Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Premenopause”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2005

Management of low bone mineral density in premenopausal women.

OBJECTIVE: To review evidence for management of low bone density in premenopausal women and to establish practical guidelines for management of low bone density in this population by family physicians. METHOD: A search of MEDLINE for relevant articles published between January 1990 and May 2004 was conducted. Articles retrieved were graded by level of evidence. Recommendations for diagnosis and therapy were based on evidence from randomized controlled trials and expert consensus. RESULTS: Low bone density in premenopausal women is not associated with the same increased risk of fracture seen in older women. In the absence of fragility fractures and loss of height, it may be a reflection of low peak bone mass and may represent the normal variation in bone mineral density (BMD). Women may have low bone density secondary to an underlying skeletal or systemic disorder. Common causes of low bone density in premenopausal women include ovulatory disturbances and low body weight. CONCLUSION: Osteoporosis is diagnosed in the premenopausal female population in the presence of fragility fractures and is not based solely on the results of BMD testing. Secondary causes of bone loss should be excluded, and any underlying condition contributing to low bone density should be corrected. Antiresorptive therapy has been evaluated only in those premenopausal women who are on glucocorticoid therapy and in those with primary hyperparathyroidism. Only in these conditions has antiresorptive therapy been shown to improve BMD.

Adult↗
PubMed2002

Reduced bone mineral density in postmenopausal women self-reporting premenopausal wrist fractures.

Postmenopausal fractures are associated with low bone mass; however, the role of low peak bone mass in young adults in determining subsequent osteoporosis suggests that premenopausal fractures may also be relevant. We therefore sought to determine whether a self-reported previous history of premenopausal wrist and nonwrist fractures could also be associated with bone density and therefore be used to predict osteoporosis. We recruited 453 volunteer women with a median age of 64 years (range 50-83 years), with no metabolic bone disease, previous femoral neck fracture, or prevalent vertebral fracture. Bone density at the femoral neck (FN) and lumbar spine (LS) was measured using a Lunar DPX-L. As expected, the 319 women who did not report any fracture had a higher T score at LS (-0.93 +/- 1.44) than the 134 women who reported a previous fracture at any site and at any age (T score -1.60 +/- 1.21, p < 0.001). The findings for the FN were similar. Compared with fracture-free women, the women who reported a first wrist fracture before menopause now had a lower LS T score (-1.77 +/- 1.20, n = 15, p < 0.05), whereas those who reported a nonwrist fracture showed no significant decrease in their LS T score (-1.26 +/- 1.00, n = 36). When both wrist and nonwrist fractures had occurred after menopause, the T score was significantly lower. Twenty percent of the fracture-free women were osteoporosis patients. After adjusting for body weight, age, hormonal replacement therapy (HRT), and hip fracture in the family, the relative risk (RR) of osteoporosis for premenopausal wrist fractures was 2.7 (95% confidence interval 1.4-4.3) vs. 1.2 (0.7-2.4) for women with premenopausal nonwrist fractures. We conclude that self-reported premenopausal wrist fractures, but no other fractures occurring before menopause, are likely to be associated with osteoporosis at 65 years of age, and therefore constitute strong grounds for screening.

Aged↗
PubMed2004

Is the association of birth weight with premenopausal breast cancer risk mediated through childhood growth?

Several studies have found positive associations between birth weight and breast cancer risk at premenopausal ages. The mechanisms underlying this association are not known, but it is possible that it may be mediated through childhood growth. We examined data from a British cohort of 2176 women born in 1946 and for whom there were prospective measurements of birth weight and of body size throughout life. In all, 59 breast cancer cases occurred during follow-up, 21 of whom were known to be premenopausal. Women who weighed at least 4 kg at birth were five times (relative risk (RR)=5.03; 95% confidence interval=1.13, 22.5) more likely to develop premenopausal breast cancer than those who weighed less than 3 kg (P-value for linear trend=0.03). This corresponded to an RR of 2.31 (0.95, 5.64) per 1 kg increase in birth weight. Birth weight was also a predictor of postnatal growth, that is, women who were heavy at birth remained taller and heavier throughout their childhood and young adulthood. However, the effect of birth weight on premenopausal breast cancer risk was only reduced slightly after simultaneous adjustment for height and body mass index (BMI) at age 2 years and height and BMI velocities throughout childhood and adolescence (adjusted RR=1.94 (0.74, 5.14) per 1 kg increase in birth weight). The pathways through which birth weight is associated with premenopausal breast cancer risk seem to be largely independent of those underlying the relation of postnatal growth to risk.

