Abstracts
Bone Mineral Density (1)
Bone Mineral Density (1)
Twelve women who had received oestradiol implantation on demand for at least 15 years following hysterectomy with bilateral oophorectomy, underwent bone densitometry of hip and spine.
Bone mass of hip and spine was significantly elevated above that of both the age matched mean to a degree hitherto undocumented.
Oestrogen in high doses or over a long period may produce a true anabolic effect on bone mass.
Wahab M et al., The effect of long-term oestradiol implantation on bone mineral density in postmenopausal women who have undergone hysterectomy and bilateral oophorectomy. Br J Obstet Gynaecol, 1997 Jun, 104:6, 728-31.
Bone Mineral Density (2)
Bone Mineral Density (2)
Assessed the effects of medroxyprogesterone acetate on bone density in women who have had a hysterectomy.
At one year, change in bone mineral density did not differ between either the treatment or placebo groups.
Medroxyprogesterone acetate at either dose as an adjunct to oestrogen did not improve bone mineral density at one year when compared with placebo. Medroxyprogesterone acetate 10 mg may not adversely affect lipids. Medroxyprogesterone acetate 20 mg, however, did reduce high density lipoprotein cholesterol and therefore may increase cardiovascular risk.
Adachi JD et al., A double-blind randomised controlled trial of the effects of medroxyprogesterone acetate on bone density of women taking oestrogen replacement therapy. Br J Obstet Gynaecol, 1997 Jan, 104:1, 64-70.
Bone Mineral Density (3)
Bone Mineral Density (3)
Evaluated the differences in symptoms, hormone and lipid levels, and bone density in two groups of women, all with previous simple hysterectomy.
There were no differences among groups in body mass index, gestations, or deliveries. Depression was more frequent in the hysterectomy group, who also had lower levels of total cholesterol, HDL cholesterol, and FSH than controls.
Hysterectomy does not have a deleterious effect on hormone or lipid levels, nor on bone density, but depression was a frequent finding.
Carranza-Lira S et al., Changes in symptomatology, hormones, lipids, and bone density after hysterectomy. Int J Fertil Womens Med, 1997 Jan-Feb, 42:1, 43-7.
Cardiovascular Risk Factors
Cardiovascular Risk Factors
Tested the effects of declining ovarian hormone levels on cardiovascular risk factors, blood pressure, lipids, weight, and physiological responses to stress.
After surgery, women who had undergone bilateral salpingo oophorectomy (n = 10) had higher levels of atherogenic lipids and stress-induced lipids and tended to have higher circulating levels of epinephrine and stress-induced systolic and diastolic blood pressure than women who had undergone hysterectomy only (n = 19).
Presence of ovarian hormones plays a key role in determining women's risk factor status.
Stoney CM et al., A natural experiment on the effects of ovarian hormones on cardiovascular risk factors and stress reactivity: bilateral salpingo oophorectomy versus hysterectomy only. Health Psychol, 1997 Jul, 16:4, 349-58.
Dietary Fiber
Dietary Fiber
Assessed the effect of high-fiber dietary instruction in relieving chronic constipation, a known and accepted complication of radical hysterectomy (RH).
Postoperatively, the dietary fiber intake was significantly higher for the treatment (T) group (22.9 g) than the control (C) group (12.4 g).
The T group reported:
taking medications to achieve regularity less often
straining less often
having pain with bowel movement (BM) less often and
having crampy abdominal pain less often than the C group.
The T group reported a significant change in the frequency of BM.
The T group took less time to defecate but had more BMs accompanied by gas.
The C group had significantly more BMs with cramps, straining, and retention and significantly more BMs, which were hard.
Dietary management seems to be an inexpensive effective therapeutic intervention for addressing bowel dysfunction associated with RH.
Griffenberg L et al., The effect of dietary fiber on bowel function following radical hysterectomy: a randomized trial. Gynecol Oncol, 1997 Sep, 66:3, 417-24.
