Journal of Endocrinological Investigation

, Volume 22, Issue 8, pp 625–635 | Cite as

Effect of SERMs on the uterus and menopausal symptoms

  • Martina Dören


Raloxifene tamoxifen HRT endometrium climacteric symptoms 


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  1. 1.
    Black L.J., Sato M., Rowley E.R., Magee D.E., Bekel A., Williams D.C., Cullinan G.J., Bendele R., Kauffman R.F., Bensch W.R., Frolik C.A., Termine J.D., Bryant H.U. Raloxifene (LY139481) prevents bone loss and reduces serum cholesterol without causing uterine hypertrophy in ovariectomized rats. J. Clin. Invest. 1994, 93: 63–69.PubMedCentralPubMedGoogle Scholar
  2. 2.
    Kleinman D., Karas M., Danilenko M., Arbeli A., Roberts C.T., LeRoith D., Levy J., Sharoni Y. Stimulation of endometrial cancer cell growth by tamoxifen is associated with increased insulin-like growth factor (IGF)-I induced tyrosine phophorylation and reduction in IGF binding proteins. Endocrinology 1996, 137: 1089–1095.PubMedGoogle Scholar
  3. 3.
    Sato M., Rippy M., Bryant H.U. Raloxifene, tamoxifen, nafoxidine, or estrogen effects on reproductive and nonreproductive tissues in ovariectomized rats. FASEB. J. 1996, 10: 905–912.PubMedGoogle Scholar
  4. 4.
    Udoff L., Langenberg P., Adashi E.Y. Combined continuous hormone replacement therapy: a critical review. Obstet. Gynecol. 1995, 86: 306–316.PubMedGoogle Scholar
  5. 5.
    Vuento M.H., Pirhonen J.P., Mäkinen J.I., Tyrkkö J.E., Laippala P.J., Grönroos M., Salmi T.A. Endometrial fluid accumulation in asymptomatic postmenopausal women. Ultrasound Obstet. Gynecol. 1996, 8: 37–41.PubMedGoogle Scholar
  6. 6.
    Gull B., Karlsson B., Wikland M., Milsom I., Granberg S. Factors influencing the presence of uterine cavity fluid in a random sample of asymptomatic post-menopausal women. Acta Obstet. Gynecol. Scand. 1998, 77: 751–757.PubMedGoogle Scholar
  7. 7.
    Delmas P.D., Bjarnason N.H., Mitlak B.H., Ravoux A.-C., Shah A., Huster W.J., Draper M., Christiansen C. Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women. N. Engl. J. Med. 1997, 337: 1641–1647.PubMedGoogle Scholar
  8. 8.
    Lufkin E.G., Whitaker M.D., Nickelsen T., Argueta R., Caplan R.H., Knickerbocker R.K., Riggs B.L. Treatment of established postmenopausal osteoporosis with raloxifene: a randomized trial. J. Bone Miner. Res. 1998, 13: 1747–1154.PubMedGoogle Scholar
  9. 9.
    Cummings S.R., Eckert S., Krueger K.A., Grady D., Powles T.J., Cauley J.A., Norton L., Nickelsen T., Bjarnason N.H., Morrow M., Lippman E., Black D., Glusman J.E., Costa A., Jordan V.C. The effect of raloxifene on risk of breast cancer in postmenopausal women. JAMA 1999, 281: 2189–2197.PubMedGoogle Scholar
  10. 10.
    Davies G.C., Huster W.J., Lu Y., Plouffe L., Lakshmanan M. Adverse events reported by postmenopausal women in controlled trials with raloxifene. Obstet. Gynecol. 1999, 93: 558–565.PubMedGoogle Scholar
  11. 11.
    Baker V.L., Draper M., Paul S., Allerheiligen S., Glant M., Shifren J., Jaffe R.B. Reproductive endocrine and endometrial effects of raloxifene hydrochloride, a selective estrogen receptor modulator, in women with regular menstrual cycles. J. Clin. Endocrinol. Metab. 1998, 83: 6–13.PubMedGoogle Scholar
  12. 12.