Adolescent↗
PubMed1994

Lactation and a reduced risk of premenopausal breast cancer.

BACKGROUND: The evidence of an association of lactation with a reduction in the risk of breast cancer among women has been limited and inconsistent. The effect of lactation appears to be confined to premenopausal women with a history of long lactation, but most studies of this relation have been limited in statistical power. We conducted a multicenter, population-based, case-control study with a sample large enough for us to describe more precisely the association between lactation and the risk of breast cancer. METHODS: Patients less than 75 years old who had breast cancer were identified from statewide tumor registries in Wisconsin, Massachusetts, Maine, and New Hampshire. Controls were randomly selected from lists of licensed drivers if the case subjects were less than 65 years old, and from lists of Medicare beneficiaries if they were 65 through 74 years old. Information on lactation, reproductive history, and family and medical history was obtained by means of telephone interviews. After the exclusion of nulliparous women, 5878 case subjects and 8216 controls remained for analysis. RESULTS: After adjustment for parity, age at first delivery, and other risk factors for breast cancer, lactation was associated with a slight reduction in the risk of breast cancer among premenopausal women, as compared with the risk among women who were parous but had never lactated (relative risk, 0.78; 95 percent confidence interval, 0.66 to 0.91); the relative risk of breast cancer among postmenopausal women who had lactated, as compared with those who had not, was 1.04 (95 percent confidence interval, 0.95 to 1.14). With an increasing cumulative duration of lactation, there was a decreasing risk of breast cancer among premenopausal women (P for trend < 0.001) but not among postmenopausal, parous women (P for trend = 0.51). A younger age at first lactation was significantly associated with a reduction in the risk of premenopausal breast cancer (P for trend = 0.003). As compared with parous women who did not lactate, the relative risk of breast cancer among women who first lactated at less than 20 years of age and breast-fed their infants for a total of six months was 0.54 (95 percent confidence interval, 0.36 to 0.82). CONCLUSIONS: There is a reduction in the risk of breast cancer among premenopausal women who have lactated. No reduction in the risk of breast cancer occurred among postmenopausal women with a history of lactation.

Age Factors↗
PubMed1996

Comparison of the clinicopathological characteristics of premenopausal and postmenopausal endometrial carcinomas: analysis of endocrinologically evaluated cases.

A study was performed to clarify the clinicopathological differences between premenopausal endometrial carcinoma, which occurs during the reproductive period, and postmenopausal endometrial carcinoma. We analyzed 76 patients with endometrial carcinoma treated in our department between January 1984 and July 1994. Using classification criteria which included menstrual history and results of endocrinological tests (serum FSH, LH and estradiol), 50 (65.7%) patients were defined as postmenopausal, 16 (21.0%) as premenopausal, and 10 (13.1%) as unclassified. From an epidemiologic viewpoint, the incidence of nulliparity was higher in the premenopausal (37.5%) than in the postmenopausal (10%) patients. However, no significant differences were observed between the two groups with regard to the incidence of obesity, diabetes and hypertension. The results of our clinicopathological study revealed that premenopausal endometrial carcinoma had a significantly higher incidence of well differentiated (63.1%) and relatively less advanced (31.1% of cases at stages III and IV) cancers than postmenopausal carcinoma (38% and 46%, respectively). These features were positively correlated with prognosis, i.e., premenopausal patients in general had a much better prognosis than postmenopausal patients.

Adult↗
PubMed1997

Ultrasound bone velocity on proximal phalanges in premenopausal, perimenopausal, and postmenopausal healthy women.

