Menopause/Female Sexual Function

  • Fran E. Kaiser
  • Margaret-Mary G. Wilson
  • John E. Morley


Menopausal age has not altered substantially since medieval times. In the United States, the average age of menopause is 51 years, and currently over 40 million women are over age 50. Only 1% of women experience menopause prior to age 40.1 Women live one-third of their life span after menopause.


Postmenopausal Woman Endometrial Cancer Luteinizing Hormone Sexual Function Obstet Gynecol 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Coulan CB, Adamson SC, Annegers JF. Incidence of premature ovarian failure. Obstet Gynecol. 1986; 67: 604–606.Google Scholar
  2. 2.
    Sheehy G. The Silent Passage. New York: Random House; 1991.Google Scholar
  3. 3.
    Landau C, Cyr MG, Moulton AW. The Complete Book of Menopause. New York: GP Putnam’s; 1994.Google Scholar
  4. 4.
    Utian WH, Jacobowitz RS. Managing Your Menopause. New York: Simon Schuster; 1990.Google Scholar
  5. 5.
    Haney AF. The physiology of the climacterium. Clin Obstet Gynecol. 1986; 29: 397–405.PubMedCrossRefGoogle Scholar
  6. 6.
    Richardson SJ, Senikas V, Nelson JF. Follicular depletion during the menopausal transition: evidence for accelerated loss and ultimate exhaustion. J Clin Endocrinol Metab. 1987; 65: 1231–1237.PubMedCrossRefGoogle Scholar
  7. 7.
    Jick H, Porter J, Morrison AS. Relation between smoking and age of natural menopause: report from Boston Collaborative Drug Surveillance Program, Boston University Medical Center. Lancet. 1977; 1: 1354–1356.PubMedCrossRefGoogle Scholar
  8. 8.
    Longcope C, Franz C, Morello C, et al. Steroid and gonadotropin levels in women during the perimenopausal years. Maturitas. 1986; 8: 189–196.PubMedCrossRefGoogle Scholar
  9. 9.
    Kohler PO, Ross GT, Odell WD. Metabolic clearance and production rates of human luteinizing hormone in pre and post menopausal women. J Clin Invest. 1968; 42: 381–388.Google Scholar
  10. 10.
    Lenton EA, Sexon L, Lee S, et al. Progressive changes in LH and FSH and LH: FSH ratio in women throughout reproductive life. Maturitas. 1988; 10: 35–43.PubMedCrossRefGoogle Scholar
  11. 11.
    Longcope C, Kato T, Horton R. Conversion of blood androgens to estrogens in normal adult men and women. J Clin Invest. 1969; 48: 2191–2201.PubMedCrossRefGoogle Scholar
  12. 12.
    Quint AR, Kaiser FE. Gonadotropin determinations and thyrotropin releasing hormone and luteinizing hormone-releasing hormone testing in critically ill postmenopausal women with hypothyroxinemia. J Clin Endocrinol Metab. 1985; 60: 464–471.PubMedCrossRefGoogle Scholar
  13. 13.
    Mishell DR Jr, Brenner PF. Menopause. In: Mishell DR Jr, Davajan V, eds. Infertility, Contraception and Reproductive Endocrinology. 2nd ed. Oradell, NJ: Medical Economics Book; 1986: 179–202.Google Scholar
  14. 14.
    Thompson B, Hart SA, Durno D. Menopausal age and symptomatology in general practice. J Biol Sci. 1973; 5: 71–82.Google Scholar
  15. 15.
    Chang RJ, Judd HL. Elevation of skin temperature of the finger as an objective index of postmenopausal hot flushes: standardization of the techniques. Am J Obstet Gynecol. 1979; 135: 713–717.PubMedGoogle Scholar
  16. 16.
    Erlik J, Medrum DR, Legasse LD, et al. Effect of megesterol acetate on flushing and bone metabolism. Maturitas. 1981; 3: 167.PubMedCrossRefGoogle Scholar
  17. 17.
    Mashchak CA, Kletsky OA, Artal R, et al. The relation of physiological changes to subjective symptoms in postmenopausal women with and without hot flushes. Maturitas. 1985; 6: 301–308.CrossRefGoogle Scholar
  18. 18.
