Pub Date : 2002-05-01DOI: 10.1089/152460902317585967
P. Greenberger
{"title":"University of Wisconsin fosters interdisciplinary research on sex differences.","authors":"P. Greenberger","doi":"10.1089/152460902317585967","DOIUrl":"https://doi.org/10.1089/152460902317585967","url":null,"abstract":"","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85887200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-05-01DOI: 10.1089/152460902317585994
E. Laan, R. V. van Lunsen, W. Everaerd, A. Riley, E. Scott, M. Boolell
OBJECTIVE This study examined the effect of a single oral dose of sildenafil citrate (Viagra, Pfizer, Inc., New York, NY) on vaginal vasocongestion and subjective sexual arousal in healthy premenopausal women. METHODS Twelve women without sexual dysfunction were randomly assigned to receive either a single oral 50 mg dose of sildenafil or matching placebo in a first session and the alternate medication in a second session. Subjective measures of sexual arousal were assessed after participants had been exposed to erotic stimulus conditions. Vaginal vasocongestion was recorded continuously during baseline, neutral, and erotic stimulus conditions. At the end of each session, subjects were also asked to specify which treatment they suspected they had received. RESULTS Significant increases in vaginal vasocongestion were found with sildenafil treatment compared with placebo. There were no differences between treatments on subjective sexual arousal experience. Analyses by suspected treatment received found that significantly stronger sexual arousal and vaginal wetness were reported for the treatment that was believed to be sildenafil vs. the treatment that was believed to be placebo. The suspected treatment sequence was incorrect for half of the women. Sildenafil was well tolerated, with no evidence of significant adverse events. CONCLUSIONS Sildenafil was found to be effective in enhancing vaginal engorgement during erotic stimulus conditions in healthy women without sexual dysfunction but was not associated with an effect on subjective sexual arousal.
{"title":"The enhancement of vaginal vasocongestion by sildenafil in healthy premenopausal women.","authors":"E. Laan, R. V. van Lunsen, W. Everaerd, A. Riley, E. Scott, M. Boolell","doi":"10.1089/152460902317585994","DOIUrl":"https://doi.org/10.1089/152460902317585994","url":null,"abstract":"OBJECTIVE\u0000This study examined the effect of a single oral dose of sildenafil citrate (Viagra, Pfizer, Inc., New York, NY) on vaginal vasocongestion and subjective sexual arousal in healthy premenopausal women.\u0000\u0000\u0000METHODS\u0000Twelve women without sexual dysfunction were randomly assigned to receive either a single oral 50 mg dose of sildenafil or matching placebo in a first session and the alternate medication in a second session. Subjective measures of sexual arousal were assessed after participants had been exposed to erotic stimulus conditions. Vaginal vasocongestion was recorded continuously during baseline, neutral, and erotic stimulus conditions. At the end of each session, subjects were also asked to specify which treatment they suspected they had received.\u0000\u0000\u0000RESULTS\u0000Significant increases in vaginal vasocongestion were found with sildenafil treatment compared with placebo. There were no differences between treatments on subjective sexual arousal experience. Analyses by suspected treatment received found that significantly stronger sexual arousal and vaginal wetness were reported for the treatment that was believed to be sildenafil vs. the treatment that was believed to be placebo. The suspected treatment sequence was incorrect for half of the women. Sildenafil was well tolerated, with no evidence of significant adverse events.\u0000\u0000\u0000CONCLUSIONS\u0000Sildenafil was found to be effective in enhancing vaginal engorgement during erotic stimulus conditions in healthy women without sexual dysfunction but was not associated with an effect on subjective sexual arousal.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77202004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-05-01DOI: 10.1089/152460902317586029
L. Wallace, J. Ballard
OBJECTIVE Osteoporosis is a significant public health problem associated with increased mortality and morbidity. Our aim in this cross-sectional study was to investigate the relationship between lifetime physical activity and calcium intake and bone mineral density (BMD) and BMC (bone mineral content) in 42 regularly menstruating Caucasian women (age 21.26+/-1.91 years, BMI 23.83+/-5.85). METHODS BMD and BMC at the lumbar spine (L2-L4), hip (femoral neck, trochanter, total), and total body were assessed by dual energy x-ray absorptiometry (DXA). Lifetime history of physical activity and calcium intake was obtained by a structured interview using valid and reliable instruments. RESULTS Measures of both lifetime physical activity and calcium intake were highly correlated. In stepwise multiple regression analyses, lean mass was the most important and