RATIONALE AND OBJECTIVES: The authors studied premenopausal, perimenopausal, and postmenopausal women to determine if ultrasound bone velocity (UBV) on proximal phalanges of women reflect bone changes related to gonadal status and age. METHODS: A total of 166 healthy women-64 postmenopausal women (mean age 58.7 +/- 9.4 years), 41 perimenopausal women (mean age 49.5 +/- 2.9 years), and 61 premenopausal women (mean age 36.8 +/- 7.1 years)-were studied. All the women underwent UBV study of the 2nd to 5th proximal phalanges on the nondominant hand and the mean value of all ultrasound measurements was calculated. RESULTS: The postmenopausal women had a UBV that differed significantly, one-way analysis of variance, from that of the perimenopausal women and premenopausal women (both P < 0.001). The UBV measurements of the perimenopausal women differed significantly from those of the premenopausal women (P < 0.01). Simple linear regression analysis of the relation between UBV and age showed that this was significant and negative in the overall group of women (r = -0.69; P < 0.0001), significant in the perimenopausal (r = -0.66; P < 0.001) and postmenopausal women (r = -0.69; P < 0.001) and nonsignificant in the premenopausal women (r = 0.08; P not significant). In the postmenopausal women, the correlation between UBV and years since menopause was larger (r = -0.71; P < 0.0001) than the correlation between UBV and chronological age. CONCLUSIONS: Ultrasound bone velocity of the phalanx, as a method for measuring changes in bone with age, has a precision that makes it possible to detect changes in bone mass in perimenopausal women and may perform similarly to other bone mass measurements.

Adult↗
PubMed2004

Low bone mineral density in premenopausal women.

With the proliferation of bone densitometers, an increasing number of premenopausal women are having their bone density tested. Approximately 15% of premenopausal women have bone mineral density that is more than 1 standard deviation less than the young-adult mean, and approximately 0.6% are more than 2.5 standard deviation below young-adult mean bone density. Most premenopausal women with low bone density have low peak bone mass, stable bone density, and low short-term absolute risk of fracture. The management of these patients involves nonpharmacologic lifestyle measures and reassurances that fracture risk is low. A minority of premenopausal women with low bone density have increased short-term absolute fracture risk with contributing diseases, conditions, or medications that should be identified and treated. Premenopausal women with fractures are at increased risk for fractures later in life. Methods for evaluating these patients and selecting those who require additional care are reviewed.

Adult↗
PubMed1999

Differences in urinary excretion patterns of the hLH beta core fragment in premenopausal, perimenopausal, and postmenopausal women.

OBJECTIVE: The heterodimeric luteinizing hormone beta core fragment (hLH beta cf) is a highly stable urinary analyte reflective of circulating hLH. It is measured easily because of its high molar content and has none of the multiple isoforms and subunit dissociation problems of LH urinary measurements. As part of a long-term effort to develop new biochemical assays to stage women during the perimenopausal transition, we have examined the patterns of urinary excretion of this metabolite of hLH in premenopausal, perimenopausal, and postmenopausal women. DESIGN: We measured the concentration of the hLH beta cf in 10 consecutive first morning void urine specimens from premenopausal, perimenopausal, and postmenopausal women. Day 1 of collection was the first day of menses in the cycling women. RESULTS: Postmenopausal women exhibited a widely fluctuating pattern of LH beta core fragment excretion, which is not correlated with hLH measured by immunofluorometric assay or with follicle-stimulating hormone measured by immunofluorometric assay. The postmenopausal group was easily distinguished from premenopausal women on the basis of an area-under-the-curve concentration function. Perimenopausal women displayed intermediate hLH beta cf concentrations; some clearly were in postmenopausal ranges, and others were in the premenopausal ranges. CONCLUSIONS: The pattern of excretion and concentrations of the hLH beta cf is significantly different between premenopausal and postmenopausal women. Perimenopausal women exhibited intermediate changes. The capability to measure this type of stable urinary metabolite as a reflection of changes in dynamics of its parent circulating hormone offers new possibilities in the development and application of large-scale testing that does not require blood sampling.

Adult↗
PubMed2004

Detection of benign endometrial masses by endometrial stripe measurement in premenopausal women.