    Jaffe RB. The menopausal and perimenopausal period. In: Yen SSC, Jaffe RB, eds. Reproductive Endocrinology. Philadelphia: WB Saunders; 1986.Google Scholar
  19. 19.
    Tataryn IV, Meldrum DR, Lu LH, et al. LH, FSH and skin temperature during the menopausal hot flush. J Clin Endocrinol Metab. 1979; 49: 152–158.PubMedCrossRefGoogle Scholar
  20. 20.
    Oldenhave A, Jaszmann LJB. The climacteric: absence and presence of hot flushes and their relation to other complaints. In: Schonbaum E, ed. The Climacteric Hot Flush, Progress in Basic and Clinical Pharmacology, VI. Basel: Karger; 1991: 6–39.Google Scholar
  21. 21.
    Lock M. Hot flushes in cultural context: the Japanese tale as a cautionary tale for the West. In: Schonbaum E, ed. The Climacteric Hot Flush, Progress in Basic and Clinical Pharmacology, VI. Basel: Karger; 1991: 40–60.Google Scholar
  22. 22.
    Okonofua FE, Lawal A, Bangbose JK. Features of menopause and menopausal age in Nigerian women. Int J Gynecol Obstet. 1990; 31: 341–345.CrossRefGoogle Scholar
  23. 23.
    Kuno Y. Human Perspiration. Springfield, IL: Charles C Thomas.Google Scholar
  24. 24.
    Coope J, Thomson JM, Poller L. Effects of “natural estrogen” replacement therapy on menopausal symptoms and blood clotting. Br Med J (Clin Res). 1973; 4: 139–143.Google Scholar
  25. 25.
    Ravnikar V, Elkind-Hirsch K, Schiff I, et al. Vasomotor flush and the release of peripheral immunoreactive luteinising hormone in postmenopausal women. Fertil Steril. 1984; 41: 881–887.PubMedGoogle Scholar
  26. 26.
    Freedman RR, Woodward S, Sabharwal SC. Alpha 2 adrenergic mechanism in menopausal hot flushes. Obstet Gynecol. 1990; 76: 573–578.PubMedGoogle Scholar
  27. 27.
    Hammar M, Berg G. Clonidine in the treatment of menopausal flushing. Acta Obstet Gynecol Scand Suppl. 1985; 132: 29–31.PubMedCrossRefGoogle Scholar
  28. 28.
    Starke K, Gothert M, Kilbringer H. Modulation of neurotransmitter release by presynaptic autoreceptors. Physiol Rev. 1989; 69: 864–989.PubMedGoogle Scholar
  29. 29.
    Curet O, Dennis T, Scatton B. Evidence for the involvement of presynaptic alpha 2 adrenoreceptors in the regulation of norepinephrine metabolism in the rat brain. J Pharmacol Exp Ther. 1987; 240: 327–336.PubMedGoogle Scholar
  30. 30.
    Casper RF, Yen SSC, Wilkes MM. Menopausal flushes. A neuroendocrine link with pulsatile LH secretion. Science. 1979; 205: 823–825.PubMedCrossRefGoogle Scholar
  31. 31.
    Casper RF, Yen SSC. Neuroendocrinology of menopausal flushes. An hypothesis of flush mechanism. Clin Endocrinol (Oxf). 1985; 22: 293–312.CrossRefGoogle Scholar
  32. 32.
    Pacifi R, Rifas L, McCracken R, et al. Ovarian steroid treatment blocks a postmenopausal increase in blood monocyte interleukin release. Proc Natl Acad Sci USA. 1989; 86: 2398–2402.CrossRefGoogle Scholar
  33. 33.
    Breder CD, Dinarello CA, Saper CB. Interleukin-1 immu-noreactive innervation of the human hypothalamus. Science. 1988; 240: 321–324.PubMedCrossRefGoogle Scholar
  34. 34.
    Dinarello CA. Interleukin-1. Rev Infect Dis. 1984; 6: 51–95.PubMedCrossRefGoogle Scholar
  35. 35.
