Some clinical effects of oestrogen-progestogen therapy in surgically castrated women.

This study reports some of the effects of oestrogen and progestogen therapy. forty-nine women who had undergone hysterectomy and bilateral salpingo-oophorectomy took part in a double blind crossover study during which they received ethinyl oestradiol 50 micrograms/day, norgestrel 250 micrograms/day, the combination of these substances "Nordiol" and placebo. Somatic complaints were assessed at monthly interviews and weight and blood pressure recorded. The addition of norgestrel to ethinyl oestradiol therapy resulted in less dryness of skin but significantly increased mastalgia and breast size. There were no significant differences between drugs on amount of facial hair, acne, arthralgia, pruritus vulvae, vaginal discharge, vaginal odour, dyspareunia, weight or blood pressure. There was a significant reduction of diastolic blood pressure with the time duration of the study.

PIP: To determine the effects of an estrogen-progestogen therapy in surgically castrated women, a double-blind crossover study was conducted using as sample 49 women (mean age, 46.2 + or - 8.9 years) who had undergone hysterectomy and bilateral salpingo-oophorectomy. The patients were given ethinyl estradiol 50 ug/day, norgestrel 250 ug/day, combination of ethinyl estradiol and norgestrel (Nordiol) and placebo. Initial and monthly assessment of patients included a semi-structured interview detailing frequency and intensity of certain clinical features, psychological tests, and measurement of weight and blood pressure. The combination pill therapy resulted in increased oiliness of skin. It also significantly increased mastalgia and breast size during the 1st 2 months of therapy. Lack of significant effects on complaints such as pruritus vulvae, vaginal discharge or dyspareunia may be due to short time interval of each drug regimen. Longer periods may be required for atrophic changes to develop. Significant reduction in diastolic blood pressure during study period may be due to initial anxiety. Further research with longer periods of hormone administration should be done.

Hormone therapy and affect.

This study investigated the influence of hormone therapy on affect in a double blind crossover trail. The sample consisted of 49 women who had previously undergone hysterectomy and bilateral oophorectomy. Therapy consisted of 3 mth each of ethynyl oestradiol-50 micron/day, levonorgestrel-250 micron/day, "Nordial"-a combination of these two substances, and placebo. Affect was measured by the Hamilton Depression Rating Scale, verbal reports by women and self-ratings on visual analogue scales. Ethinyl oestradiol was found to have a beneficial influence on aspects of affect such as Hamilton scores, anxiety irritability and insomnia. The influence of hormones on Hamilton scores could be partly but not fully explained by the alleviation of hot flushes. Norgestrel showed less favourable changes initially but these tended to diminish by the third therapy month. Most of the women studied were not clinically depressed. Anxiety symptoms were the major features exhibited in the group of women investigated. The results of this study suggest that visual analogue rating scales are of questionable validity in assessing affect in patients without any appreciable psychiatric morbidity.

PIP: This study investigated the influence of hormone therapy on affect in a double blind crossover trial. The sample consisted of 49 women who had previously undergone hysterectomy and bilateral oophorectomy. Therapy consisted of 3 mth each of ethinyl estradiol--50 mcg/day; levonorgestrel--250 mcg/day; "Nordial"--a combination of these 2 substances; and placebo. Affect was measured by the Hamilton Depression Rating Scale, verbal reports by women and self-ratings on visual analogue scales. Ethinyl estradiol was found to have a beneficial influence on aspects of affect such as Hamilton scores, anxiety, irritability, and insomnia. The influence of hormones on Hamilton scores could be partly but not fully explained by the alleviation of hot flushes. Norgestrel showed less favorable changes initially but these tended to diminish by the 3rd therapy month. Most of the women studied were not clinically depressed. Anxiety symptoms were the major features exhibited in the group of women investigated. The results of this study suggest that visual analogue rating scales are of questionable validity in assessing affect in patients without any appreciable psychiatric morbidity.

Treatment effectiveness of hypnosis and behaviour therapy in smoking cessation: a methodological refinement.

Studies in smoking cessation have generally failed to adequately control for active treatment effects and have assumed that measures of smoking behaviour (i.e., estimated smoking rate, self-monitoring and chemical analysis) are equally reliable measures. Sixty smokers were randomly assigned to one of four different smoking cessation treatment groups: hypnosis, focussed smoking, attention placebo and a waiting list control. Subjects were asked to estimate and monitor their own smoking behaviour. Blood samples were also taken for thiocyanate analysis before treatment. Smoking rates were similarly measured directly, at 3 months and 6 months after treatment. The results indicate that the three measures of smoking behaviour were all highly correlated. No significant differences were found between treatments, directly after treatment or at the 3- and 6-month follow-ups. These results suggest that active treatment effects may not be responsible for behavioural change in a smoking cessation program. The implications of these findings are discussed.