consistent factor for predicting BMD and BMC at all skeletal sites (attributable r2 = 28.8%-78.7%). Lifetime physical activity contributed to 3.0% of the variation in total body BMD, and life-time weight-bearing physical activity explained 15.1% of variance in lumbar spine BMC. Current calcium intake predicted 6% of the variance in BMD at the femoral neck and trochanter. CONCLUSIONS We found lean mass to be a powerful predictor of BMD and BMC in young women. Because lean mass can be modified to some extent by physical activity, public health efforts must be directed at increasing physical activity throughout the lifespan. Furthermore, our results suggest that adequate calcium intake may help to enhance bone mass, thus decreasing the risk of osteoporotic fracture later in life.
{"title":"Lifetime physical activity and calcium intake related to bone density in young women.","authors":"L. Wallace, J. Ballard","doi":"10.1089/152460902317586029","DOIUrl":"https://doi.org/10.1089/152460902317586029","url":null,"abstract":"OBJECTIVE\u0000Osteoporosis is a significant public health problem associated with increased mortality and morbidity. Our aim in this cross-sectional study was to investigate the relationship between lifetime physical activity and calcium intake and bone mineral density (BMD) and BMC (bone mineral content) in 42 regularly menstruating Caucasian women (age 21.26+/-1.91 years, BMI 23.83+/-5.85).\u0000\u0000\u0000METHODS\u0000BMD and BMC at the lumbar spine (L2-L4), hip (femoral neck, trochanter, total), and total body were assessed by dual energy x-ray absorptiometry (DXA). Lifetime history of physical activity and calcium intake was obtained by a structured interview using valid and reliable instruments.\u0000\u0000\u0000RESULTS\u0000Measures of both lifetime physical activity and calcium intake were highly correlated. In stepwise multiple regression analyses, lean mass was the most important and consistent factor for predicting BMD and BMC at all skeletal sites (attributable r2 = 28.8%-78.7%). Lifetime physical activity contributed to 3.0% of the variation in total body BMD, and life-time weight-bearing physical activity explained 15.1% of variance in lumbar spine BMC. Current calcium intake predicted 6% of the variance in BMD at the femoral neck and trochanter.\u0000\u0000\u0000CONCLUSIONS\u0000We found lean mass to be a powerful predictor of BMD and BMC in young women. Because lean mass can be modified to some extent by physical activity, public health efforts must be directed at increasing physical activity throughout the lifespan. Furthermore, our results suggest that adequate calcium intake may help to enhance bone mass, thus decreasing the risk of osteoporotic fracture later in life.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87985337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-05-01DOI: 10.1089/152460902317585949
R. Merkatz
331 FEMALE SEXUAL DYSFUNCTION (FSD) affects a significant number of women of all ages, but the prevalence tends to increase with age. Almost 10 million American women aged 50–74 years selfreport diminished vaginal lubrication, pain and discomfort with intercourse, decreased arousal, and difficulty in achieving orgasm.1,2 Their discomfort and distress have received all too little attention in the scientific literature. This issue of the Journal of Women’s Health & Gender Based-Medicine reports results of two studies that address different aspects of research on female sexual functioning—methodological, physiological, and treatment.3,4 A third study was reported in the previous issue of the Journal.5 The authors of these papers do us an enormous service. The papers help to focus our attention and advance our understanding of critical issues with which the field of female sexuality is grappling as it struggles to establish a sound scientific foundation. This work was presaged by a recent international consensus conference establishing criteria for previously identified distinct FSD entities, including hypoactive sexual desire disorder (HSDD), female sexual arousal disorder (FSAD), orgasmic disorder (FOD), and sexual pain disorder.6 There was agreement at this conference that FSD should be approached from both psychogenic and organic perspectives to provide clinical end points and outcomes. For example, FSAD was redefined as the persistent or recurring inability to attain or maintain sufficient sexual excitement so as to cause personal distress, which may be associated with a lack of subjective excitement, lack of genital lubrication/swelling, or other somatic changes. In addition, conference participants identified useful and clinically relevant subtypes for several of the other disorders, for example, sexual pain disorder, which may include vaginismus and dyspareunia. In the first of these studies, Quirk et al.5 describe the development of a female sexual function questionnaire (SFQ) designed to provide a valid and sensitive measure of the nature and severity of most types of FSD and a sensitive measure of the effect of treatment