More than a hot flash.
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OBJECTIVE: To assess the efficacy and safety of 17-beta estradiol buccal tablets in reducing hot flush frequency (HFF) in postmenopausal women. METHODS: Estradiol buccal tablets containing 0.05, 0.1, 0.2, or 0.4 mg or placebo were administered for 28 days to 99 postmenopausal women in a randomized, double-blind study; 19 premenopausal women were studied concurrently for comparison of laboratory data. Objective and subjective assessments of HFF were obtained along with measures of estradiol, estrone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). RESULTS: Measurements of HFF revealed significant decreases from baseline in all estradiol groups (P < 0.01). In the 0.4 mg group, HFF decreased significantly compared to placebo (P < 0.01). All estradiol doses produced similar improvement in the vaginal maturation index. Mean serum estradiol levels increased as doses increased but were lower than in the premenopausal subjects. Mean serum FSH and LH levels decreased in all estradiol groups but not to the levels of the premenopausal subjects; the greatest decrease occurred at the two highest estradiol doses. CONCLUSION: A numerical dose-response relationship with hot flushes was seen in this pilot study comparing 0.05, 0.1, 0.2, and 0.4 mg buccal estradiol. Only 0.4 mg 17-beta estradiol significantly reduced the occurrence of hot flushes compared to placebo.
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Hot flushes in climacteric age can cause noticeable discomfort to those who have them. This functional disturbance confirms the strong relationship between the gonadic steroids and the central neurotransmitters. These complex mechanisms which control reproductive functions limit our knowledge of the pathogenesis of hot flushes. The possible intervention of prostaglandins in the rising of this disturbance and their participation in dismenorrhea have raised the hypothesis that the prostaglandins may be the common denominator in the development of dysmenorrhea in fertile age women and of hot flushes in climacteric age women. Under this context, we examined a number of women in menopause to determine if they suffered with dysmenorrhea in fertile age.
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