    Fisher B., Costantino J., Wickerham D.L., Redmond C.K., Kavanah M., Cronin W.M., Vogel V., Robidoux A., Dimitrov N., Atkins J., Daly M., Wieand S., Tan-Chiu E., Ford L., Wolmark N. and other National Surgical Adjuvant Breast and Bowel Project Investigators. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J. Natl. Cancer Inst. 1998, 90: 1371–1388.PubMedGoogle Scholar
  13. 13.
    Ferrazzi E., Cartei G., Mattarazzo R., Fiorentino M. Oestrogen-like effect of tamoxifen on vaginal epithelium. B.M.J. 1977, 1: 1351–1352.Google Scholar
  14. 14.
    Lahti E., Vuopala S., Kauppila A., Blanco G., Ruokonen A., Laatikainen T. Maturation of vaginal and endometrial epithelium in postmenopausal breast cancer patients receiving long-term tamoxifen. Gynecol. Oncol. 1994, 55: 410–414.PubMedGoogle Scholar
  15. 15.
    Dijkhuizen F.P.H.L.J., Brölmann H.A.M., Oddens B.J.J., Roumen R.M.H., Coubergh J.W.W, Heintz A.P.M. Transvaginal ultrasonography and endometrial changes in the postmenopausal breast cancer patients receiving tamoxifen. Maturitas 1996, 25: 45–50.PubMedGoogle Scholar
  16. 16.
    Nuovo M.A., Nuovo G.J., McCaffrey R.M., Levine R.M, Baron B., Winkler B. Endometrial polyps in postmenopausal patients receiving tamoxifen. Int. J. Gynecol. Pathol. 1989, 8: 125–131.PubMedGoogle Scholar
  17. 17.
    The writing group for the PEPI trial. Effects of hormone replacement therapy on endometrial histology in postmenopausal women. JAMA 1996, 275: 370–375.Google Scholar
  18. 18.
    Nand S.L., Webster M.A., Baber R., O’Connor V., for the Ogen/Provera Study Group. Bleeding pattern and endometrial changes during continuous combined hormone replacement therapy. Obstet. Gynecol. 1998, 91: 678–684.PubMedGoogle Scholar
  19. 19.
    Woodruff J.D., Pickar J.H. for the Menopause Study Group. Incidence of endometrial hyperplasia in post-menopausal women taking conjugated estrogens (Premarin) with medroxyprogesterone acetate or conjugated estrogens alone. Am. J. Obstet. Gynecol. 1994, 170: 1213–1223.PubMedGoogle Scholar
  20. 20.
    Johannisson E., Holinka C.F., Arrenbrecht S. Transdermal sequential and continuous hormone replacement regimens with estradiol and norethisterone acetate in postmenopausal women: effects of the endometrium. Int. J. Fertil. 1997, 42 (Suppl. 2): 388–398.Google Scholar
  21. 21.
    Ross A.H., Boyd M.E., Colgan T.J., Ferenczy A., Fugere P., Lorrain J. Comparison of transdermal and oral sequential gestagen in combination with transdermal estradiol: effects on bleeding patterns and endometrial histology. Obstet. Gynecol. 1993, 82: 773–779.PubMedGoogle Scholar
  22. 22.
    Shah A.S., Scheel W.H., Glant M.D., Fugére P. Raloxifene HCL is not stimulatory in the endometrium as assessed by the Blaustein criteria and an estrogenicity scoring system. ACOG 46th Annual Clinical Meeting, May 9–13, 1998, New Orleans, p. 66 (Abstract).Google Scholar
  23. 23.
    Goldstein S., Srikanth R., Parsons A., Londoño J., Kenemans P., Wilkie B.S., Walsh B., Shah A., Scheele W. Effects of raloxifene on the endometrium in healthy postmenopausal women. Menopause 1998, 5: 277–278 (Abstract).Google Scholar
  24. 24.
    Glant M., Eisenhut C., Draper M. A scale for assessing postmenopausal endometrial proliferation in response to potential or known selective estrogen receptor modulators. Am. J. Clin. Pathol. 1995, 104: 341–342 (Abstract).Google Scholar
  25. 25.
