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Symptoms and Metabolic Sequelae of the Menopause

  • Conference paper
HRT and Osteoporosis

Abstract

The endocrinological and metabolic changes which accompany the climacteric produce a multitude of symptoms and have profound effects on the emotional, psychological and physical well-being of women. With increased longevity the vast majority of British women experience the menopause and subsequently spend more than a third of their lives in a state of oestrogen deficiency. Many of the associated symptoms and long-term metabolic disadvantages can be prevented with oestrogen therapy. Thus women receiving oestrogen replacement therapy suffer fewer strokes, fewer heart attacks, and less depression, and their life expectancy is increased by more than 3 years compared to untreated women. It is thus appropriate, when screening for prevention of osteoporosis is considered, that cognizance is made of the fact that women are not merely “skeletons” and the general benefits of oestrogen therapy must be considered.

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References

  1. Caspar RF, Yen SSC, Wilkes MM. Menopausal flushes: a neuroendocrine link with pulsatile luteinizing hormone secretion. Science 1979; 205:823–5.

    Article  Google Scholar 

  2. Meldrum DR, Erlik Y, Lu JKH et al. Objective recorded hot flushes in patients with pituitary insufficiency. J Clin Endocrinol Metab 1981; 52:684–7.

    Article  PubMed  CAS  Google Scholar 

  3. Casper RF, Yen SSC. Menopausal flushes: effect of pituitary gonadotrophin desensitisation by a potent luteinizing hormone-releasing factor agonist. J Clin Endocrinol Metab 1981; 53:1056–8.

    Article  PubMed  CAS  Google Scholar 

  4. Studd JWW, Chakravarti S, Oram D. The climacteric. In: Greenblatt R, Studd JWW, eds. The menopause, clinics in obstetrics and gynaecology. Philadelphia: W.B. Saunders, 1977; 4:3–29.

    Google Scholar 

  5. Gambone J, Meldrum DR, Laufer L et al. Further delineation of hypothalamic dysfunction responsible for menopausal hot flushes. J Clin Endocrinol Metab 1984; 59:1097–102.

    Article  PubMed  CAS  Google Scholar 

  6. Tataryn IV, Lomax P, Bajorek JG, Chesarek W, Meldrum DR, Judd HL. Postmenopausal hot flushes: a disorder of thermoregulation. Maturitas 1980; 2:101–7.

    Article  PubMed  CAS  Google Scholar 

  7. Kronenberg F, Cote LJ, Linkie DM, Dyrenfurther I, Downey JA. Menopausal hot flushes: thermoregulatory, cardiovascular and circulating catecholamine and LH changes. Maturitas 1984; 6:31–43.

    Article  PubMed  CAS  Google Scholar 

  8. Brincat M, de Trafford JC, Lafferty K, Studd J WW. Peripheral vasomotor control and menopausal flushing — a preliminary report. Br J Obstet Gynaecol 1984; 91:1107–10.

    Article  PubMed  CAS  Google Scholar 

  9. Erlik Y, Tataryn I, Meldrum D et al. Association of waking episodes with menopausal hot flushes. JAMA 1981; 245:1741–7.

    Article  PubMed  CAS  Google Scholar 

  10. Winner ST, Morgan CA, Grimley Evans J. Perimenopausal risk of falling and incidence of distal forearm fracture. Br Med J 1989; 298:1486–8.

    Article  CAS  Google Scholar 

  11. Versi E, Brincat M, Cardozo LD, O’Dowd T, Cooper D, Studd JWW. Correlation of urethral phsiology and skin collagen in postmenopausal women. Br J Obstet Gynaecol 1988; 2:147–52.

    Google Scholar 

  12. Albright F, Bloomberg E, Smith PH. Postmenopausal osteoporosis. Trans Assoc Am Physicians 1940; 55:298–305.

    CAS  Google Scholar 

  13. Savvas M, Treasure J, Studd J. Fogelman I, Moniz C, Brincat M. The effect of anorexia nervosa on skin thickness, skin collagen and bone density. Br J Obstet Gynaecol 1989; 96:1392–4.