intervention. Although earlier validated scales exist that measure FSD, including the Derogatis Sexual Functioning Inventory (DSFI)7 and the Brief Index of Sexual Function for Women (BSIF-W),8 these instruments were developed before the more recent classification of sexual dysfunction.6 As a result, they may lack current construct validity and thus fail to provide systematic assessment of the key clinical features of specific sexual dysfunction disorders. In contrast, the SFQ was designed to evaluate seven domains of female sexual function, five of which map directly onto the clinically relevant subtypes of FSD identified in the current classification scheme: desire, arousal-sensations, arousallubrication, orgasm, and pain. The results presented suggest that the SFQ has very good internal consistency, moderate to good reli
{"title":"Female sexual dysfunction.","authors":"R. Merkatz","doi":"10.1089/152460902317585949","DOIUrl":"https://doi.org/10.1089/152460902317585949","url":null,"abstract":"331 FEMALE SEXUAL DYSFUNCTION (FSD) affects a significant number of women of all ages, but the prevalence tends to increase with age. Almost 10 million American women aged 50–74 years selfreport diminished vaginal lubrication, pain and discomfort with intercourse, decreased arousal, and difficulty in achieving orgasm.1,2 Their discomfort and distress have received all too little attention in the scientific literature. This issue of the Journal of Women’s Health & Gender Based-Medicine reports results of two studies that address different aspects of research on female sexual functioning—methodological, physiological, and treatment.3,4 A third study was reported in the previous issue of the Journal.5 The authors of these papers do us an enormous service. The papers help to focus our attention and advance our understanding of critical issues with which the field of female sexuality is grappling as it struggles to establish a sound scientific foundation. This work was presaged by a recent international consensus conference establishing criteria for previously identified distinct FSD entities, including hypoactive sexual desire disorder (HSDD), female sexual arousal disorder (FSAD), orgasmic disorder (FOD), and sexual pain disorder.6 There was agreement at this conference that FSD should be approached from both psychogenic and organic perspectives to provide clinical end points and outcomes. For example, FSAD was redefined as the persistent or recurring inability to attain or maintain sufficient sexual excitement so as to cause personal distress, which may be associated with a lack of subjective excitement, lack of genital lubrication/swelling, or other somatic changes. In addition, conference participants identified useful and clinically relevant subtypes for several of the other disorders, for example, sexual pain disorder, which may include vaginismus and dyspareunia. In the first of these studies, Quirk et al.5 describe the development of a female sexual function questionnaire (SFQ) designed to provide a valid and sensitive measure of the nature and severity of most types of FSD and a sensitive measure of the effect of treatment intervention. Although earlier validated scales exist that measure FSD, including the Derogatis Sexual Functioning Inventory (DSFI)7 and the Brief Index of Sexual Function for Women (BSIF-W),8 these instruments were developed before the more recent classification of sexual dysfunction.6 As a result, they may lack current construct validity and thus fail to provide systematic assessment of the key clinical features of specific sexual dysfunction disorders. In contrast, the SFQ was designed to evaluate seven domains of female sexual function, five of which map directly onto the clinically relevant subtypes of FSD identified in the current classification scheme: desire, arousal-sensations, arousallubrication, orgasm, and pain. The results presented suggest that the SFQ has very good internal consistency, moderate to good reli","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87365499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-05-01DOI: 10.1089/152460902317585985
M. Haymart, Timm L. Dickfeld, C. Nass, R. Blumenthal
There have been eight major studies assessing percutaneous coronary intervention (PCI) vs. medical therapy in the past 10 years. Women were inadequately represented in many of these studies, but because of similar long-term survival curves in women and men, most of the PCI data can be applied to women until more trials are published. According to currently available data, PCI offers greater angina relief and improvement in exercise tolerance than medicine alone, but has a greater risk of procedure-related complications in women. As a result of the rapid advancement of cardiovascular therapy, many of these studies did not incorporate optimal medical therapy or current PCI therapies. It is likely that for most patients (including women) with moderate angina, the best management may be a combination of PCI, medical therapy, and lifestyle changes.