    Boss S.M., Huster W.J., Neild J.A., Glant M.D., Eisenhut C.C., Draper M.W. Effects of raloxifene hydrochloride on the endometrium of postmenopausal women. Am. J. Obstet. Gynecol 1998, 177: 1458–1464.Google Scholar
  26. 26.
    Assikis V.J., Jordan V.C. Gynecologic effects of tamoxifen and the association with endometrial carcinoma. Int. J. Gynecol. Obstet. 1995, 49: 241–257.Google Scholar
  27. 27.
    MacMahon B. Overview of studies on endometrial cancer and other types of cancer in humans: perspectives of an epidemiologist. Sem. Oncol. 1997, 24 (Suppl. 1): 122–139.Google Scholar
  28. 28.
    Grady D., Gebretsadik T., Kerlikowke K., Ernster V., Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet. Gynecol. 1995, 85: 304–313.PubMedGoogle Scholar
  29. 29.
    Kedar R.P., Bourne T.H., Powles T.J., Collins W.P., Asjley S.E., Cosgrove D.O., Campbell S. Effects of tamoxifen on uterus and ovaries of post-menopausal women in a randomized breast cancer prevention trial. Lancet 1994, 343: 1318–1321.PubMedGoogle Scholar
  30. 30.
    Timmermann D., Deprest J., Bourne T.H., van den Berghe I., Collins W.P., Vergote I. A randomized trial on the use of ultrasonography or office hysteroscopy for endometrial assessment in tamoxifen-treated postmenopausal breast cancer patients. Am. J. Obstet. Gynecol. 1998, 179: 62–70.Google Scholar
  31. 31.
    Neven P., de Muylder X., van Belle Y., van Hoff I., Vanderick G. Longitudinal hysteroscopic follow-up during tamoxifen treatment. Lancet 1998, 351: 36.PubMedGoogle Scholar
  32. 32.
    Cohen C.J. Tamoxifen and endometrial cancer: tamoxifen effects on the human female genital tract. Sem. Oncol. 1997, 24 (Suppl 1): 55–64.Google Scholar
  33. 33.
    Porter K.B., Tsibris J.C.M., Porter G.W., Fuchs-Young R., Nicosia S.V., O’Brien W.F., Spellacy W.N. Effects of raloxifene in a guinea pig model for leiomyomas. Am. J. Obstet. Gynecol. 1998, 179: 1283–1287.PubMedGoogle Scholar
  34. 34.
    Rullo S., Tagliaferri T., Bandierra F., Fiorelli C., Felici A., Piccioni M.G., FraMarino dei Malatesta M.L. Uterine changes during tamoxifen therapy. Clin. Exp. Obstet. Gynecol. 20: 116–119, 1993.PubMedGoogle Scholar
  35. 35.
    Dilts P.V., Hopkins M.P., Chang A.E., Cody R.L. Rapid growth of leiomyoma in patients receiving tamoxifen. Am. J. Obstet. Gynecol. 1992, 166: 167–168.PubMedGoogle Scholar
  36. 36.
    Ylöstalo P., Granberg S., Bäckström A.-C., Hirsjärvi-Lahti T. Uterine findings by transvaginal sonography during percutaneous estrogen treatment in postmenopausal women. Maturitas 1996, 23: 313–317.PubMedGoogle Scholar
  37. 37.
    Hammar M., Berg G., Fåhraeus L., Larsson-Cohn U. Climacteric symptoms in an unselected sample of Swedish women. Maturitas 1984, 6: 345–350.PubMedGoogle Scholar
  38. 38.
    Kaufert P. Women and their health in the middle years: a Manitoba project. Soc. Sci. Med. 1984, 3: 1029–1030.Google Scholar
  39. 39.
    Ballinger S.E. Psychosocial stress and symptoms of menopause: a comparative study of menopause clinic patients and non-patients. Maturitas 1985, 7: 315–327.PubMedGoogle Scholar
  40. 40.
    McKinlay J.B., McKinlay S.M., Brambilla D. The relative contribution of endocrine changes and social circumstances in mid-aged women. J. Health Soc. Behav. 1987, 28: 345–363.PubMedGoogle Scholar
  41. 41.
    Holte A. Prevalence of climacteric complaints in a representative sample of middle-aged women in Oslo, Norway. J. Psychosom. Obstet. Gynecol. 1991, 12: 303–317.Google Scholar
  42. 42.