OBJECTIVE: Our objective was to estimate whether a transvaginal endometrial stripe of less than 5 mm in premenopausal women would exclude endometrial polyps and intracavitary leiomyomata, thereby eliminating the need for sonohysterography. METHODS: Data from 206 consecutive sonohysterograms performed in premenopausal women with abnormal uterine bleeding between August 1998 and October 2001 were collected retrospectively. Endometrial stripe measurements were obtained in the sagittal plane before sonohysterography. Baseline endometrial stripe images were reviewed by one of the authors, who was blinded to sonohysterography and pathology results, to evaluate for gross endometrial abnormalities on transvaginal ultrasonography. RESULTS: Endometrial stripe measurements were obtained before sonohysterography in 200 of the 206 consecutive exams in premenopausal subjects. Of the 80 subjects with an endometrial stripe measurement less than 5 mm, 11 had endometrial polyps and 5 had submucosal fibroids on sonohysterography. With an endometrial stripe thickness of less than 5 mm, the sensitivity was 74% (95% confidence interval 62-84), the specificity was 46% (95% confidence interval 38-54), the positive predictive value was 37%, and the negative predictive value was 80%. The detection of pathology was not improved by excluding cases with an abnormal-appearing endometrial stripe on the baseline transvaginal images. The use of other endometrial stripe cutoff values did not improve the diagnostic accuracy. CONCLUSION: Using an endometrial stripe cutoff of 5 mm in premenopausal women would miss significant intracavitary pathology. The sonographic evaluation of abnormal uterine bleeding in premenopausal women should include sonohysterography or equivalently accurate testing regardless of endometrial stripe thickness.

Adolescent↗
PubMedDate not supplied

A case-control study evaluating the association of purposeful physical activity, body fat distribution, and steroid hormones on premenopausal breast cancer risk.

The objective of this case-control study was to investigate the relationship between purposeful physical activity, body fat distribution, body mass index, and steroid hormones. These factors are known to be implicated in modulating breast cancer risk in premenopausal women. A total of 112 newly diagnosed, premenopausal breast cancer patients and 106 age-matched premenopausal disease-free controls were admitted to the study. Information regarding personal, medical, hormonal, and reproductive history, smoking and alcohol use, physical activity history, and anthropometric measurements was obtained. Serum samples for steroid hormone assays were collected and analyzed. Disease-free premenopausal controls had a significantly higher physical activity index (PAI) (p</=0.05), however, significantly higher weight (p</=0.05), body mass index (BMI) (p=0.01), waist (p</=0.005) and hip (p</=0.05) circumferences, waist:hip ratios (p</=0.05), and serum total estradiol levels (p<0.0005) were observed in cancer cases. The final model using stepwise logistic regression analysis indicates that the variables that significantly predicted breast cancer risk were waist:hip ratio (odds ratio [OR]=1.11, p</=0.005) and serum total estradiol levels (OR=1.03, p</=0.0001). Our study provides some evidence that purposeful physical activity may reduce upper body fat distribution associated with adult weight gain. This may be a result of alterations in the steroid hormone pathway, such as reduced estradiol levels. This demonstrates the potential mechanism through which increased physical activity can reduce the risk for breast cancer in premenopausal women.

Adult↗
PubMed2005

Assessment of cerebrocortical regions associated with sexual arousal in premenopausal and menopausal women by using BOLD-based functional MRI.

PURPOSE: The aim of this study was to compare the cerebral regions associated with sexual arousal between premenopausal and menopausal women by using functional magnetic resonance imaging (f MRI). MATERIALS AND METHODS: Ten premenopausal and 10 menopausal women underwent fMRI on a 1.5T MR scanner using the blood oxygen level dependent technique. To identify the activated brain regions associated with sexual response, brain activation was assessed during 1 minute of a nonerotic film, followed by 4 minutes of an erotic film. RESULTS: The overall activation ratios of the premenopausal women were greater than those of the menopausal women by approximately 8% on average. The limbic, temporal association areas, and parietal lobe showed greater enhancement of signal intensities in premenopausal women. However, signal enhancement in the genu of the corpus callosum and superior frontal gyrus was dominant in menopausal women. CONCLUSIONS: The activated brain center associated with visually evoked sexual arousal showed qualitative and quantitative differences between premenopausal and menopausal women.

Adult↗
PubMed2005

Body fatness during childhood and adolescence and incidence of breast cancer in premenopausal women: a prospective cohort study.

