Browsing by Subject "Menopause"

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  • Multanen, J.; Rantalainen, T.; Kautiainen, H.; Ahola, R.; Jamsa, T.; Nieminen, M. T.; Lammentausta, E.; Hakkinen, A.; Kiviranta, I.; Heinonen, A. (2017)
    It is uncertain whether subjects with mild knee osteoarthritis, and who may be at risk of osteoporosis, can exercise safely with the aim of improving hip bone strength. This RCT showed that participating in a high-impact exercise program improved femoral neck strength without any detrimental effects on knee cartilage composition. No previous studies have examined whether high-impact exercise can improve bone strength and articular cartilage quality in subjects with mild knee osteoarthritis. In this 12-month RCT, we assessed the effects of progressive high-impact exercise on femoral neck structural strength and biochemical composition of knee cartilage in postmenopausal women. Eighty postmenopausal women with mild knee radiographic osteoarthritis were randomly assigned into the exercise (n = 40) or control (n = 40) group. Femoral neck structural strength was assessed with dual-energy X-ray absorptiometry. The knee cartilage region exposed to exercise loading was measured by the quantitative MRI techniques of T2 mapping and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Also, an accelerometer-based body movement monitor was used to evaluate the total physical activity loading on the changes of femoral neck strength in all participants. Training effects on the outcome variables were estimated by the bootstrap analysis of covariance. A significant between-group difference in femoral neck bending strength in favor of the trainees was observed after the 12-month intervention (4.4%, p <0.01). The change in femoral neck bending strength remained significant after adjusting for baseline value, age, height, and body mass (4.0%, p = 0.020). In all participants, the change in bending strength was associated with the total physical activity loading (r = 0.29, p = 0.012). The exercise participation had no effect on knee cartilage composition. The high-impact training increased femoral neck strength without having any harmful effect on knee cartilage in women with mild knee osteoarthritis. These findings imply that progressive high-impact exercise is a feasible method in seeking to prevent hip fractures in postmenopausal women whose articular cartilage may also be frail.
  • Rahkola-Soisalo, Päivi; Savolainen-Peltonen, Hanna; Mika, Gissler; Hoti, Fabian; Vattulainen, Pia; Ylikorkala, Olavi; Mikkola, Tomi S. (2019)
    Introduction and hypothesisThe impact of estradiol-based hormone therapy (HT) on the incidence of stress urinary incontinence (SUI) is unknown. Therefore, we compared the use of such HT regimens and tibolone in women with and without SUI.MethodsThe women with a history of SUI operation (N=15,002) were identified from the Finnish National Hospital Discharge Register, and the control women without such an operation (N=44,389) from the Finnish Central Population Register. The use of HT was traced from the National Drug Reimbursement Register, and the odd ratios (ORs) with 95% confidence intervals (95% CIs) for SUI were calculated by using the conditional logistic regression analysis.ResultsThe cases had used any HT more often than the controls. The use of systemic estradiol-only or estradiol-progestin therapy was accompanied by an increased SUI risk (OR 3.8, 95% CI: 3.6-4.0 and OR 2.7, 95% CI: 2.6-2.9 respectively). The use of estradiol with noretisterone acetate showed a higher risk of increase than that with medroxyprogesterone acetate. Age over 55years at the initiation of systemic HT was accompanied by a higher SUI risk increase than that under 55years of age. The use of tibolone, an estradiol + levonorgestrel-releasing intrauterine device, or vaginal estradiol also increased the risk.ConclusionsThe use of HT regimens may predispose to the de novo development or worsening of pre-existing SUI. Thus, caution is needed when these regimens are prescribed to women with mild stress-related urine leakage or with established SUI risk factors.
