausal Chinese women: potential interaction between osteocalcin and oestrogen receptor α.

    PubMed

    Xu, Hong; He, Lu-Ling; Xiong, Chao-Peng; Gong, Cheng-Xin; Liu, Chang-Le; Peng, Lu-Lu; Cheng, Ya-Jun; Jiang, Fu-Qing; Tan, Li-Ping; Tang, Lan; Peng, Wei; Tu, Yun-Ming; Yang, Yu-Ping; Luo, Dan; Zou, Lin; Liang, Shang-Dong

    2015-01-01

    Fasting plasma glucose (FPG) levels are usually tightly regulated within a narrow physiologic range. Variation of FPG levels is clinically important and is strongly heritable. Several lines of evidence suggest the importance of the oestrogen receptor α (ER-α) and osteocalcin (also known as BGP, for bone Gla protein) in determining FPG; however, whether their polymorphisms are associated with FPG variation is not well understood. To investigate whether ER-a PvuII and BGP HindIII genetic polymorphisms and their potential interaction are associated with FPG variation. The study subjects were 328 unrelated pre-menopausal Chinese women aged 21 years and over (mean age ± SD, 33.2 ± 5.9 years), with an average FPG of 4.92 (SD = 0.81). All subjects were genotyped at the ER-α PvuII and BGP HindIII loci using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). The ER-α PvuII genotypes were significantly associated with FPG (p = 0.007). In addition, a significant interaction was observed of the ER-α PvuII polymorphism with BGP HindIII polymorphism on FPG variation (p = 0.013), although the BGP HindIII polymorphism was not shown to be individually associated with FPG. The PvuII polymorphism of the ER-α gene and its potential interaction with the HindIII polymorphism of the BGP gene were associated with FPG in pre-menopausal Chinese women.

  4. Sexual dysfunction is frequent in premenopausal women with diabetes, obesity, and hypothyroidism, and correlates with markers of increased cardiovascular risk. A preliminary report.

    PubMed

    Veronelli, Annamaria; Mauri, Chiara; Zecchini, Barbara; Peca, Maria Grazia; Turri, Olivia; Valitutti, Maria Teresa; dall'Asta, Chiara; Pontiroli, Antonio E

    2009-06-01

    Female sexual dysfunction (FSD) is characterized by reduced sexual appetite and altered psychologic and physiologic response to sexual intercourse; it is reported to be frequent in diabetes mellitus, but no data have been reported in thyroid disorders. To compare the prevalence of FSD in diabetic, in obese, and in hypothyroid women vs. healthy women, and to correlate FSD with endocrine and metabolic profiles. We evaluated, through a questionnaire (Female Sexual Function Index [FSFI]), the prevalence of FSD in 91 women affected by diabetes mellitus, obesity, or hypothyroidism, and in 36 healthy women, all aged 22-51 years and in premenopausal state. FSFI score, endocrine and metabolic parameters (triglycerides, high-density lipoprotein [HDL] and low-density lipoprotein [LDL] cholesterol, free-triiodothyronine (FT3), free-thyroxine (FT4), thyroid stimulating hormone [TSH], 17-beta-estradiol, testosterone, glycated hemoglobin 1c (HbA1c), thyroid autoantibodies, E-selectin, P-selectin, intercellular adhesion molecule-1 [ICAM-1], plasminogen-activator inhibitor-1 [PAI-1]), and anthropometric parameters (body mass index, waist, blood pressure [BP]). A reduced FSFI score was more frequent in diabetic, obese, and hypothyroid women vs. healthy women (P < 0.01). In the different groups of women, FSFI score was inversely correlated (pairwise correlation) with at least one of the following: HbA1c, TSH, LDL-cholesterol, PAI-1, diastolic BP, presence of thyroid Ab, and directly correlated with HDL-cholesterol (always P < 0.05 or less). At stepwise regression analysis, HDL-cholesterol (protective) and HbA1c, LDL-cholesterol, PAI-1, and diastolic BP (negatively) predicted reduced FSFI score. These data indicate an increased prevalence of sexual dysfunction in diabetic, in obese, and in hypothyroid women, associated with markers of cardiovascular risk.

  5. Effects of low-fat diet on serum lipids in premenopausal and postmenopausal women: a meta-analysis of randomized controlled trials.

