Women’s Health and Menopause: Risk Reduction Strategies (Medical Science Symposia Series (11))

Despite its universality in human female aging, the menopause and its biology are not completely understood. New biologic mechanisms by which sex hormones may be detrimental or confer protection are continually being discovered. We are now starting to understand that the role of the estrogen receptor is not identical in all tissues. Important nongenomic effects for sex hormones have also been described. Hormone replacement therapy (HRT) has produced effects on health risks: some are reduced, some are increased, and the rest remain uncertain. HRT is being used by an increasing number of women to alleviate climacteric symptoms in the perimenopausal period and to prevent osteoporosis and cardiovascular disease later. Positive effects on Alzheimer's disease and dementia on the one hand, and an increase in venous thrombosis on the other, are currently being reported by several groups. Both the preventive benefits and the risk of breast cancer seem to be linked to long-term and current use. HRT requires further testing through specific clinical trials, currently underway in the United States, before confident recommendations may be made about the full range of benefits and risks. Front Matter....Pages i-xxix The Problem of Menopause in Europe....Pages 1-7 Menopause: Problems and Interventions in the United States....Pages 9-13 Hormone Replacement Therapy and Oral Contraceptives: Limitations of Epidemiological Studies....Pages 15-23 Genetic Factors in Follicular Aging....Pages 25-27 Premature Menopause....Pages 29-38 When Should Hormonal Replacement Therapy Be Introduced? Associated Problems....Pages 39-44 Connective Tissue Changes....Pages 45-53 The Effect of Low Dose Estrogen on Bone Mass in the Late Postmenopausal Years....Pages 55-59 Perimenopausal Changes in Body Weight, Body Fat Distribution and Hormonal Replacement Therapy....Pages 61-67 The Effects of Estrogen Receptor Gene Disruption on Bone....Pages 69-73 Osteoporosis: Different Treatment Options....Pages 75-78 Inherited Risk of Osteoporosis: A Piece in the Puzzle of Menopause Genetics....Pages 79-85 Estrogen Replacement Therapy and Osteoporosis: Practical Implications of New Research Findings....Pages 87-90 HRT, Plasma Risk Factors, and Cardiovascular Disease....Pages 91-98 Menopause, HRT, and Hemostasis....Pages 99-103 Angina in Women....Pages 105-110 Effect of Estrogen on Anatomical and Functional Sequelae of Coronary Artery Disease....Pages 111-117 Cardiovascular Disease: Reduced Mortality with Long-Term HRT Treatment....Pages 119-124 HRT and the Secondary Prevention of Coronary Heart Disease....Pages 125-128 Effects of Hormone Replacement Therapy on Lipids and Lipoproteins in Dyslipidemic Postmenopausal Women: A Comparison Between Transdermal and Oral Estrogen....Pages 129-133 Which Effects Does Early HRT Have on Perimenopausal Changes in the Lipoprotein Profile, Glucose Metabolism, and the Blood Coagulation-Fibrinolysis System?....Pages 135-139 Blood Flows in Cerebral Arteries After Suspension of Postmenopausal Hormone Replacement Therapy. A Randomized Crossover Study....Pages 141-144 Influence of Melatonin on the Internal Carotid Artery Pulsatility Index of Young and Aged Women....Pages 145-148 Epidemiology of Alzheimer’s Disease and Other Types of Dementias....Pages 149-162 Estrogen Replacement Therapy and Cognitive Functions in Elderly Women....Pages 163-168 Hormonal Replacement Therapy, Cognitive Disturbances, and Alzheimer’s Disease....Pages 169-176 Hormone Replacement Therapy in the Prevention and Treatment of Climacteric Depression....Pages 177-183 Estrogen Across the Lifespan and Alzheimer’s Disease....Pages 185-190 Estrogen Effect on Brain Biology and Cognition....Pages 191-198 Dysphoria and Mood Disorders in Menopause....Pages 199-208 A Model System for the Study of Estrogen Receptor Activity in Cells of Neural Origin....Pages 209-215 The Risk of Breast Cancer in Relation to Hormone Replacement Therapy....Pages 217-221 Potential Benefits of Estrogen and Progestogen on Malignancy....Pages 223-232 Hormone Replacement Therapy after Breast Cancer....Pages 233-240 Endometrial Histology: Findings from the Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial....Pages 241-245 Effects of Quarterly Hormone Replacement Therapy on Climacteric Symptoms, Endometrial Safety, and Lipoproteins....Pages 247-251 Individualization of Hormone Replacement Therapy....Pages 253-256 Clinical Experiences with a Combination of Estradiol Valerate and Cyproterone Acetate for Hormone Replacement....Pages 257-261 HRT: From Motivation to Compliance....Pages 263-273 The Pharmacologic Profile of Conjugated Equine Estrogens....Pages 275-282 Hormone Replacement Therapy with Conjugated Equine Estrogens and Medroxyprogesterone Acetate....Pages 283-287 Bleeding Patterns and Compliance with CEE Plus MPA Continuous Sequential or Combined Regimens in Postmenopausal Women....Pages 289-293 CEE-MPA: A Relevant Reduction in Cardiovascular Disease Risk....Pages 295-302 Hormone Replacement Therapy and Breast and Gynecologic Cancers....Pages 303-313 Raloxifene HCl: A Tissue Selective Estrogen Receptor Modifier (SERM) for Replacement Therapy in Postmenopausal Women....Pages 315-320 Dietary Phyto-Estrogens and the Menopause....Pages 321-325 Primary and Secondary Prevention of Cardiovascular Diseases in Menopausal Women: Alternative Treatment to Hormonal Replacement Therapy....Pages 327-338 Back Matter....Pages 339-341