    Hunter M. The South-East England longitudinal study of the climacteric and postmenopause. Maturitas 1992, 14: 117–126.PubMedGoogle Scholar
  43. 43.
    Oldenhave A., Jaszmann L.J.B., Haspels A.A., Everaerd W.T.A.M. Impact of climacteric on well-being: a survey based on 5213 women aged 39 to 60 years old. Am. J. Obstet. Gynecol. 1993, 168: 772–780.PubMedGoogle Scholar
  44. 44.
    Lock M., Kaufert P., Gilbert P. Cultural construction of the menopausal syndrome: the Japanese case. Maturitas 1988, 10: 317–332.PubMedGoogle Scholar
  45. 45.
    Boulet M.J., Oddens B.J., Lehert P., Vemer H.M., Visser A. Climacteric and menopause in seven south-east Asian countries. Maturitas 1994, 19: 157–176.PubMedGoogle Scholar
  46. 46.
    Beyene Y. Cultural significance and physiological manifestations of menopause: a biocultural analysis. Cult. Med. Psychiatry 1986, 10: 47–71.PubMedGoogle Scholar
  47. 47.
    Mohyi D., Tabassi K., Simon J. Differential diagnosis of hot flashes. Maturitas 1997, 27: 203–214.PubMedGoogle Scholar
  48. 48.
    Molnar G.W. Body temperatures during menopausal hot flashes. J. Appl. Physiol. 1975, 38: 499–503.PubMedGoogle Scholar
  49. 49.
    Tataryn I.V., Meldrum D.R., Lu K.H., Frumar A.M., Judd H.L. LH, FSH, and skin temperature during menopausal hot flush. J. Clin. Endocrinol. Metab. 1979, 49: 152–154.PubMedGoogle Scholar
  50. 50.
    Kronenberg F. Hot flashes. In: Lobo R.A. (Ed.), Treatment of the postmenopausal women: basic and clinical aspects. Raven Press, New York, 1994, p. 97–117.Google Scholar
  51. 51.
    Woodward S., Greville H.W., Freedman R.R. Ventilatory response during menopausal hot flashes. Menopause 1995, 2: 81–88.Google Scholar
  52. 52.
    Casper R.F., Yen S.S.C. Neuroendocrinology of menopausal flushes: an hypothesis of fluid mechanism. Clin. Endocrinol. 1985, 22: 293–312.Google Scholar
  53. 53.
    Genazzani A.R., Stomati M., Spinetti A., Greco M.M., Genazzani A.D., Petraglia F. Neuroendocrinology of the climacteric period and hormonal replacement therapy. In: Wren B.G. (Ed.), Progress in the management of the menopause. Parthenon Publishing, Lancaster, 1997, p. 380–384.Google Scholar
  54. 54.
    Merchenthaler I., Funkhouser J.M., Carver J.M., Lundeen S.G., Ghosh K., Winneker R.C. Effect of estrogens and antiestrogens in a rat model for hot flush. Maturitas 1998, 30: 307–316.PubMedGoogle Scholar
  55. 55.
    Germaine L., Freedman R.R. Behavioral treatment of menopausal hot flushes: evaluation by objective methods. J. Consult. Clin. Psychol. 1984, 52: 1072–1079.PubMedGoogle Scholar
  56. 56.
    Wyon Y., Lindgren R., Lundeberg T., Hammar M. Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women. Menopause 1995, 2: 3–12.Google Scholar
  57. 57.
    Hammar M., Berg G., Lindgren R. Does physical exercise influence the frequency of postmenopausal hot flushes? Acta Obstet. Gynecol. Scand. 1991, 69: 409–412.Google Scholar
  58. 58.
    Schiff I., Tulchinsky D., Cramer D., Ryan K.J. Oral medroxyprogesterone in the treatment of post-menopausal symptoms. JAMA 1980, 244: 1443–1445.PubMedGoogle Scholar
  59. 59.
    Clayden J.R., Bell J.W., Pollard P. Menopausal flushing: double-blind trial of a nonhormonal medication. B.M.J. 1975, 1: 409–412.Google Scholar
  60. 60.