    PubMed

    Wu, Liping; Ma, Di; Walton-Moss, Benita; He, Zhong

    2014-01-01

    This study aims to conduct a meta-analysis to evaluate the effects of a low-fat diet, in comparison with participants' usual diet, on serum lipids in premenopausal and postmenopausal women. Ten electronic databases were searched for relevant articles reporting randomized controlled trials through August 31, 2012, including PubMed/Medline, EMBASE, Cochrane Library, CINAHL, Web of Science, SCOPUS, ProQuest Dissertations and Theses, SinoMed, CNKI (Chinese database), and WanFang (Chinese database). This systematic review and meta-analysis, which evaluated the effects of a low-fat diet, in comparison with the participants' usual diet, was conducted according to the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. All analyses were performed using RevMan version 5 (Cochrane Collaboration). From 512 potentially relevant publication citations reviewed, 8 randomized clinical trials were included in the meta-analysis, representing 22 groups (11 intervention groups and 11 control groups). A total of 1,536 women (900 in the intervention group and 636 in the control group) met the inclusion criteria. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) values changed more favorably in participants randomized to low-fat diets than in participants randomized to their usual diets. Low-fat diet was found to induce significant reductions in TC (random-effects model: mean difference [MD], -0.49 mmol/L; 95% CI, -0.69 to -0.29; I = 42%; Peffect < 0.00001), HDL-C (MD, -0.12 mmol/L; 95% CI, -0.20 to -0.05; I = 49%; Peffect = 0.00006), and LDL-C (MD, -0.24 mmol/L; 95% CI, -0.38 to -0.09; I = 42%; Peffect = 0.001) for two groups. For subgroup analysis, low-fat diet was efficacious in reducing TC, HDL-C, and LDL-C in premenopausal women but did not significantly reduce the same outcomes in postmenopausal women. However, there were also no statistically significant differences in triglycerides (TG

  6. Hypertension and age at onset of natural menopause in Korean postmenopausal women: Results from the Korea National Health and Nutrition Examination Survey (2008-2013).

    PubMed

    Lim, Hee-Sook; Kim, Tae-Hee; Lee, Hae-Hyeog; Park, Yoon-Hyung; Kim, Jun-Mo; Lee, Bo-Ra

    2016-08-01

    Menopause is a natural phenomenon of aging, although the timing and management of menopause can significantly affect a woman's quality of life. It is therefore important to identify measures to ensure a healthy menopause. We set out to investigate the association between hypertension and early menopause in Korean women. This cross-sectional study was based on 2008-2013 data from the Korea National Health and Nutrition Examination Survey (KNHANES). Of the 53,829 participants surveyed, 13,584 women were selected. We analyzed the contents of the health interview, health examination, and nutrition survey. The main outcome was defined based on hazard ratios (HR) to identify the effects of hypertension on age at onset of menopause. Among postmenopausal women (n=6650), the mean age at onset of menopause was 50.4 years. Premenopausal hypertension was statistically significantly associated with age at menopause, oral contraceptive usage, household income, education level, occupation, marital status and smoking and drinking habits. With lower age at diagnosis of hypertension, HRs for menopause tended to be higher, and hypertension diagnosed before age 40 years conferred a statistically significantly higher HR (Model 1, HR=2.32, 95% CI=1.87-2.88; Model 2, HR=2.31, 95% CI=1.86-2.86; Model 3, HR=2.23, 95% CI=1.80-2.77; Model 4, HR=2.00, 95% CI=1.52-2.63). Premature menopause is strongly associated with lifestyle factors, in combination with incomplete management of chronic diseases. Our findings support the hypothesis that younger age at diagnosis of hypertension is associated with younger age at onset of menopause in Korean women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Hormone Replacement Therapy and Risk of Breast Cancer in Korean Women: A Quantitative Systematic Review

    PubMed Central

    Bae, Jong-Myon; Kim, Eun Hee

    2015-01-01

    Objectives: The epidemiological characteristics of breast cancer incidence by age group in Korean women are unique. This systematic review aimed to investigate the association between hormone replacement therapy (HRT) and breast cancer risk in Korean women. Methods: We searched electronic databases such as KoreaMed, KMbase, KISS, and RISS4U as well as PubMed for publications on Korean breast cancer patients. We also conducted manual searching based on references and citations in potential papers. All of the analytically epidemiologic studies that obtained individual data on HRT exposure and breast cancer occurrence in Korean women were selected. We restricted the inclusion of case-control studies to those that included age-matched controls. Estimates of summary odds ratio (SOR) with 95% confidence intervals (CIs) were calculated using random effect models. Results: One cohort and five case-control studies were finally selected. Based on the heterogeneity that existed among the six studies (I-squared=70.2%), a random effect model was applied. The summary effect size of HRT history from the six articles indicated no statistical significance in breast cancer risk (SOR, 0.983; 95% CI, 0.620 to 1.556). Conclusions: These facts support no significant effect of HRT history in the risk of breast cancer in Korean women. It is necessary to conduct a pooled analysis. PMID:26429288