    Jilka RL, Hangoc G, Girasole A, et al. Increased osteoclast development after estrogen loss: mediation by interleukin-6. Science. 1992; 257: 88–91.PubMedCrossRefGoogle Scholar
  36. 36.
    Roodman GD. Interleukin-6-an osteoporotic factor? J Bone Mineral Res. 1992; 7: 475–478.CrossRefGoogle Scholar
  37. 37.
    Lee SJ, Kanis JA. An association between osteoporosis and premenstrual symptoms and postmenopausal symptoms. Bone Miner. 1994; 24 (2): 127–134.PubMedCrossRefGoogle Scholar
  38. 38.
    Meldrum DR, Defazio JD, Erlik Y, et al. Pituitary hormones during the menopausal hot flush. Obstet Gynecol. 1984; 64: 752.PubMedGoogle Scholar
  39. 39.
    Meldrum DR, Tataryn IV, Frumar AM, et al. Gonadotrophine, estrogens and adrenal steroids during the menopausal hot flush. J Clin Endocrinol Metab. 1980; 50: 685.PubMedCrossRefGoogle Scholar
  40. 40.
    Defazio J, Meldrum DR, Laufer L, et al. Induction of hot flashes in premenopausal women treated with a long acting GNRH agonist. J Clin Endocrinol Metab.1983;56:445448.Google Scholar
  41. 41.
    Germaine LM, Freedman RR. Behavioral treatment of menopausal hot flushes: evaluation by objective methods. J Consult Clin Psychol. 1984; 52: 1072–1079.PubMedCrossRefGoogle Scholar
  42. 42.
    Tartaryn IV, Lomax P, Meldrum DR, et al. Objective techniques for the assessment of postmenopausal hot flushes. Obstet Gynecol. 1981; 57: 340–344.Google Scholar
  43. 43.
    Freedman RR. Laboratory and ambulatory monitoring of menopausal hot flashes. Psychophysiology. 1989; 26: 573–579.PubMedCrossRefGoogle Scholar
  44. 44.
    Suave L. Les Greffes Ovariennes. Envisagees Au Point De Vue De La Pratique Chirurgicale. Paris: G Steintied; 1909.Google Scholar
  45. 45.
    Harriet C, Anderson M, Raju SK, et al. Estrogen replacement after oophorectomy: comparison of patches and implants. Br Med J. 1992; 305: 90–91.CrossRefGoogle Scholar
  46. 46.
    Haas S, Walsh B, Evans S, et al. The effect of transdermal estradiol on hormone and metabolic dynamics over a six week period. Obstet Gynecol. 1988; 71: 671–676.PubMedGoogle Scholar
  47. 47.
    Loprinzi CL, Michalak JC, Quella SK. Megesterol acetate for the prevention of hot flashes. N Engl J Med. 1994; 331: 347–351.PubMedCrossRefGoogle Scholar
  48. 48.
    Tax L. Hormone replacement therapy? Livial (Org OD14), a new possibility. In: Schonbaum E, ed. The Climacteric Hot Flush, Progress in Basic and Clinical Pharmacology, VI. Basel: Karger; 1991: 143–159.Google Scholar
  49. 49.
    Clayden JR, Bell JW, Pollard P. Menopausal flushing: double blind trial of a non hormonal mechanism. Br Med J. 1974; 1: 409–412.PubMedCrossRefGoogle Scholar
  50. 50.
    Schundler AE, Muller D, Keller E, et al. Studies with clonidine in menopausal women. Arch Gynecol. 1979; 227: 341–347.CrossRefGoogle Scholar
  51. 51.
    Lindsay R, Hart DM. Failure of response of menopausal vasomotor symptoms to clonidine. Maturitas. 1978; 1: 21–25.PubMedCrossRefGoogle Scholar
  52. 52.
    Wren BG, Brown LB. A double blind trial with clonidine and a placebo to treat hot flushes. Med J Aust. 1986; 144: 369–370.PubMedGoogle Scholar
  53. 53.
    Jones KP, Ravnikar VA, Schiff I. Effect of Lofexidine on vasomotor flushes. Maturitas. 1985; 7: 135.PubMedCrossRefGoogle Scholar
  54. 54.