    Jones K.P., Ravnikar V., Schiff I. A preliminary evaluation of the effect of lofexidine on vasomotor flushes in post-menopausal women. Maturitas 1985, 7: 135–139.PubMedGoogle Scholar
  61. 61.
    Nesheim B.-I., Saetre T. Reduction of menopausal hot flushes by methyldopa: a double blind crossover trial. Eur. J. Clin. Pharmacol. 1981, 20: 413–416.PubMedGoogle Scholar
  62. 62.
    Lebherz T.B., French L. Nonhormonal treatment of the menopausal syndrome. Obstet. Gynecol. 1969, 33: 795–799.PubMedGoogle Scholar
  63. 63.
    Melis G.B., Gambacciani M., Cagnacci A., Paoletti A.M., Mais V., Fioretti P. Effects of the dopamine antagonist veralipride on hot flushes and luteinizing hormone secretion in postmenopausal women. Obstet. Gynecol. 1988, 72: 688–692.PubMedGoogle Scholar
  64. 64.
    Coope J., Williams S., Patterson J.S. A study of the effectiveness of propranolol in menopausal hot flushes. Br. J. Obstet. Gynaecol. 1978, 85: 472–475.PubMedGoogle Scholar
  65. 65.
    Alcoff J.M., Campbell D., Tribble D., Oldfield B., Cruess D. Double-blind, placebo-controlled, crossover trial of propranolol as treatment for menopausal vasomotor symptoms. Clin. Ther. 1981, 3: 356–364.PubMedGoogle Scholar
  66. 66.
    Albertazzi P., Pansini F., Bonaccorsi G., Zanotti L., Forini E., de Aloysio D. The effect of dietary soy supplementation of hot flushes. Obstet. Gynecol. 1998, 91: 6–11.PubMedGoogle Scholar
  67. 67.
    Dalais F.S., Rice G.E., Wahlqvist M.L., Grehan M., Murkies A.L., Medley G., Ayton R., Strauss B.J.G. Effects of dietary phytoestrogens in postmenopausal women. Climacteric 1998, 1: 124–129.PubMedGoogle Scholar
  68. 68.
    Stoll W. Phytotherapeutikum beeinflußt atrophisches Vaginalepithel — Doppelblindversuch Cimicifuga vs Östrogenpräparat. Therapeutikon 1985, 1: 1–15.Google Scholar
  69. 69.
    Liske E., Wüstenberg P. Therapy of climacteric complaints with cimicifuga racemosa: herbal medicine with clinically proven evidence. Menopause 1998, 5: 250 (Abstract).Google Scholar
  70. 70.
    Draper M.W., Flower D.E., Huster W.J., Neild J.A., Harper K.D., Arnaud C. A controlled trial of raloxifene (LY 139481)HCL: impact on bone turnover and serum lipid profile in healthy postmenopausal women. J. Bone Miner. Res. 1996, 11: 835–842.PubMedGoogle Scholar
  71. 71.
    Walsh B.W., Kuller L.H., Wild R.A., Paul S., Farmer M., Lawrence J.B., Shah A.S., Andersen P.W. Effects of raloxifene on serum lipids and coagulation factors in healthy postmenopausal women. JAMA 1998, 279: 1445–1451.PubMedGoogle Scholar
  72. 72.
    Bolognese M., Moffett A., Jensen C., MacDonald B. Idoxifene is well tolerated in osteopenic post-menopausal women. Menopause 1998, 5: 271–272 (Abstract).Google Scholar
  73. 73.
    Kupperman H.S., Wetchler B.B., Blatt M.H. Contemporary therapy of the menopausal syndrome. JAMA 1959, 171: 1627–1637.Google Scholar
  74. 74.
    Hunter M., Battersby R., Whitehead M. Relationship between psychological symptoms, somatic complaints and menopausal status. Maturitas 1986, 8: 217–228.PubMedGoogle Scholar
  75. 75.
    Hilditch J.R., Lewis J., Peter A., van Maris B., Ross A., Franssen E., Guyatt G.H., Norton P.G., Dunn E. A menopause-specific quality of life questionnaire: development and psychometric properties. Maturitas 1996, 24: 161–175.PubMedGoogle Scholar
  76. 76.