INTRODUCTION: Body mass index (BMI) during adulthood is inversely related to the incidence of premenopausal breast cancer, but the role of body fatness earlier in life is less clear. We examined prospectively the relation between body fatness during childhood and adolescence and the incidence of breast cancer in premenopausal women. METHODS: Participants were 109,267 premenopausal women in the Nurses' Health Study II who recalled their body fatness at ages 5, 10 and 20 years using a validated 9-level figure drawing. Over 12 years of follow up, 1318 incident cases of breast cancer were identified. Cox proportional hazards regression was used to compute relative risks (RRs) and 95% confidence intervals (CIs) for body fatness at each age and for average childhood (ages 5-10 years) and adolescent (ages 10-20 years) fatness. RESULTS: Body fatness at each age was inversely associated with premenopausal breast cancer incidence; the multivariate RRs were 0.48 (95% CI 0.35-0.55) and 0.57 (95% CI 0.39-0.83) for the most overweight compared with the most lean in childhood and adolescence, respectively (P for trend < 0.0001). The association for childhood body fatness was only slightly attenuated after adjustment for later BMI, with a multivariate RR of 0.52 (95% CI 0.38-0.71) for the most overweight compared with the most lean (P for trend = 0.001). Adjustment for menstrual cycle characteristics had little impact on the association. CONCLUSION: Greater body fatness during childhood and adolescence is associated with reduced incidence of premenopausal breast cancer, independent of adult BMI and menstrual cycle characteristics.

Adiposity↗
PubMed2001

Combined tamoxifen and luteinizing hormone-releasing hormone (LHRH) agonist versus LHRH agonist alone in premenopausal advanced breast cancer: a meta-analysis of four randomized trials.

PURPOSE: The logic behind the application of luteinizing hormone-releasing hormone (LHRH) agonists in combination with tamoxifen in premenopausal women is that LHRH agonists on the one hand suppress the tamoxifen-induced stimulation of the pituitary-ovarian function and, on the other hand, seem as effective as surgical castration. This meta-analysis combines all randomized evidence to compare the combined treatment with LHRH agonist alone with respect to overall survival, progression-free survival, and objective response in premenopausal women with advanced breast cancer. PATIENTS AND METHODS: Four clinical trials randomizing a total of 506 premenopausal women with advanced breast cancer to LHRH agonist alone or to the combined treatment of LHRH agonist plus tamoxifen were identified. Meta-analytic techniques were used to analyze individual patient data from these trials. RESULTS: With a median follow-up of 6.8 years, there was a significant survival benefit (stratified log-rank test, P = .02; hazards ratio [HR] = 0.78) and progression-free survival benefit (stratified log-rank test, P = .0003; HR = 0.70) in favor of the combined treatment. The overall response rate was significantly higher on combined endocrine treatment (stratified Mantel Haenszel test, P = .03; odds ratio = 0.67). CONCLUSION: The combination of LHRH agonist plus tamoxifen is superior to LHRH agonist alone in premenopausal women with advanced breast cancer. Therefore, if a premenopausal woman with advanced breast cancer is thought to be suitable for endocrine treatment, it is proposed that the combination of a LHRH agonist plus tamoxifen be considered as the new standard treatment.

Antineoplastic Agents, Hormonal↗
PubMed1995

Comparison of markers for bone formation and resorption in premenopausal and postmenopausal subjects, and osteoporosis patients.

Recently, the biochemical markers for bone metabolism have been developed and are expected to reflect the minor change of bone turnover. We compared bone formation markers: alkaline phosphatase-(Alp), bone gla-protein(BGP), carboxy-terminal propeptide of type I collagen(PICP); and bone resorption markers: carboxy-terminal telopeptide of type I collagen(ICTP), pyridinoline(Pyr), deoxypyridinoline(Dpyr) to see if they reflected the effects of aging and menopause in 95 premenopausal and 66 postmenopausal healthy subjects. We also compared the bone turnover in 29 vertebral osteoporosis patients. All markers except ICTP significantly increased with age in the healthy subjects. Alp, BGP, PICP, Pyr, and Dpyr were significantly higher in the postmenopausal group than in the premenopausal group. BGP, Pyr, and Dpyr in premenopausal subjects in their 50s were already significantly increased compared with BGP, Pyr, and Dpyr in premenopausal subjects in their 30s and 40s. To evaluate the discrimination power of the six markers in the postmenopausal subjects and in patients with osteoporosis, the z scores of six markers were calculated against the premenopausal group. z-scores of bone resorption markers(ICTP, Pyr, and Dpyr) were much higher than those of bone formation markers (Alp, BGP, and PICP) in patients with osteoporosis, even though z-scores of bone resorption markers were similar to those of bone formation markers in postmenopausal subjects. In conclusion, Alp, BGP, PICP, Pyr, and Dpyr had good performance in postmenopausal status. Resorption markers increased more than formation markers in osteoporosis subjects, and the bone turnover in osteoporosis subjects was more uncoupled than in postmenopausal subjects.