  8. Beliefs, practices, and experiences of Korean women in relation to childbirth.

    PubMed

    Park, K J; Peterson, L M

    1991-01-01

    Korean women's health beliefs and childbirth experiences in the United States were examined. A convenience sampling procedure was used, and face-to-face interviews were conducted in Korean. Interviews were audiotaped, typed, and translated from Korean to English. These women had a holistic concept of health. Some practices were influence by ancient Chinese medicine. Childbirth experiences indicated that language is a barrier requiring specific interventions. Recommendations include (a) development of an assessment tool with which health-care professionals can identify individual health beliefs early in pregnancy; (b) development of a bilingual pamphlet about medical terms and the U.S. health-care system; (c) development of a short bilingual dictionary of common foods for use in menu selection during hospitalization; and (d) provision of English practice periods based on anticipatory guidance principles to prepare women to ask for specific assistance.

  9. Effect of the gonadotropin-releasing hormone analogue triptorelin on the occurrence of chemotherapy-induced early menopause in premenopausal women with breast cancer: a randomized trial.

    PubMed

    Del Mastro, Lucia; Boni, Luca; Michelotti, Andrea; Gamucci, Teresa; Olmeo, Nina; Gori, Stefania; Giordano, Monica; Garrone, Ornella; Pronzato, Paolo; Bighin, Claudia; Levaggi, Alessia; Giraudi, Sara; Cresti, Nicola; Magnolfi, Emanuela; Scotto, Tiziana; Vecchio, Carlo; Venturini, Marco

    2011-07-20

    Premenopausal patients with breast cancer are at high risk of premature ovarian failure induced by systemic treatments, but no standard strategies for preventing this adverse effect are yet available. To determine the effect of the temporary ovarian suppression obtained by administering the gonadotropin-releasing hormone analogue triptorelin during chemotherapy on the incidence of early menopause in young patients with breast cancer undergoing adjuvant or neoadjuvant chemotherapy. The PROMISE-GIM6 (Prevention of Menopause Induced by Chemotherapy: A Study in Early Breast Cancer Patients-Gruppo Italiano Mammella 6) study, a parallel, randomized, open-label, phase 3 superiority trial, was conducted at 16 sites in Italy and enrolled 281 patients between October 2003 and January 2008. The patients were premenopausal women with stage I through III breast cancer who were candidates for adjuvant or neoadjuvant chemotherapy. Assuming a 60% rate of early menopause in the group treated with chemotherapy alone, it was estimated that 280 patients had to be enrolled to detect a 20% absolute reduction in early menopause in the group treated with chemotherapy plus triptorelin. The intention-to-treat analysis was performed by including all randomized patients and using imputed values for missing data. Before beginning chemotherapy, patients were randomly allocated to receive chemotherapy alone or combined with triptorelin. Triptorelin was administered intramuscularly at a dose of 3.75 mg at least 1 week before the start of chemotherapy and then every 4 weeks for the duration of chemotherapy. Incidence of early menopause (defined as no resumption of menstrual activity and postmenopausal levels of follicle-stimulating hormone and estradiol 1 year after the last cycle of chemotherapy). The clinical and tumor characteristics of the 133 patients randomized to chemotherapy alone and the 148 patients randomized to chemotherapy plus triptorelin were similar. Twelve months after the last

  10. Indoor air pollution from biomass burning activates Akt in airway cells and peripheral blood lymphocytes: a study among premenopausal women in rural India.

    PubMed

    Mondal, Nandan K; Roy, Amrita; Mukherjee, Bidisha; Das, Debangshu; Ray, Manas R

    2010-12-01

    Biomass burning is a major source of indoor air pollution in rural India. The authors investigated in this study whether cumulative exposures to biomass smoke cause activation of the serine/threonine kinase Akt in airway cells and peripheral blood lymphocytes (PBL). For this, the authors enrolled 87 premenopausal (median age 34 years), nonsmoking women who used to cook with biomass (wood, dung, crop wastes) and 85 age-matched control women who cooked with cleaner fuel liquefied petroleum gas. Immunocytochemical and immunoblotting assays revealed significantly higher levels of phosphorylated forms of Akt protein (p-Akt(ser473) and p-Akt(thr308)) in PBL, airway epithelial cells, alveolar macrophages, and neutrophils in sputum of biomass-using women than control. Akt activation in biomass users was associated with marked rise in generation of reactive oxygen species and concomitant depletion of superoxide dismutase. Measurement of particulate matter having a diameter of less than 10 and 2.5 µm in indoor air by real-time a