    Hammond MG, Hatley L, Talbert LM. A double blind study to evaluate the effect of methlydopa on menopausal vasomotor flushes. J Clin Endocrinol Metab. 1984; 58: 1158.PubMedCrossRefGoogle Scholar
  55. 55.
    Swartzman LC, Edelberg R, Kemmann E. Impact of stress on objectively recorded menopausal hot flushes and on flush report bias. Health Psychol. 1990; 9 (5): 529–545.PubMedCrossRefGoogle Scholar
  56. 56.
    Freedman RR, Woodward S. Behavioral treatment of menopausal hot flushes: evalution by ambulatory monitoring. Am J Obstet Gynecol. 1992; 167: 436–439.PubMedGoogle Scholar
  57. 57.
    Hammar M, Berg G, Lindgren R. Does physical exercise influence the frequency of postmenopausal hot flushes? Acta Obstet Gynecol Scand. 1990; 69: 409–412.PubMedCrossRefGoogle Scholar
  58. 58.
    Erlik Y, Meldrum DR, Judd HL. Estrogen levels in postmenopausal women with hot flushes. Obstet Gynecol. 1982; 59: 403.PubMedGoogle Scholar
  59. 59.
    Grodin JM, Siiteri PK, Macdonald PC. Source of estrogen production in postmenopausal women. J Clin Endocrinol Metab. 1973; 36: 207.PubMedCrossRefGoogle Scholar
  60. 60.
    Davidson BJ, Gambone JC, Lagasse LD. Free estradiol in postmenopausal women with and without endometrial cancer. J Clin Endocrinol Metab. 1981; 52: 404.PubMedCrossRefGoogle Scholar
  61. 61.
    Lomax P, Schonbaum E. Postmenopausal hot flushes and their management. Pharmacol Ther. 1993; 57: 347–358.PubMedCrossRefGoogle Scholar
  62. 62.
    Chenoy R, Hussain S, Tayob Y, et al. Effect of oral gamolenic acid from evening primrose oil on menopausal flushing. Br Med J. 194; 308: 501–503.Google Scholar
  63. 63.
    Utian WH. Current perspectives in the management of the menopausal and postmenopausal patient. Obstet Gynecol. 1990; 75 (4 suppl): 15–25.Google Scholar
  64. 64.
    Bretschneider JG, McCoy L. Sexual interest and behavior in healthy 80–120 year olds. Arch Sex Behay. 1988; 17: 109–129.CrossRefGoogle Scholar
  65. 65.
    Roughan PA, Kaiser FE, Morley JE. Sexuality and the older woman. Clin Geriatr Med. 1993; 9: 87–106.PubMedGoogle Scholar
  66. 66.
    Cardozo LD. Sex and the bladder. Br J Med. 1988; 296: 587–588.CrossRefGoogle Scholar
  67. 67.
    Cust MP, Gangar KF, Hillard TC, et al. A risk benefit assessment of estrogen therapy in postmenopausal women. Drug Safety. 1990; 5: 345–358.PubMedCrossRefGoogle Scholar
  68. 68.
    Holte A, Mikkelsen A. Psychosocial determinants of climacteric complaints. Maturitas. 1991; 13: 205–215.PubMedCrossRefGoogle Scholar
  69. 69.
    Kampen DL, Sherwin BB. Estrogen use and verbal memory in healthy postmenopausal women. Obstet Gynecol. 1994; 83 (6): 979–983.PubMedCrossRefGoogle Scholar
  70. 70.
    Sherwinn BB. The impact of different doses of estrogen and progestin on mood and sexual behavior in postmenopausal women. J Clin Endocrinol Metab. 1991; 72: 336–343.CrossRefGoogle Scholar
  71. 71.
    Sherwin BB, Suranyi-Cadotte BE. Upregulatory effect of estrogen on platelet 3H-imipramine binding sites in surgically menopausal women. Biol Psychiatry. 1990; 28: 339–348.PubMedCrossRefGoogle Scholar
  72. 72.
    National Health Center for Health Statistics: 1982 Summary. National Hospital Discharge Survey. (No. 95). Vital Health Stat 1983.Google Scholar
  73. 73.