Adult↗
PubMed2001

Inhaled corticosteroids reduce bone mineral density in early postmenopausal but not premenopausal asthmatic women.

Inhaled corticosteroids are widely used in the treatment of bronchial asthma, but it is still uncertain whether long-term use of the inhaled corticosteroids affects bone metabolism in asthmatic patients. In this study, we examined the effect of inhaled beclomethasone dipropionate (BDP) on bone mineral density (BMD) and biochemical markers of bone metabolism in pre- and early postmenopausal asthmatic women. Thirty-six (17 premenopausal and 19 early postmenopausal) asthmatic women and 45 healthy control (24 premenopausal and 21 early postmenopausal) women were investigated. All the asthmatic patients were treated with BDP (542 +/- 298 microg/day; 100-1200 microg/day) without any systemic administration of corticosteroids for at least 1 year. In premenopausal women, BMD as well as the biochemical markers of bone metabolism did not differ between control subjects and BDP-treated asthmatic patients. By contrast, in early postmenopausal women, BMD was significantly lower in BDP-treated asthmatic patients than in control subjects. In these early postmenopausal women, serum intact osteocalcin concentration was lower in the BDP-treated asthmatic patients than in the control subjects whereas urinary free pyridinoline (F-PYD) and free deoxypyridinoline (F-DPD) concentrations did not differ between the groups. Thus, early postmenopausal, but not premenopausal, asthmatic patients who were treated with inhaled BDP had reduced BMD, which was associated with a decreased level of the bone formation marker. Ovarian hormones may be protective against the adverse effect of inhaled BDP on bone metabolism in the premenopausal patients.

Absorptiometry, Photon↗
PubMed2006

Progressive high-intensity resistance training and bone mineral density changes among premenopausal women: evidence of discordant site-specific skeletal effects.

Regular weight-bearing physical activity has been widely recommended for adult women and may be beneficial in preserving bone mineral density (BMD). However, there is conflicting evidence regarding the effects of resistance training on BMD in premenopausal women. Novel systematic review and meta-analysis evidence is presented on the effects of progressive high-intensity resistance training on BMD in premenopausal women. Structured computer searches of MEDLINE, EMBASE, PubMed, Web of Science, SportDiscus and Evidence Based Medicine Reviews Multifile were undertaken along with hand-searching of key journals and reference lists to locate relevant studies published up to September 2004. Criteria for included studies were published controlled studies and randomised controlled trials (RCTs) evaluating the effects of progressive, high-intensity resistance training studies on BMD in premenopausal women. Two authors reached consensus on all included and excluded studies. Study outcomes for analysis were radiographic BMD assessment from first follow-up at lumbar spine and femoral neck. Primary outcomes for analysis were absolute changes in BMD g/cm(2) at lumbar spine and femoral neck. Relative changes (percentage change) in BMD at lumbar spine were also assessed. Data were extracted from studies including study design, participant characteristics and treatment mode, intensity and duration, using electronic data extraction forms. Where necessary, relevant information was obtained by contacting study authors. Methodological quality of studies was assessed using a well recognised three-question instrument designed to assess bias. Informal assessment for small sample study effects and potential bias was undertaken through visual inspection of funnel plots. The weighted mean difference method (inverse of the variances) was used for combining study group estimates. Quantification of the effect of heterogeneity among study outcomes was assessed using the I(2) statistic. Random effects and fixed-effect models were applied according to observed study heterogeneity. Comparisons resulting in I(2) > 50.0% were considered heterogeneous. Where heterogeneity was observed, a random effects model was applied. Pooled estimates of effect were calculated using the Cochrane Collaboration's Review Manager (RevMan) 4.2.1 software.High-intensity progressive resistance training was shown to be efficacious in increasing absolute BMD at the lumbar spine (p < 0.00001) but not the femoral neck (p = 0.78) in premenopausal women. The weighted mean difference (WMD) using a fixed-effect model for six controlled trials investigating the lumbar spine BMD change was 0.014 g/cm(2) (95% CI 0.009, 0.019; p < 0.00001). The relative BMD change for this site was 0.98% (WMD [random effects], 95% CI 0.49, 3.91%; p = 0.04). In contrast, studies evaluating femoral neck BMD changes showed no significant BMD change (WMD [fixed effect], 0.001 g/cm(2) 95% CI -0.006, 0.008; p = 0.78). Funnel plot inspection of lumbar spine effects indicated that smaller studies demonstrated larger treatment effects. An asymmetry towards studies with positive BMD outcomes was also noted. The methodological quality score of all included studies was low and no study presented a valid intention-to-treat accounting for participant drop-out (attrition). As such, the modest overall treatment effects for resistance training on BMD among premenopausal women observed in this review may be biased and should be interpreted with caution. It is concluded that further RCTs of resistance training of sufficiently long duration and providing optimum type, intensity and volume of loading, with intention-to-treat analysis are now required.