{"title":"Percutaneous coronary intervention vs. medical therapy: what are the implications for women?","authors":"M. Haymart, Timm L. Dickfeld, C. Nass, R. Blumenthal","doi":"10.1089/152460902317585985","DOIUrl":"https://doi.org/10.1089/152460902317585985","url":null,"abstract":"There have been eight major studies assessing percutaneous coronary intervention (PCI) vs. medical therapy in the past 10 years. Women were inadequately represented in many of these studies, but because of similar long-term survival curves in women and men, most of the PCI data can be applied to women until more trials are published. According to currently available data, PCI offers greater angina relief and improvement in exercise tolerance than medicine alone, but has a greater risk of procedure-related complications in women. As a result of the rapid advancement of cardiovascular therapy, many of these studies did not incorporate optimal medical therapy or current PCI therapies. It is likely that for most patients (including women) with moderate angina, the best management may be a combination of PCI, medical therapy, and lifestyle changes.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76462763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1089/152460902753668475
F. Quirk, J. Heiman, R. Rosen, E. Laan, Michael D. Smith, M. Boolell
OBJECTIVE To better evaluate efficacy in clinical trials of drugs as potential treatments for female sexual dysfunctions (FSD), a brief, multidimensional measure of female sexual function was developed. METHODS Data from semistructured interviews with 82 women with or without FSD, aged 19-65 years, generated a pool of 61 items that addressed aspects of female sexual function. On review by a panel, individual items were selected for face validity and clinical relevance. Thirty-one items were used as a sexual function questionnaire (SFQ-V1) in two multicenter, phase II clinical trials totaling 781 women with FSD. Normative data were generated from a sample of 201 women without FSD. RESULTS Factor analysis produced seven domains of female sexual function: desire, physical arousal-sensation, physical arousal-lubrication, enjoyment, orgasm, pain, and partner relationship. The internal consistency of the domains ranged from 0.65 to 0.91, and test-retest reliability ranged from 0.21 to 0.71 for Cohen's weighted kappa and 0.42 to 0.78 for Pearson's correlation coefficient. There was a significant difference between the baseline mean SFQ domain scores of patients with FSD compared with those of women without FSD (p < 0.0001). End-of-study SFQ scores were significantly different for women who reported improvement vs. women who reported no improvement (p < 0.001). CONCLUSIONS The SFQ produced seven domains of female sexual function with excellent internal consistency, moderate to good reliability, excellent discriminant validity, and sensitivity. The results suggest that the SFQ may be a valuable new tool for evaluating and diagnosing subsets of FSD and, ultimately, for evaluating treatments of these disorders.