  • Slopien, Radoslaw; Wender-Ozegowska, Ewa; Rogowicz-Frontczak, Anita; Meczekalski, Blazej; Zozulinska-Ziolkiewicz, Dorota; Jaremek, Jesse D.; Cano, Antonio; Chedraui, Peter; Goulis, Dimitrios G.; Lopes, Patrice; Mishra, Gita; Mueck, Alfred; Rees, Margaret; Senturk, Levent M.; Simoncini, Tommaso; Stevenson, John C.; Stute, Petra; Tuomikoski, Pauliina; Paschou, Stavroula A.; Anagnostis, Panagiotis; Lambrinoudaki, Irene (2018)
    Introduction: Whether menopause increases the risk of type 2 diabetes mellitus (T2DM) independently of ageing has been a matter of debate. Controversy also exists about the benefits and risks of menopausal hormone therapy (MHT) in women with T2DM. Aims: To summarise the evidence on 1) the effect of menopause on metabolic parameters and the risk of T2DM, 2) the effect of T2DM on age at menopause, 3) the effect of MHT on the risk of T2DM, and 4) the management of postmenopausal women with T2DM. Materials and methods: Literature review and consensus of experts' opinions. Results and conclusion: Metabolic changes during the menopausal transition include an increase in and the central redistribution of adipose tissue, as well as a decrease in energy expenditure. In addition, there is impairment of insulin secretion and insulin sensitivity and an increase in the risk of T2DM. MHT has a favourable effect on glucose metabolism, both in women with and in women without T2DM, while it may delay the onset of T2DM. MHT in women with T2DM should be administered according to their risk of cardiovascular disease (CVD). In women with T2DM and low CVD risk, oral oestrogens may be preferred, while transdermal 17 beta-oestradiol is preferred for women with T2DM and coexistent CVD risk factors, such as obesity. In any case, a progestogen with neutral effects on glucose metabolism should be used, such as progesterone, dydrogesterone or transdermal norethisterone. Postmenopausal women with T2DM should be managed primarily with lifestyle intervention, including diet and exercise. Most of them will eventually require pharmacological therapy. The selection of antidiabetic medications should be based on the patient's specific characteristics and comorbidities, as well on the metabolic, cardiovascular and bone effects of the medications.
  • Tiitinen, Aila; Kero, Katja (2020)
    Emättimen paikallisten estrogeenihoitojen ei ole todettu lisäävän rintasyöpäriskiä. Limakalvojen kuivuminen on yleinen oire vaihdevuosien jälkeen, ja rintasyöpähoidot voivat pahentaa oireita. Hoitona voidaan aina käyttää hormonittomia kosteuttavia geelejä tai tabletteja. Liukuvoiteen käyttö yhdynnöissä on suositeltavaa. Rintasyövän hoidon jälkeen voidaan käyttää paikallisia estrogeenejä. Paikallishoitoa voidaan nykytiedon mukaan harkita myös aromataasinestäjää käyttävillä. Ensisijaisia ovat estriolia sisältävät valmisteet.
  • Lampio, Laura; Saaresranta, Tarja; Engblom, Janne; Polo, Olli; Polo-Kantola, Paivi (2016)
    Objective: This follow-up study aimed to evaluate risk factors for menopausal sleep disturbances already identifiable before menopause. Methods: At baseline, all 81 women were premenopausal. At year-five follow-up, 27 of the women were premenopausal, 40 postmenopausal, and 14 postmenopausal and using hormone therapy. We used the Basic Nordic Sleep Questionnaire to study sleep; additional questionnaires evaluated risk factors for sleep impairment. Results: Sleep quality differed only marginally between the groups. The following baseline variables were associated with impaired sleep quality at follow-up: depressive symptoms increased the risk of nocturnal awakenings (OR 1.16 (95%CI 1.02-1.32), p = 0.025), morning tiredness (OR 1.22 (95%CI 1.06-1.40), p = 0.007), daytime tiredness (OR 1.24 (95%CI 1.06-1.44), p = 0.007) and propensity to fall asleep during work or leisure time (OR 1.18 (95%CI 1.01-1.37), p = 0.036). Personal crises increased the risk of longer sleep latency (OR 5.46 (95%CI 1.13-26.32), p = 0.035) and of propensity to fall asleep when not active (OR 5.41 (95%CI 1.42-20.83), p = 0.014). Use of medications affecting the CNS increased the risk of worse general sleep quality (OR 11.44 (95% CI 1.07-121.79), p = 0.044). Perceived impaired general health (OR 2.87 (95%CI 1.04-7.94), p = 0.043) and frequent night sweats (OR 10.50 (95%CI 2.25-49.01), p = 0.003) increased the risk of difficulty falling asleep. Conclusions: Various premenopausal health-related factors seem to predict poor sleep in menopausal transition. Menopause itself appears to have only minor effects. Thus, it is essential to identify high risk women to allow timely interventions that may prevent the development of sleep disturbances at menopause. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Jalava-Broman, Jaana; Junttila, Niina; Sillanmäki, Lauri; Mäkinen, Juha; Rautava, Päivi (2020)
    Objective: To identify subgroups of women who differ with respect to self-evaluated stress, hostility, optimism and sense of coherence, and to identify differences, if any, in whether these subgroups use or do not use hormone replacement therapy (HT). Study design and methods: This time-trend study is based on the Finnish national HeSSup study, in which nationwide cohorts of Finnish women aged 52-56 years randomly selected in 2000 (n = 1321) and in 2010 (n = 1389) responded to postal questionnaires related to four psychological behavior patterns. Main outcome measures: Relationships between psychological behavior patterns (stress, hostility, optimism and sense of coherence) and how menopausal symptoms are experienced and how this relates to the use of HT. Results: The proportion of HT users was higher among those with more stress and hostility and less optimism and sense of coherence than among those low in stress and hostility and high in optimism and sense of coherence. Conclusions: Differences in psychological behavior patterns influence the perception of menopausal symptoms and the use of HT. When the treatment of women at menopause is planned, psychological behavior patterns should be considered, as these reflect the ability to cope with menopausal symptoms.