Bone Density↗
PubMed2003

Effect of raloxifene on insulin-like growth factor-I, insulin-like growth factor binding protein-3, and leptin in premenopausal women at high risk for developing breast cancer.

Elevated insulin-like growth factor I (IGF-I) is associated with an increased risk for developing breast cancer in premenopausal women, whereas lower leptin levels have been documented in premenopausal breast cancer cases. We determined the effect of raloxifene on IGF-I, insulin-like growth factor binding protein 3 (IGFBP-3), and leptin in premenopausal women at high risk for developing invasive breast cancer. Twenty-eight premenopausal women (median age 43 years) participating in a pilot breast cancer prevention trial provided 56 matched serum samples. Specimens were collected at baseline and after treatment with 60 mg of raloxifene daily. Median treatment duration was 3 months (range: 6 weeks to 12 months). Samples were frozen at -70 degrees C until analysis. IGF-I, IGFBP-3, and leptin were measured by ELISA. Significance was evaluated by the Wilcoxon signed rank test. Raloxifene administration increased serum IGFBP-3 [mean change 245 ng/ml; P = 0.017; 95% confidence interval (CI), 76-415] and leptin (mean change 2.1 ng/ml; P = 0.005; 95% CI, 0.6-3.7). No significant change in serum IGF-I was detected (mean change 2.6 ng/ml; P = 0.84; 95% CI, -15.4 to 20.6). IGF-I:IGFBP-3 molar ratio was stable (mean change -0.014; P = 0.30; 95% CI, -0.041 to 0.012). Raloxifene administration is associated with an increase in IGFBP-3 and leptin in premenopausal high risk women. Increases in IGFBP-3 may potentially decrease the activity of circulating IGF-I. The effect of modulating the IGF pathway and leptin on breast cancer risk needs additional evaluation.

Administration, Oral↗
PubMedDate not supplied

Cytochrome P450 3A4 activity in premenopausal and postmenopausal women, based on 6-beta-hydroxycortisol:cortisol ratios.

STUDY OBJECTIVE: To characterize cytochrome P450 (CYP) 3A4 activity in premenopausal and postmenopausal women by evaluating the urinary 6-beta-hydroxycortisol:cortisol ratio. DESIGN: Prospective study SUBJECTS: Thirteen premenopausal and 13 postmenopausal women who were healthy and not receiving drugs known to affect CYP3A4 activity INTERVENTIONS: Beginning on day 2 of menses, premenopausal women collected first morning urine samples every other day for a complete menstrual cycle. Postmenopausal women collected first morning urine every other day for 28 days. MEASUREMENTS AND MAIN RESULTS: Mean weekly 6-beta-hydroxycortisol:cortisol ratios did not differ during the phase (week) of the menstrual cycle. Daily ratios did not differ in postmenopausal women. No difference between premenopausal and postmenopausal women was found on comparing overall median ratios. CONCLUSION: Cytochrome P450 3A4 activity as measured by 6-beta-hydroxy cortisol:cortisol ratio did not differ by week of menstrual cycle, suggesting no menstrual cycle-related changes. Menopause does not appear to be associated with differences in CYP3A4 activity, compared with premenopause.

Adult↗