    Easterday CL, Grimes DA, Riggs JA. Hysterectomy in the United States. Obstet Gynecol. 1983; 62: 203–212.PubMedGoogle Scholar
  74. 74.
    Greenwood S. Hysterectomy and ovarian removal: a major health issue in the perimenopausal years. West J Med. 1988; 149: 771–772.PubMedGoogle Scholar
  75. 75.
    Macintosh MC. Incidence of hysterectomy in New Zealand. NZ Med J. 1987; 100: 345–347.Google Scholar
  76. 76.
    vanKeep PA, Wildemeersh D, Lehort P. Hysterectomy in six European countries. Maturitas. 1983; 5: 69–75.CrossRefGoogle Scholar
  77. 77.
    Kjerulff K, Langenberg P, Guzinski G. The socioeconomic correlates of hysterectomies in the United States. Am J Public Health. 1994; 84 (2): 319.CrossRefGoogle Scholar
  78. 78.
    Pokras R. Hysterectomy: past, present and future. Stat Bull Metrop Insur Co. 1989; 70: 12.PubMedGoogle Scholar
  79. 79.
    Irwin KL, Peterson HB, Hughes JM, et al. MMWR CDC. Surveill Summ. 1986; 35: 100Google Scholar
  80. 80.
    Bernstein SJ, McGlynn EA, Siu AL, et al. The appropriateness of hysterectomy. A comparison of care in seven health plans. Health Maintenance Organization Quality of Care Consortium. JAMA. 1993; 269: 2398–2402.PubMedCrossRefGoogle Scholar
  81. 81.
    Pokras R, Hufnagel VG. Hysterectomies in the United States. 1965–1984. Am J Public Health. 1988; 78: 852–853.PubMedCrossRefGoogle Scholar
  82. 82.
    Barber HRK. Ovarian Cancer. Cancer. 1986; 36: 149–184.Google Scholar
  83. 83.
    Jacobs I, Oram D. Prevention of ovarian cancer: a survey of the practice of prophylactic oophorectomy by fellows and members of the Royal College of Obstetricians and Gynaecologists. Br J Obstet Gynecol. 1989; 96: 510–515.CrossRefGoogle Scholar
  84. 84.
    Howe HL. Age specific hysterectomy and oophorectomy prevalence rates and the risk of cancer of the reproductive system. Am J Public Health. 1984; 74: 560–563.PubMedCrossRefGoogle Scholar
  85. 85.
    Deneef JC, Hollenbeck ZJR. The fate of the ovaries preserved at the time of hysterectomy. Am J Obstet Gynecol. 1966; 96: 1088–1097.Google Scholar
  86. 86.
    Haines CJ, Chung JK, Leung DH. A prospective study of the frequency of acute menopausal symptoms in Hong Kong Chinese women. Maturitas. 1994; 18: 175–181.PubMedCrossRefGoogle Scholar
  87. 87.
    Haspels AA. Hysterectomized women with ovarian conservation report more severe climacteric complaints than do normal women of similar age. Am J Obstet Gynecol. 1993; 168 (3 pt1): 765–771.PubMedGoogle Scholar
  88. 88.
    Garcia C, Cutler WB. Preservation of the ovary: a reevaluation. Fertil Steril. 1984; 42: 510–514.PubMedGoogle Scholar
  89. 89.
    Nilas L, Loft A. Ovarian function after premenopausal hysterectomy. Ugeskrift Laeger. 1993; 155: 3818–3822.Google Scholar
  90. 90.
    Hreshchyshyn MM, Hopkins A, Zylstra S. Effects of natural menopause, hysterectomy and oophorectomy on lumbar spine and femoral neck bone densities. Obstet Gynecol. 1988; 72: 631–638.PubMedGoogle Scholar
  91. 91.
    Kikku P, Gronroos M, Hirvonen T, et al. Supravaginal uterine amputation vs. hysterectomy: effects on libido and orgasm. Acta Obstet Gynecol Scand. 1983; 62: 147–152.CrossRefGoogle Scholar
  92. 92.
    Sherwin BB, Gelfand MM. The role of androgens in the maintenance of sexual function in the oophorectomized woman. Psychosom Med. 1987; 49: 397–409.PubMedGoogle Scholar
  93. 93.