    Greene J.G. Constructing a standard climacteric scale. Maturitas 1998, 29: 25–31.PubMedGoogle Scholar
  77. 77.
    Shumaker S.A., Anderson R.T., Czajkowski S.M. Psychological tests and scales. In: Spilker B. (Ed.), Quality of life assessments in clinical trials. Raven Press, New York, 1990, p. 95–113.Google Scholar
  78. 78.
    Wiklund I. Methods of assessing the impact of climacteric complaints on quality of life. Maturitas 1998, 29: 41–50.PubMedGoogle Scholar
  79. 79.
    Toran-Allerand C.D. Interactions of estrogen with growth factors in the developing central nervous system. In: Hochberg R.B., Naftolin F. (Eds.), The new biology of steroid hormones. Raven Press, New York, 1994, p. 311–321.Google Scholar
  80. 80.
    Haskell S.G., Richardson E.D., Horwitz R.I. The effect of estrogen replacement therapy on cognitive function in women: a critical review of the literature. J. Clin. Epidemiol. 1997, 50: 1249–1264.PubMedGoogle Scholar
  81. 81.
    Yaffe K., Sawaya G., Lieberburg I., Grady D. Estrogen therapy in postmenopausal women. Effects on cognitive function and dementia. JAMA 1998, 279: 688–695.PubMedGoogle Scholar
  82. 82.
    Polo-Kantola P., Portin R., Koskinen T., Polo O., Irjala K., Erkkola R. Climacteric symptoms do not impair cognitive performances in postmenopause. Maturitas 1997, 27: 13–23.PubMedGoogle Scholar
  83. 83.
    Reboussin B.A., Greendale G., Espeland M.A. Effect of hormone replacement therapy on self-reported cognitive symptoms: results from the Postmenopausal Estrogen/Progestin Interventions (PEPI) trial. Climacteric 1998, 1: 172–179.PubMedGoogle Scholar
  84. 84.
    Nickelsen T., Lufkin E.G., Riggs B.L., Cox D.A., Crook T.H. Raloxifene hydrochloride, a selective estrogen receptor modulator: safety assessment of effects on cognitive function and mood in postmenopausal women. Psychoneuroendocrinology 1999, 24: 115–123.PubMedGoogle Scholar
  85. 85.
    Nilsen J., Mor G., Naftolin F. Raloxifene induces neurite outgrowth in estrogen receptor positive PC12 cells. Menopause 1998, 5: 211–216.PubMedGoogle Scholar
  86. 86.
    Siefer D.B., Roa-Pena L., Keefe D.L. Increasing hypothalamic arcuate nucleus glial peroxidase activity in ageing female rats is reduced by an antiestrogen and a gonadotropin-releasing hormone agonist. Menopause 1994, 1: 83–90.Google Scholar
  87. 87.
    Clemens J.A., Bennett D.R., Black L.J., Jones C.D. Effects of a new antiestrogen, keoxifene (LY156758), on growth of carcinogen-induced mammary tumors and on LH and prolactin levels. Life Sci. 1983, 32: 2869–2875.PubMedGoogle Scholar
  88. 88.
    Shugrue P.J., Lane M.V., Merchenthaler I. Regulation of progesterone receptor messenger ribonucleic acid in the rat medial preoptic nucleus by estrogenic and antiestrogenic compounds: an in situ hybridization study. Endocrinology 1997, 138: 5476–5484.Google Scholar
  89. 89.
    Collins A., Landgren B.-M. Reproductive health, use of estrogen and experience of symptoms in perimenopausal women: a population-based study. Maturitas 1994, 20: 101–111.PubMedGoogle Scholar
  90. 90.
    Dennerstein L., Smith A.M.A., Morse C. Psychological well-being, mid-life and the menopause. Maturitas 1994, 20: 1–11.PubMedGoogle Scholar
  91. 91.
    Kaufert P., Gilbert P., Tate R. The Manitoba project: a re-examining of the link between menopause and depression. Maturitas 1992, 14: 143–156.PubMedGoogle Scholar
  92. 92.