Epidemiology (Hysterectomy)
Epidemiology
Data were obtained from the Epidemiologic Follow-up to the First National Health and Nutrition Examination Survey, a nationally representative cohort followed prospectively from the mid-1970s through 1992. Black and white women 25-49 years of age, interviewed during follow-up, were included in the analyses.
The probability of undergoing a hysterectomy was estimated by demographic and reproductive factors. Hysterectomy as confirmed by hospital records was our main outcome measure.
Women who had completed 9-11 years of education were more likely to have undergone a hysterectomy than were women with either more or less education. Women who had completed 9-11 years of education were also more likely to have had a hysterectomy because of menstrual problems.
3 or more miscarriages, especially if caused by uterine prolapse, increased the probability of hysterectomy.
Having had no live births decreased the probability of hysterectomy for menstrual disorders and uterine prolapse, but women who had their first child before age 20 were at increased risk of hysterectomy because of endometriosis.
Hysterectomy appears to be associated with low education, high parity, and a history of multiple miscarriages. The influence of these factors varies depending on the primary indication for the hysterectomy.
Brett KM et al., Epidemiology of hysterectomy in the United States: demographic and reproductive factors in a nationally representative sample. J Womens Health, 1997 Jun, 6:3, 309-16.
Glucose (Hysterectomy)
Glucose
Investigated metabolic changes during and after abdominal hysterectomy with specific regard to glycerol metabolism.
Hysterectomy was associated with an increase of postoperative glycerol turnover from 3.56 +/- 1.28 to 6.46 +/- 2.44 mumol.kg-1.min-1.
This increment was inversely related to the age of the patients.
Glycerol concentration tended to increase perioperatively.
Hepatic glucose production and glucose plasma levels increased postoperatively from 9.75 +/- 1.61 to 12.79 +/- 1.45 mumol.kg-1.min-1 and 4.6 +/- 0.9 to 6.2 +/- 0.9 mmol/L, respectively.
Cortisol and catecholamine levels rose during and after surgery, while insulin and glucagon remained unchanged.
Stable isotope technique allowed a more differentiated look at metabolic pathways than static plasma substrate concentrations, especially under perioperative conditions.
Schricker T et al., Assessment of perioperative glycerol metabolism by stable isotope tracer technique. Nutrition, 1997 Mar, 13:3, 191-5.
Hormone Replacement & LDL Levels
Hormone Replacement & LDL Levels
To test the "lipid"-lowering effects of continuous combined "hormone"-replacement therapy in hypercholesterolemic postmenopausal women.
Total "cholesterol" fell from 261 mg/dL to 250 mg/dL to 233 mg/dL, with LDL reduction from 181 mg/dL to 173 mg/dL to 150 mg/dL, on diet and diet plus continuous combined hormone-replacement therapy, respectively (all P < 0.05).
Whereas 26 of the 32 women had LDL values above 160 mg/dL during the Hi-Sat diet, only 10 of the 32 women remained with LDL values in this range during Step-One diet plus hormone therapy.
Continuous combined hormone-replacement therapy was associated with an increase in high density lipoprotein (HDL) cholesterol levels from 51 mg/dL to 54 mg/dL (P < 0.05). The 2 women whose HDL cholesterol levels were < 35 mg/dL during the Step-One diet plus placebo achieved HDL cholesterol levels > 35 mg/dL during hormone therapy.
Nevertheless, continuous combined hormone-replacement therapy was associated with a high frequency of side effects, including breast tenderness and uterine "bleeding". Most bothersome side effects dissipated after an initial adjustment "period".
Continuous combined hormone-replacement therapy can produce significant and therapeutic reductions in LDL cholesterol levels in hypercholesterolemic postmenopausal women. After internists become familiar with the expected side effects and their time course, this regimen may provide an effective approach in the management of "hypercholesterolemia" in postmenopausal women who have not undergone hysterectomy.
Denke-MA: Effects of continuous combined hormone-replacement therapy on lipid levels in hypercholesterolemic postmenopausal women. Am-J-Med. 1995 Jul; 99(1): 29-35 .
| Signup Free Applied Health Journal |
||||
|
FREE Sample Issue Your email address is all we need to start you on a better path to health. We respect your privacy.
|