    Sherwin BB, Gelfand MM. Differential symptom response to parenteral estrogen and/or androgen administration in the surgical menopause. Am J Obstet Gynecol. 1985; 151: 153–160.PubMedGoogle Scholar
  94. 94.
    Rosen RC, Taylor JF, Leibliem SR, et al. Prevalence of sexual dysfunction in women: results of a survey study of women in an outpatient gynecological clinic. J Sex Marital Ther. 1993; 19: 171–188.PubMedCrossRefGoogle Scholar
  95. 95.
    Roughan PA, Kaiser FE, Morley JE. Sexuality and the older woman. Clin Geriatr Med. 1993; 9: 87–106.PubMedGoogle Scholar
  96. 96.
    Kehoe M. Lesbians Over 60 Speak for Themselves. New York: Harrington Park Press; 1989.Google Scholar
  97. 97.
    Kinsey AC, Pomeray WB, Martin CE, et al. Sexual Behavior in the Human Female. Philadelphia: WB Saunders; 1953.Google Scholar
  98. 98.
    Masters W, Johnson V. Human Sexual Response. Boston: Little, Brown; 1970.Google Scholar
  99. 99.
    Sarrel PM. Sexuality and menopause. Obstet Gynecol. 1990; 75: 26S - 30S.PubMedGoogle Scholar
  100. 100.
    Glatt AE, Zinner SH, McCormack WM. The prevalence of dyspareunia. Obstet Gynecol. 1990; 75: 433–436.PubMedGoogle Scholar
  101. 101.
    Campbell S, Whitehead M. Estrogen therapy and the menopausal syndrome. Clin Obstet Gynecol. 1977; 42: 31.Google Scholar
  102. 102.
    Bachmann G, Leiblum SR, Kemmen E, et al. Sexual expression and its determinants in the post-menopausal woman. Maturitas. 1984; 6: 19–29.PubMedCrossRefGoogle Scholar
  103. 103.
    McCoy NL, Davidson JM. A longitudinal study of the effects of menopause on sexuality. Maturitas. 1985; 7: 203–210.PubMedCrossRefGoogle Scholar
  104. 104.
    Myers LS, Dixon J, Morrissette D, et al. Effects of estrogen, androgen, and progestin on sexual psychophysiology and behavior in postmenopausal women. J Clin Endocrinol Metab. 1990; 70: 1124–1131.PubMedCrossRefGoogle Scholar
  105. 105.
    Sherwin BB, Gelfand MM, Brender W. Androgen enhances sexual motivation in females: a prospective crossover study of sex steroid administration in surgical menopause. Psychsom Med. 1985; 7: 339–351.Google Scholar
  106. 106.
    Wasow M, Loeb MB. Sexuality in nursing homes. J Am Geriatr Soc. 1979; 27: 73–79.PubMedGoogle Scholar
  107. 107.
    Kaiser FE, Morley JE. Sexuality and dementia. In: Morris JC, ed. Handbook of Dementing Illnesses. New York: Marcel Dekker; 1994: 539–548.Google Scholar
  108. 108.
    Davis LJ. Rape and older women. In: Warner CG, ed. Rape and Sexual Assault Management and Intervention. Rockville, MD: Aspen Publishers; 1980: 94–118.Google Scholar
  109. 109.
    Ramin SM, Satin AJ, Stone IC Jr, et al. Sexual assault in post-menopausal women. Obstet Gynecol. 1992; 80: 860–864.PubMedGoogle Scholar
  110. 110.
    Kannel WB, Hjortland JC, McNamara PM, et al. Menopause and risk of cardiovascular disease: the Framingham Study. Ann Intern Med. 1976; 85: 447–452.PubMedGoogle Scholar
  111. 111.
    Barrett-Connor E, Miller V. Estrogens, lipids, and heart disease. Clin Geriatr Med. 1993; 9: 57–67.PubMedGoogle Scholar
  112. 112.
    Bush TL, Barrett-Connor E, Cowan LD, et al. Cardiovascular mortality and noncontraceptive estrogen use in women: results from the Lipid Research Clinics’ Program Follow-Up Study. Circulation. 1987; 75: 1002–1009.CrossRefGoogle Scholar
  113. 113.