    Limouzin-Lamothe M.A., Mairin N., Joyce C.R., Le Gal M. Quality of life after the menopause: influence of hormonal replacement therapy. Am. J. Obstet. Gynecol. 1994, 170: 618–624.PubMedGoogle Scholar
  93. 93.
    Zweifel J.E., O’Brien W.H. A meta-analysis of the effect of hormone replacement therapy upon depressed mood. Psychoneuroendocrinology 1997, 22: 189–212.PubMedGoogle Scholar
  94. 94.
    Daly E., Gray A., Barlow D., MacPherson K., Roche M., Vessey M. Measuring the impact of menopausal symptoms on quality of life. B.M.J. 1993, 307: 836–840.Google Scholar
  95. 95.
    Groeneveld F.P.M.J., Bareman F.P., Barentsen R., Dokter H.J., Drogendijk A.C., Hoes A.W. Vasomotor symptoms and well-being in the climacteric years. Maturitas 1996, 23: 293–299.PubMedGoogle Scholar
  96. 96.
    Holte A. Menopause, mood and hormone replacement therapy: methodological issues. Maturitas 1998, 29: 5–18.PubMedGoogle Scholar
  97. 97.
    Palinkas L.A., Barrett-Connor E. Estrogen use and depressive symptoms in post-menopausal women. Obstet. Gynecol. 1992, 80: 30–36.PubMedGoogle Scholar
  98. 98.
    McCoy N.L. Methodological problems in the study of sexuality and the menopause. Maturitas 1998, 29: 51–60.PubMedGoogle Scholar
  99. 99.
    Sherwin B.B. The use of androgens in the postmenopause: evidence from clinical studies. In: Wren B.G. (Ed.), Progress in the management of the menopause. Parthenon Publishing, Lancaster, 1997, p. 263–266.Google Scholar
  100. 100.
    Samsioe G., Heraib F., Lidfeldt J., Nerbrand C., Lindholm L., Agardh C.-D., Scherstén B. Urogenital symptoms in women aged 50–60. Gynecol. Endocrinol. 1999, 13: 113–117.PubMedGoogle Scholar
  101. 101.
    Dören M. Urogenital aging — creation of improved awareness. Am. J. Obstet. Gynecol. 1998, 178: S254–266.PubMedGoogle Scholar
  102. 102.
    Fantl J.A., Cardozo L.A., McClish D.K. and the Hormones and the Urogenital Therapy Committee. Estrogen therapy in the management of urinary incontinence in postmenopausal women: a meta-analysis. First report of the Hormones and Urogenital Therapy Committee. Obstet. Gynecol 1994, 83: 112–118.Google Scholar
  103. 103.
    Sultana C.J., Walters M.D. Estrogen and urinary incontinence. Maturitas 1994, 20: 129–138.PubMedGoogle Scholar
  104. 104.
    Barlow D.H., Samsioe G., van Geelen J.M. A study of European women’s experience of the problems of urogenital ageing and its management. Maturitas 1997, 27: 239–247.PubMedGoogle Scholar
  105. 105.
    Thom D.H., Brown J.S. Reproductive and hormonal risk factors for urinary incontinence in later life: a review of the clinical and epidemiologic literature. J. Am. Geriatr. Soc. 1998, 46: 1411–1417.PubMedGoogle Scholar
  106. 106.
    Cardozo L., Bachmann G., McClish D., Fonda D., Birgerson L. Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: Second Report of the Hormones and Urogenital Therapy Committee. Obstet. Gynecol. 1998, 92: 722–777.PubMedGoogle Scholar
  107. 107.
    Cohen F., Watts S., Beymer K. Vaginal complaints in healthy postmenopausal women: data from a 3-year trial comparing raloxifene with conjugated estrogens or placebo. Menopause 1998, 5: 283 (Abstract).Google Scholar
  108. 108.
    Murray T.M., Rawlins M.R., Derzko C., Rao L.G. Effects of raloxifene and estrogen on human vaginal epithelial cells. J. Bone Miner. Res. 1997, 12 (Suppl. 1): 346 (Abstract).Google Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 1999

Authors and Affiliations

  • Martina Dören
    • 1
  1. 1.Department of Family PlanningKing’s College HospitalDenmark HillUK

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