    Article  PubMed  CAS  Google Scholar 

  14. Kirby JD, Munro DD. Steroid induced atrophy in an animal and human model. Br J Dermatol 1976; 94:111–19.

    Article  PubMed  Google Scholar 

  15. Arho P. Skin thickness and collagen content in some endocrine and connective tissue diseases Acta Derm Venerol 1972: 69 (Suppl):1–48.

    CAS  Google Scholar 

  16. Brincat M, Studd JWW, Moniz CF, Parsons V, Darby AJ. Skin thickness and skin collagen mimic an index of osteoporosis in the postmenopausal woman. In: Christiansen C, et al. eds. Osteoporosis. Proceedings of the Copenhagen international symposium on osteoporosis, 1984; 353–5.

    Google Scholar 

  17. Brincat M, Moniz CF, Studd JWW, Darby AJ, Magos AL, Cooper D. Sex hormones and skin collagen content in postmenopausal women. Br Med J 1983; 287:1337–8.

    Article  CAS  Google Scholar 

  18. Siddle N, Sarrel P, Whitehead M. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril 1987; 47:94–100.

    PubMed  CAS  Google Scholar 

  19. Watson NR, Studd JWW, Henderson AF. The effect of simple hysterectomy on bone density in premenopausal women. Proceedings of the second congress of the international society of gynaecological endocrinology, Jerusalem, Israel, 18–23 March 1990 (in press).

    Google Scholar 

  20. Dominion J. The role of psychiatry in the menopause. Clin Obstet Gynecol 1977; 4:241–58.

    Google Scholar 

  21. Schneider M, Brotherton P. Physiological, psychological and situation stresses in depression during the climacteric. Maturitas 1979; 1:153–8.

    Article  PubMed  CAS  Google Scholar 

  22. Kaufert PA. Myth and menopause. Soc. Health Ill 1982; 4:141–66.

    Article  Google Scholar 

  23. Montgomery JC, Brincat M, Tapp A, Appleby L, Versi E, Fenwick PBC, Studd JWW. Effect of oestrogen and testosterone implants on psychological disorders in the climacteric. Lancet 1987; i:297–9.

    Article  Google Scholar 

  24. Studd JWW, Watson NR. Estrogens and depression in women. In: Belfort P, Pinotti JA, Eskes TKAB, eds. Proceedings of the 12th world congress of gynecology and obstetrics, Rio, 1988; 297–301.

    Google Scholar 

  25. Van Keep PA, Kellerhals JM. The impact of socio-cultural factors on symptom formation. Psychother Psychosom 1974; 23:251–63.

    Article  PubMed  Google Scholar 

  26. Brown GW, Harris T. Social origins of depression. London: Tavistock Publications, 1978.

    Google Scholar 

  27. Jaszmann L. Epidemiology of climacteric and post-climacteric complaints. In: Van Keep PA, Lauritzen C, eds. Ageing and oestrogens. Basel: Karger, 1973; 22–5.

    Google Scholar 

  28. Magos AL, Brincat M, Studd JWW. Treatment of the pre-menstrual syndrome by subcutaneous oestradiol implants and cyclical oral norethisterone — a placebo controlled study. Br Med J 1986; 1:1629–33.

    Article  Google Scholar 

  29. Watson NR, Studd JWW, Riddle AF, Savvas M. Suppression of ovulation by transdermal oestradiol patches. Br Med J 1988; 297:900–1.

    Article  CAS  Google Scholar 

  30. Castelli W. Epidemiology of coronary heart disease: The Framingham study. Am J Med 1984; 76:4–12.

    Article  PubMed  CAS  Google Scholar 

  31. Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease: The Framingham Study. Am J Med 1977; 62:707–14.

    Article  PubMed  CAS  Google Scholar 

  32. Bush TL, Barrett-Connor E, Cowan LD et al. Cardiovascular mortality and non-contraceptive use of oestrogen in women. Circulation 1987; 75:1102–9.

    Article  PubMed  CAS  Google Scholar 

  33. Barr DP, Russ EM, Elder HA. The influence of estrogens on lipoproteins in atherosclerosis. Trans Assoc Am Physicians 1952; 65:102–11.

