The journal of the British Menopause Society最新文献

Perimenopausal depression affects a considerable number of women and is associated with significant disability and morbidity. Major and minor depressions are the two most prevalent forms of acute depressive illness. Major depression has an estimated lifetime prevalence of 17% and affects approximately twice as many women as men. While the relationship between the onset of depressive illness and reproductive senescence is controversial, epidemiological and clinic-based studies that have distinguished between the perimenopause and the postmenopause have documented that, for some middle-aged women, the perimenopause is associated with an increased vulnerability to depression. Future studies of perimenopausal depression should identify the number of women affected, individual risk factors and the role of hormonal therapies in this condition.

The role of diet in cancer is a major public health issue Foods associated with a low risk of cancer are those typically included in the so-called Mediterranean diet, which is also associated with low mortality rates from cardiovascular disease. Implementing such a diet would involve increasing the consumption of fruits, vegetables, cereals, whole-grain foods and fish, while reducing the intake of refined carbohydrates and red meat. In addition, olive oil should replace saturated fats. Omega-3 fatty acids found in fish inhibit the growth in vitro of colon, breast and prostate cancers. Fibre can bind bile acids, which produce carcinogenic metabolites, and fermented fibre produces volatile fatty acids that can protect against colon cancer. It has been hypothesized that the anti-cancer actions of olive oil may relate to the ability of its mono-unsaturated fatty acid, oleic acid, to regulate oncogenes.

Polycystic ovary syndrome (PCOS) is a common syndrome among young women. It is associated with fertility problems, clinical manifestations of hyperandrogenism and metabolic disturbance, particularly insulin resistance. The long-term consequences of PCOS have not been fully determined, but there is an increased risk of progression to diabetes and an increase in cardiovascular risk factors. The extent to which PCOS is present in postmenopausal women and the degree to which it increases various risk factors in addition to the known risk of the postmenopausal period are not yet known. This paper reviews the pathophysiology of PCOS and its long-term consequences and considers the evidence to date that is applicable to the postmenopausal woman.

Over-expression of the human epidermal growth factor receptor 2 (HER2) protein, amplification of the HER2 gene or both occur in 15-25% of breast cancers and are associated with aggressive tumour behaviour. Trastuzumab (Herceptin), a humanized murine monoclonal antibody against the HER2 protein, has been shown to benefit patients with HER2-positive metastatic breast cancer when administered alone or in combination with chemotherapy. When to start therapy, the duration of treatment, adjuvant chemotherapy regimens and cardiotoxicity issues are examined.

The objective of this systematic review was to determine the effect on long-term health outcomes of lifestyle interventions designed to produce weight loss in postmenopausal women. A systematic search of the MEDLINE, EMBASE, PsychINFO and CINAHL databases retrieved four randomized controlled trials (RCTs) and one controlled clinical trial (CCT) of at least 24 weeks' duration as well as one systematic review. The majority of the studies recruited from the community, had samples with similar baseline characteristics and assessed completers only. Drop-out rates varied from 2.5% to 16%. All active-treatment arms demonstrated significant improvements in weight and body composition from baseline. Significant effects between treatment groups were shown only in intervention versus control studies. Significant weight loss was not accompanied by beneficial changes in cardiovascular risk factors in the majority of studies. None of the studies of weight loss reported disease outcomes. Weight loss in active-treatment arms varied from 1.5 kg to 9 kg over 6-12 months. The study that produced the greatest weight loss demonstrated improvements in risk factors and it may be that only this one study produced sufficient weight loss to do so. Many of the studies were probably underpowered and too short in duration to detect change in risk factors. Lifestyle interventions do produce weight loss in overweight postmenopausal women and have the potential to improve disease outcomes associated with overweight.