{"title":"Development of a sexual function questionnaire for clinical trials of female sexual dysfunction.","authors":"F. Quirk, J. Heiman, R. Rosen, E. Laan, Michael D. Smith, M. Boolell","doi":"10.1089/152460902753668475","DOIUrl":"https://doi.org/10.1089/152460902753668475","url":null,"abstract":"OBJECTIVE\u0000To better evaluate efficacy in clinical trials of drugs as potential treatments for female sexual dysfunctions (FSD), a brief, multidimensional measure of female sexual function was developed.\u0000\u0000\u0000METHODS\u0000Data from semistructured interviews with 82 women with or without FSD, aged 19-65 years, generated a pool of 61 items that addressed aspects of female sexual function. On review by a panel, individual items were selected for face validity and clinical relevance. Thirty-one items were used as a sexual function questionnaire (SFQ-V1) in two multicenter, phase II clinical trials totaling 781 women with FSD. Normative data were generated from a sample of 201 women without FSD.\u0000\u0000\u0000RESULTS\u0000Factor analysis produced seven domains of female sexual function: desire, physical arousal-sensation, physical arousal-lubrication, enjoyment, orgasm, pain, and partner relationship. The internal consistency of the domains ranged from 0.65 to 0.91, and test-retest reliability ranged from 0.21 to 0.71 for Cohen's weighted kappa and 0.42 to 0.78 for Pearson's correlation coefficient. There was a significant difference between the baseline mean SFQ domain scores of patients with FSD compared with those of women without FSD (p < 0.0001). End-of-study SFQ scores were significantly different for women who reported improvement vs. women who reported no improvement (p < 0.001).\u0000\u0000\u0000CONCLUSIONS\u0000The SFQ produced seven domains of female sexual function with excellent internal consistency, moderate to good reliability, excellent discriminant validity, and sensitivity. The results suggest that the SFQ may be a valuable new tool for evaluating and diagnosing subsets of FSD and, ultimately, for evaluating treatments of these disorders.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86823023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1089/152460902753668411
L. Dickstein, E. Leibenluft
{"title":"Toward optimal health: the experts discuss depression. Interview by Jodi Godfrey Meisler.","authors":"L. Dickstein, E. Leibenluft","doi":"10.1089/152460902753668411","DOIUrl":"https://doi.org/10.1089/152460902753668411","url":null,"abstract":"","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88170764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1089/152460902753668420
C. Crandall
OBJECTIVE Because of the limited efficacy of available agents and to limit toxicity, there is considerable interest in combination pharmacotherapy for osteoporosis. METHODS A search was performed for randomized controlled trials in MEDLINE (1966-present) using the keywords osteoporosis treatment and combination. RESULTS Twenty-four randomized controlled trials evaluated osteoporosis medications in combination. Study duration ranged from 1 to 4 years. No serious adverse events were definitively attributable to study drugs. Fracture reduction outcome is not shown for any combination regimen. The literature was mixed regarding bone density augmentation. Combinations of nandrolone decanoate plus calcitonin, calcitonin plus growth hormone (GH), or pamidronate plus GH may be contradictory or detrimental to bone mineral density (BMD). For postmenopausal osteoporosis or osteopenia, four combinations appear to increase hip and lumbar BMD: 10 mg alendronate with 0.625 mg conjugated equine estrogens (CEE), cyclic etidronate with 0.625mg CEE, 10 mg alendronate with 2 mg estradiol (E(2)), and tibolone with fluoride. For steroid-related osteoporosis, intermittent etidronate with fluoride increases lumbar BMD. CONCLUSIONS The few trials including Food and Drug Administration (FDA)-approved medications suggest that 10 mg/day alendronate with estrogen (equivalent of 0.625 mg CEE daily) can increase BMD moreso than each medication given singly in postmenopausal osteoporotic women. Estrogen dose and type must be controlled in future trials. Long-term safety data are lacking. The utility of these combinations rests on whether bone density changes will translate into decreased fracture rates.