    PubMed  CAS  Google Scholar 

  34. Jensen J, Rio BJ, Strom V, Nilas L, Christiansen C. Long-term effects of percutaneous oestrogens and oral progesterone on serum lipoproteins in postmenopausal women. Am J Obstet Gynecol 1987; 156:66–71.

    PubMed  CAS  Google Scholar 

  35. Knopp RH, Walden CE, Wahl PW et al. Oral contraceptive and post-menopausal estrogen effects on lipoprotein, triglyceride and cholesterol in an adult female population relationship to estrogen and progestin potency. J Clin Endocrinol Metab 1981; 53:1123–32.

    Article  PubMed  CAS  Google Scholar 

  36. Wilson PWF, Garrison RJ, Castelli WP. Post-menopausal estrogen use, cigarette smoking and cardiovascular morbidity in women over 50. The Framingham Study. N Engl J Med 1985; 313:1038–43.

    Article  PubMed  CAS  Google Scholar 

  37. Tikkanen MJ, Nikkila EA, Kuusi T, Sipinen S. High density lipoprotein-2 and hepatic lipase: reciprocal changes produced by estrogen and norgestrel. J Clin Endocrinol Metab 1982; 54:1113–17.

    Article  PubMed  CAS  Google Scholar 

  38. Sarrel PM. Estrogen replacement therapy. Obstet Gynecol 1988; 72:Suppl 3s–5s.

    Google Scholar 

  39. Tikkanen MJ, Nikkila EA, Kuusi T, Sipinen S. Reduction of plasma high-density lipoprotein cholesterol and increase of post-heparin plasma hepatic lipase activity during pregostin treatment. Clin Chim Acta 1981; 115:63–71.

    Article  PubMed  CAS  Google Scholar 

  40. Hirvonen E, Malkonen M, Manninen V. Effects of different progestogens on lipoproteins during post-menopausal replacement therapy. N Engl J Med 1981; 304:560–5.

    Article  PubMed  CAS  Google Scholar 

  41. Kloosterboer HJ, van Wayjen RGA, van den Ende A. Effects of the oral contraceptive combination 0.150 mg desogestrel and 0.02 mg ethinyloestradiol on serum lipids including the HDL subfraction. Acta Obstet Gynecol Scand 1987; 144:33–6.

    Article  Google Scholar 

  42. Kuusi T, Nikkila EA, Tikkanen MJ, Sipinen S. Effects of two progestins with different androgenic properties on hepatic endothelial lipase and high density lipoprotein-2. Atherosclerosis 1985; 54:251–62.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. J. W. W. Studd
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  2. N. R. Watson
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  3. A. Henderson
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Editor information

Editors and Affiliations

  1. Clarendon Wing, Leeds General Infirmary, Leeds, LS1 3EX, UK

    James O. Drife MD, FRCS Ed, FRCOG (Professor of Obstetrics and Gynaecology) (Professor of Obstetrics and Gynaecology)

  2. King’s College Hospital, London, SE5 9RS, UK

    John W. W. Studd MD, BS, FRCOG (Consultant Obstetrician and Gynaecologist, Director) (Consultant Obstetrician and Gynaecologist, Director)

  3. The Menopause Clinic, Dulwich Hospital, East Dulwich Grove, London, SE22 8PT, UK

    John W. W. Studd MD, BS, FRCOG (Consultant Obstetrician and Gynaecologist, Director) (Consultant Obstetrician and Gynaecologist, Director)

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© 1990 Springer-Verlag London Limited

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Studd, J.W.W., Watson, N.R., Henderson, A. (1990). Symptoms and Metabolic Sequelae of the Menopause. In: Drife, J.O., Studd, J.W.W. (eds) HRT and Osteoporosis. Springer, London. https://doi.org/10.1007/978-1-4471-1799-5_3

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  • DOI: https://doi.org/10.1007/978-1-4471-1799-5_3

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1801-5

  • Online ISBN: 978-1-4471-1799-5

  • eBook Packages: Springer Book Archive

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