    Beichetz PE. Hormonal treatment of postmenopausal women. N Engl J Med. 1994; 330: 1062–1071.CrossRefGoogle Scholar
  114. 114.
    Nabulsi AA, Folson AR, White A, et al. Association of hormone-replacement therapy with various cardiovascular risk factors in postmenopausal women. N Engl J Med. 1993; 328: 1069–1075.PubMedCrossRefGoogle Scholar
  115. 115.
    Wren BG. The effect of estrogen on the female cardiovascular system. Med J Aust. 1992; 157 (3): 204–208.PubMedGoogle Scholar
  116. 116.
    Frankfurt M. Hormonal contraception and substitution therapy: the importance of progestogen for cardiovascular disease. Geburtshilfe Frauenheilk. 1992; 52: 653–662.CrossRefGoogle Scholar
  117. 117.
    Manson JE, Rimm EB, Colditz GA, et al. A prospective study of postmenopausal estrogen therapy and subsequent incidence of non-insulin dependent diabetes mellitus. Ann Epidemiol. 1992; 2: 665–673.PubMedCrossRefGoogle Scholar
  118. 118.
    Renard E, Bringer J, Jaffiol C. Sex steroids. Effects on the carbohydrate metabolism before and after menopause. Presse Med. 1993; 22: 431–435.PubMedGoogle Scholar
  119. 119.
    Boston Collaborative Drug Project. Surgically confirmed gallbladder disease, venous thromboembolism and breast tumors in relation to postmenopausal estrogen therapy. N Engl J Med. 1974; 290: 15–19.Google Scholar
  120. 120.
    Breslau NA. Calcium, estrogen and progestin in the treatment of osteoporosis. Rheum Dis Clin North Am. 1994; 20: 691–716.Google Scholar
  121. 121.
    Riggs BL, Melton LJ III. Clinical heterogeneity of involutional osteoporosis: implications for preventive therapy. J Clin Endocrinol Metab. 1990; 70: 1229–1232.PubMedCrossRefGoogle Scholar
  122. 122.
    Stevenson JC. Pathogenesis, prevention and treatment of osteoporosis. Obstet Gynecol. 1990; 75 (4 suppl): 365–415.Google Scholar
  123. 123.
    Christiansen C, Christensen MS, Transbol I. Bone mass in postmenopausal women after withdrawal of estrogen/ gestagen replacement therapy. Lancet. 1981; 1: 459–461.PubMedCrossRefGoogle Scholar
  124. 124.
    Lindsay R, Aitken JM, Anderson JB, et al. Long-term prevention of postmenopausal osteoporosis by estrogen. Lancet. 1976; 1: 1038.PubMedCrossRefGoogle Scholar
  125. 125.
    Lindsay R, Tohme J. Estrogen treatment of patients with established postmenopausal osteoporosis. Obstet Gynecol. 1990; 76: 220.Google Scholar
  126. 126.
    Ribot C, Tremolliere F, Pouilles JM, et al. Preventive effects of transdermal administration of 17-beta estradiol in postmenopausal bone loss: a 2-year prospective study. Obstet Gynecol. 1990; 75 (4 suppl): 425.Google Scholar
  127. 127.
    Erikssen EF, Colvard DS, Berg NJ, et al. Evidence of estrogen receptors in normal human osteoblast like cells. Science. 1988; 241: 84.CrossRefGoogle Scholar
  128. 128.
    Ernst MC, Schmid C, Frankenfoldt ER, et al. Estradiol stimulation of osteoblast proliferation in vitro: mediator roles for TGF-beta, PGE-2, IGF-1 (abstract). Calcif Tissue Int. 1988; 42 (1 suppl): 117.Google Scholar
  129. 129.
    Girasole G, Sakagami Y, Hustmyer FG, et al. 17 beta estradiol inhibits cytokine induced IL-6 production by bone marrow stromal cells and osteoblasts (abstract). J Bone Miner Res. 1990; 5 (2 suppl): 795.Google Scholar
  130. 130.