{"title":"Combination treatment of osteoporosis: a clinical review.","authors":"C. Crandall","doi":"10.1089/152460902753668420","DOIUrl":"https://doi.org/10.1089/152460902753668420","url":null,"abstract":"OBJECTIVE\u0000Because of the limited efficacy of available agents and to limit toxicity, there is considerable interest in combination pharmacotherapy for osteoporosis.\u0000\u0000\u0000METHODS\u0000A search was performed for randomized controlled trials in MEDLINE (1966-present) using the keywords osteoporosis treatment and combination.\u0000\u0000\u0000RESULTS\u0000Twenty-four randomized controlled trials evaluated osteoporosis medications in combination. Study duration ranged from 1 to 4 years. No serious adverse events were definitively attributable to study drugs. Fracture reduction outcome is not shown for any combination regimen. The literature was mixed regarding bone density augmentation. Combinations of nandrolone decanoate plus calcitonin, calcitonin plus growth hormone (GH), or pamidronate plus GH may be contradictory or detrimental to bone mineral density (BMD). For postmenopausal osteoporosis or osteopenia, four combinations appear to increase hip and lumbar BMD: 10 mg alendronate with 0.625 mg conjugated equine estrogens (CEE), cyclic etidronate with 0.625mg CEE, 10 mg alendronate with 2 mg estradiol (E(2)), and tibolone with fluoride. For steroid-related osteoporosis, intermittent etidronate with fluoride increases lumbar BMD.\u0000\u0000\u0000CONCLUSIONS\u0000The few trials including Food and Drug Administration (FDA)-approved medications suggest that 10 mg/day alendronate with estrogen (equivalent of 0.625 mg CEE daily) can increase BMD moreso than each medication given singly in postmenopausal osteoporotic women. Estrogen dose and type must be controlled in future trials. Long-term safety data are lacking. The utility of these combinations rests on whether bone density changes will translate into decreased fracture rates.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85566584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1089/152460902753668439
Tara M. D'Eon, B. Braun
OBJECTIVE Compared with men, women use more fat and less carbohydrate to fuel exercise at the same relative intensity. Circulating levels of estrogen and progesterone are likely to play an important role in explaining this gender difference in exercise substrate utilization. METHODS Studies, mainly using animal models, have shown that estrogen increases fatty acid availability (lipolysis) and decreases carbohydrate availability and uptake. Studies conducted in humans corroborate the reduction in carbohydrate turnover and oxidation in the presence of estrogen, but the impact on fatty acid availability and utilization is less clear. RESULTS The effect of circulating estrogen may be mediated, at least in part, by changes in the sensitivity of stored carbohydrate and lipids to mobilization in response to epinephrine. The role of progesterone in metabolic regulation during exercise has not been systematically studied in humans. CONCLUSIONS Understanding the role of the ovarian hormones in fat and carbohydrate metabolism during exercise may have practical applications in terms of understanding the metabolic consequences of amenorrhea, menopause, and hormone replacement therapy (HRT).
{"title":"The roles of estrogen and progesterone in regulating carbohydrate and fat utilization at rest and during exercise.","authors":"Tara M. D'Eon, B. Braun","doi":"10.1089/152460902753668439","DOIUrl":"https://doi.org/10.1089/152460902753668439","url":null,"abstract":"OBJECTIVE\u0000Compared with men, women use more fat and less carbohydrate to fuel exercise at the same relative intensity. Circulating levels of estrogen and progesterone are likely to play an important role in explaining this gender difference in exercise substrate utilization.\u0000\u0000\u0000METHODS\u0000Studies, mainly using animal models, have shown that estrogen increases fatty acid availability (lipolysis) and decreases carbohydrate availability and uptake. Studies conducted in humans corroborate the reduction in carbohydrate turnover and oxidation in the presence of estrogen, but the impact on fatty acid availability and utilization is less clear.\u0000\u0000\u0000RESULTS\u0000The effect of circulating estrogen may be mediated, at least in part, by changes in the sensitivity of stored carbohydrate and lipids to mobilization in response to epinephrine. The role of progesterone in metabolic regulation during exercise has not been systematically studied in humans.\u0000\u0000\u0000CONCLUSIONS\u0000Understanding the role of the ovarian hormones in fat and carbohydrate metabolism during exercise may have practical applications in terms of understanding the metabolic consequences of amenorrhea, menopause, and hormone replacement therapy (HRT).","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89260162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1089/152460902753668466