  • Vihma, Veera; Wang, Feng; Savolainen-Peltonen, Hanna; Turpeinen, Ursula; Hamalainen, Esa; Leidenius, Marjut; Mikkola, Tomi S.; Tikkanen, Matti J. (2016)
    Estrone is the most abundant estrogen after the menopause. We developed a liquid chromatography-tandem mass spectrometric method (LC-MS/MS) for determination of estrone in adipose tissue. Subcutaneous adipose tissue from the breast was collected during elective surgery in postmenopausal women undergoing mastectomy for treatment of breast cancer (n = 13) or reduction mammoplasty (controls, n = 11). Homogenized adipose tissue was extracted with organic solvents and the estrone fraction was purified by LH-20 column chromatography from the excess of lipids. The concentration of estrone was analyzed by LC-MS/MS. The method was accurate with an intra-assay variation of 8% and an interassay variation of 10%. The median concentration of estrone in subcutaneous adipose tissue from the breast did not differ between breast cancer and control women, 920 pmol/kg and 890 pmol/kg, respectively. In breast cancer patients but not in the controls, breast adipose tissue estrone levels correlated positively with the serum estrone concentration. In conclusion, the new method provides a reliable means to measure estrone concentrations in adipose tissue in postmenopausal women. (C) 2015 Elsevier Ltd. All rights reserved.
  • Katuwal, Sushmita; Tapanainen, Juha S.; Pukkala, Eero; Kauppila, Antti (2019)
    BackgroundThe length of interval between successive childbirths (birth interval) might influence the incidence of breast cancer, either by stimulating or by inhibiting the factors that are responsible for the initiation of breast cancer or its early development.MethodsThis is a case-control study nested in a cohort of 47,479 Finnish grand-multiparous (GM) women born after 1934, and registered as having had at least five births before 2013. The 1354 women with breast cancer diagnosis were compared with controls (1:5) matched by parity and date of birth of the mother. Conditional logistic regression was used to estimate odds ratios of the risk of ductal and lobular breast cancer subtypes associated with each of the intervals between the 1st and 5th birth, stratified by age at diagnosis. Age at first and last birth before index date were used as covariates.ResultsIncreased intervals between the 1st and 5th births were associated with an increased risk of lobular breast cancer. In contrast, regarding ductal cancer, premenopausal women with shorter length of interval (
  • Katuwal, Sushmita; Tapanainen, Juha S; Pukkala, Eero; Kauppila, Antti (BioMed Central, 2019)
    Abstract Background The length of interval between successive childbirths (birth interval) might influence the incidence of breast cancer, either by stimulating or by inhibiting the factors that are responsible for the initiation of breast cancer or its early development. Methods This is a case-control study nested in a cohort of 47,479 Finnish grand-multiparous (GM) women born after 1934, and registered as having had at least five births before 2013. The 1354 women with breast cancer diagnosis were compared with controls (1:5) matched by parity and date of birth of the mother. Conditional logistic regression was used to estimate odds ratios of the risk of ductal and lobular breast cancer subtypes associated with each of the intervals between the 1st and 5th birth, stratified by age at diagnosis. Age at first and last birth before index date were used as covariates. Results Increased intervals between the 1st and 5th births were associated with an increased risk of lobular breast cancer. In contrast, regarding ductal cancer, premenopausal women with shorter length of interval (< 2 years) between the 1st and 2nd birth had greater risk and longer intervals (3+ years) were associated with reduced risk. Spacing between the 2nd and 5th birth did not influence the risk of ductal breast cancer. Conclusion The findings of our study suggest that the effect of the length of birth interval on breast cancer depends on the age and histology. The protective effect of shorter birth intervals on lobular breast among postmenopausal women and the opposite effect on ductal cancer in premenopausal women may reflect distinct differentiation and functional roles of lobular and ductal cells, and possibly also different response to hormonal exposure.
  • Lampio, Laura; Saaresranta, Tarja; Polo, Päivi (2018)
  • Kausto, Johanna; Kaila-Kangas, Leena; Lallukka, Tea; Leino-Arjas, Päivi (2020)
    Joissakin maissa on laadittu vaihdevuosiin liittyviä ohjeistuksia työnantajille ja ¬työntekijöille.