    Pacifici R, Rifas L, Vered I, et al. Interleukin-1 secretion from human blood monocytes in normal and osteoporotic women. Effect of menopause and estrogen/progesterone treatment (abstract). J Bone Miner Res. 1988; 3: A541.Google Scholar
  131. 131.
    Feyen JHM, Raisz LG. Prostaglandin production by calvariae from sham operated and oophorectomized rats: effect of beta estradiol in vivo. Endocrinology. 1987; 121: 819.PubMedCrossRefGoogle Scholar
  132. 132.
    Love RR, Mazess RB, Burden HS, et al. Effects of Tamoxifen on bone mineral density in postmenopausal women with breast cancer. N Engl J Med. 1992; 326: 852.PubMedCrossRefGoogle Scholar
  133. 133.
    Maclntyre I, Stevenson JC, Whitehead MI, et al. Calcitonin for prevention of postmenopausal bone loss. Lancet. 1988; 1: 900–902.CrossRefGoogle Scholar
  134. 134.
    Gambrell RD Jr. Prevention of endometrial cancer with progestogens. Maturitas. 1986; 8: 159–168.PubMedCrossRefGoogle Scholar
  135. 135.
    Persson I, Adami HO, Bergkrist L, et al. Risk of endometrial cancer after treatment with oestrogens alone or in conjunction with progestogens: results of a prospective study. Br Med J. 1989; 298: 147–151.CrossRefGoogle Scholar
  136. 136.
    Whitehead MI, Townsend PT, Pryse-Davies J, et al. Effects of estrogens and progestins on the biochemistry and morphology of the postmenopausal endometrium. N Engl 143. J Med. 1981; 305: 1599–1605.Google Scholar
  137. 137.
    Creasman WT, Henderson D, Henshaw W, et al. Estrogen replacement therapy in the patient treated for endometrial cancer. Obstet Gynecol. 1986; 67: 326–330.PubMedGoogle Scholar
  138. 138.
    Kaufman DW, Kelly JP, Welch WR, et al. Noncontraceptive estrogen use and epithelial ovarian cancer. Am J Epidemiol. 1989; 130: 1142.PubMedGoogle Scholar
  139. 139.
    Dupont WD, Page DL. Menopausal estrogen replacement therapy and breast cancer. Arch Intern Med. 1991; 151: 67–72.PubMedCrossRefGoogle Scholar
  140. 140.
    Colditz GA, Stampfer MJ, Willett WC, et al. Prospective study of estrogen replacement therapy and risk of breast cancer in postmenopausal women. JAMA. 1990; 264: 2648.Google Scholar
  141. 141.
    Steinberg KK, Thacker SB, Smith SJ, et al. A meta-analysis of the effect of estrogen replacement therapy on the risk of breast cancer. JAMA. 1991; 265: 1985–1990.PubMedCrossRefGoogle Scholar
  142. 142.
    Colditz GA, Hankinson SE, Hunter DJ, et al. The use of estrogens and the risk of breast cancer in postmenopausal women. N Engl J Med. 1995; 332: 1589–1593.PubMedCrossRefGoogle Scholar
  143. 143.
    Cobleigh MA, Berris RF, Bush T, et al. Estrogen replacement therapy in breast cancer survivors. JAMA. 1994; 272: 540–545.PubMedCrossRefGoogle Scholar
  144. 144.
    Ramikar VA. Compliance with hormone therapy. Am J Obstet Gynecol. 1987; 154: 1332.Google Scholar
  145. 145.
    Lufkin EG, Ory Si. Relative value of transdermal estrogen and oral estrogen therapy in various clinical situations. Mayo Clin Proc. 1994; 69: 131–135.PubMedCrossRefGoogle Scholar
  146. 146.
    Silberstein SD, Merriam GR. Estrogens, progestins, and headache. Neurology. 1991; 41: 786–793.PubMedCrossRefGoogle Scholar
  147. 147.
    Gambrell RD Jr. Management of hormone replacement therapy side effects. J North Am Menopause Soc. 1994; 1: 67–72.Google Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Fran E. Kaiser
  • Margaret-Mary G. Wilson
  • John E. Morley

There are no affiliations available

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