I. Dzuba, Elsa María Yunes Díaz, Betania Allen, Y. Leonard, E. L. Lazcano Ponce, K. Shah, D. Bishai, A. Lorincz, D. Ferris, Bernardo Turnbull, M. Hernández Ávila, J. Salmerón
OBJECTIVE To explore the acceptability of the self-collection of samples for human papillomavirus (HPV) testing in comparison with that of the Pap test. METHODS The study population consisted of 1069 women 20 years and older who were eligible for coverage through the Mexican Institute of Social Security (IMSS). These women were randomly selected among participants in a larger study to evaluate the use of HPV testing as an alternative in cervical cancer screening. All participants provided a self-collected vaginal sample for HPV testing according to explicit instructions and underwent a Pap test. Afterwards, each woman was interviewed about her experience and opinion regarding the two procedures. Acceptability was measured by a calculated score based on discomfort, pain, embarrassment, privacy, perception of personal treatment during the Pap test, and understanding of how to perform the self-sampling method. RESULTS Ninety-three percent of women experienced sufficient privacy with the Pap test, whereas 98% of women reported that privacy with the self-sampling procedure was acceptable. The Pap test consistently provoked more discomfort, pain, and embarrassment than self-sampling. Sixty-eight percent of the women who indicated a test preference chose self-sampling. Preference for this method was positively associated with monthly household income. Women reported a preference for self-sampling because it is more comfortable (71.2%) and causes less embarrassment (55.8%). CONCLUSIONS Self-sampling is more acceptable than the Pap test and could improve coverage rates of early detection programs. The incorporation of self-collected samples to detect HPV could encourage participation in screening programs among those women who reject the Pap test because of the necessary pelvic examination.
{"title":"The acceptability of self-collected samples for HPV testing vs. the pap test as alternatives in cervical cancer screening.","authors":"I. Dzuba, Elsa María Yunes Díaz, Betania Allen, Y. Leonard, E. L. Lazcano Ponce, K. Shah, D. Bishai, A. Lorincz, D. Ferris, Bernardo Turnbull, M. Hernández Ávila, J. Salmerón","doi":"10.1089/152460902753668466","DOIUrl":"https://doi.org/10.1089/152460902753668466","url":null,"abstract":"OBJECTIVE\u0000To explore the acceptability of the self-collection of samples for human papillomavirus (HPV) testing in comparison with that of the Pap test.\u0000\u0000\u0000METHODS\u0000The study population consisted of 1069 women 20 years and older who were eligible for coverage through the Mexican Institute of Social Security (IMSS). These women were randomly selected among participants in a larger study to evaluate the use of HPV testing as an alternative in cervical cancer screening. All participants provided a self-collected vaginal sample for HPV testing according to explicit instructions and underwent a Pap test. Afterwards, each woman was interviewed about her experience and opinion regarding the two procedures. Acceptability was measured by a calculated score based on discomfort, pain, embarrassment, privacy, perception of personal treatment during the Pap test, and understanding of how to perform the self-sampling method.\u0000\u0000\u0000RESULTS\u0000Ninety-three percent of women experienced sufficient privacy with the Pap test, whereas 98% of women reported that privacy with the self-sampling procedure was acceptable. The Pap test consistently provoked more discomfort, pain, and embarrassment than self-sampling. Sixty-eight percent of the women who indicated a test preference chose self-sampling. Preference for this method was positively associated with monthly household income. Women reported a preference for self-sampling because it is more comfortable (71.2%) and causes less embarrassment (55.8%).\u0000\u0000\u0000CONCLUSIONS\u0000Self-sampling is more acceptable than the Pap test and could improve coverage rates of early detection programs. The incorporation of self-collected samples to detect HPV could encourage participation in screening programs among those women who reject the Pap test because of the necessary pelvic examination.","PeriodicalId":80044,"journal":{"name":"Journal of women's health & gender-based medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72945497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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