Baseline Mental Health and Psychosocial Functioning of Transgender Adolescents Seeking Gender-Affirming Hormone Therapy.

OBJECTIVE: Research suggests that adolescents seeking gender-affirming hormone therapy experience elevated rates of depression, anxiety, and difficulties with peer relationships. Less is known regarding more specific aspects of mental health and psychosocial functioning. Furthermore, few studies have explored variations in mental health and psychosocial functioning by age, gender, degree of physical dysphoria, and informant type (adolescent, mother, and father). METHOD: Participants are adolescents (n = 149) and parents/guardians (n = 247) who presented to a multidisciplinary gender clinic in Dallas, TX for an initial assessment before initiation of gender-affirming hormone therapy. Adolescents completed the Youth Self-Report (YSR) and the Body Image Scale (a measure of physical dysphoria), and parents/guardians completed the Child Behavior Checklist (CBCL). RESULTS: Approximately half of participants reported clinically significant difficulties with internalizing symptoms and psychosocial functioning (particularly engagement in activities), with approximately one-third indicating significant difficulties with depression, anxiety, obsessive compulsive, and posttraumatic stress symptoms. Parents reported fewer symptoms than adolescents across several subscales, but differences were generally small. By contrast, gender differences were found across all internalizing subscales and were generally large. Age and body dissatisfaction were not independently associated with broadband measures but, in combination with gender, were strongly associated with variance in YSR and CBCL reports of internalizing symptoms. CONCLUSION: Elevated rates of depression, anxiety, and competency difficulties were broadly consistent with the previous literature and demonstrate the need for investment in the clinical training and infrastructure to provide comprehensive care to this population. Differences in mental health and psychosocial functioning by gender and clinic location appear to be less straightforward.

Identifying Predictors of Prolonged Levothyroxine Dose Adjustment After Thyroidectomy.

BACKGROUND: Levothyroxine (LT4) is one of the most prescribed drugs in the United States; however, many patients started on LT4 after thyroidectomy suffer from symptoms of hyper- or hypo-thyroidism before achieving euthyroidism. This study aims to describe the time required for dose adjustment before achieving euthyroidism and identify predictors of prolonged dose adjustment (PDA+) after thyroidectomy. METHODS: This is a single institution retrospective cohort study of patients who achieved euthyroidism with LT4 therapy between 2008 and 2017 after total or completion thyroidectomy for benign disease. Patients who needed at least three dose adjustments (top quartile) were considered PDA+. Binomial logistic regression was used to identify predictors of PDA+. RESULTS: The 605 patients in this study achieved euthyroidism in a median of 116 d (standard deviation 124.9) and one dose adjustment (standard deviation 1.3). The 508 PDA- patients achieved euthyroidism in a median of 101 d and one dose adjustment. The 97 PDA+ patients achieved euthyroidism in a median of 271 d and three dose adjustments. Iron supplementation (odds ratio = 4.4, 95% confidence interval = 1.4-13.5, P = 0.010) and multivitamin with mineral supplementation (odds ratio = 2.4, 95% confidence interval = 1.3-4.3, P = 0.004) were independently associated with PDA+. Age, gender, preoperative thyroid disease, and comorbidities did not independently predict PDA+. CONCLUSIONS: After thyroidectomy, achieving euthyroidism can take nearly 4 mo. Iron and mineral supplementation are associated with PDA+. This information can inform the preoperative counseling of patients and suggests that this may expedite achieving euthyroidism.

Coffee consumption and risk of endometrial cancer: a dose-response meta-analysis of prospective cohort studies.

This is a dose-response (DR) meta-analysis to evaluate the association of coffee consumption on endometrial cancer (EC) risk. A total 1,534,039 participants from 13 published articles were added in this meta-analysis. The RR of total coffee consumption and EC were 0.80 (95% CI: 0.74-0.86). A stronger association between coffee intake and EC incidence was found in patients who were never treated with hormones, 0.60 (95% CI: 0.50-0.72), and subjects with a BMI ≥25 kg/m(2), 0.57 (95% CI: 0.46-0.71). The overall RRs for caffeinated and decaffeinated coffee were 0.66 (95% CI: 0.52-0.84) and 0.77 (95% CI: 0.63-0.94), respectively. A linear DR relationship was seen in coffee, caffeinated coffee, decaffeinated coffee and caffeine intake. The EC risk decreased by 5% for every 1 cup per day of coffee intake, 7% for every 1 cup per day of caffeinated coffee intake, 4% for every 1 cup per day of decaffeinated intake of coffee, and 4% for every 100 mg of caffeine intake per day. In conclusion, coffee and intake of caffeine might significantly reduce the incidence of EC, and these effects may be modified by BMI and history of hormone therapy.

Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia.

This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P < .001), age between 50 and 54 years (P < .01), lower self-health rating (P < .05), education level of diploma or professional degree (P < .05), employment as professionals or entrepreneurs (P < .05), and the use of hormone replacement therapy (P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654).

Application of the 10-item Cervantes Scale among mid-aged Ecuadorian women for the assessment of menopausal symptoms.

BACKGROUND: The majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture. OBJECTIVE: To assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10). METHOD: This was a cross sectional study in which a total of 451 Ecuadorian women (40-59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data. RESULTS: Median age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores. CONCLUSION: In this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects.

The use of complementary and alternative medicine by women transitioning through menopause in Germany: results of a survey of women aged 45-60 years.

OBJECTIVES: To describe prevalence rates of complementary and alternative medicine therapies (CAM) for the relief of menopausal complaints among German women. Furthermore, to investigate the perceived effectiveness of these therapies. DESIGN: A self-administered questionnaire was sent to 9785 randomly selected women in Germany aged between 45 and 60 years. RESULTS: A total of 1893 (19.3%) questionnaires have been sent back. The mean age of all participants was 52.6±4.3 years. 81% (n=1517) of the responding women stated that they had experienced menopausal complaints at least once. Symptoms ranged from vasomotor symptoms, including hot flushes and night sweats, in 71.2% of cases, to bladder problems in 42.7%. The average symptom score (MRS II total score, range 1-44) among the respondents was 12.76±9.6. More than half (56%; n=1049/1872) of the responding women had used some form of therapy to alleviate their symptoms at least once. The majority of women undertaking a therapy (64.8%; n=679/1049) had used only CAM interventions (either one or more type of CAM), 14.2% (n=149) had used hormone replacement therapy (HRT) only, while 21.1% (n=221/1049) had tried both CAM and HRT. Popular CAM interventions by the respondents were an alteration of lifestyle (28.7%), St. John's wort (18.3%) and homoeopathy (14.9%). An alteration in lifestyle was rated as the most effective CAM treatment with 84.9% (n=457). Other treatments like hormone yoga (79.2%; n=42), homoeopathy (73.7%; n=205) and TCM (59.1%; n=94) were also perceived to be effective. Phytoestrogens were rated as the most ineffective (45.5%; n=50). CONCLUSION: CAM interventions to alleviate menopausal complaints are popular among German women, with 48.2% (n=900/1872) of respondents reporting having used CAM either alone or in combination with HRT. However, the users rated the effects of CAM differently, with some reporting CAM to be highly effective, while others indicate lower effectiveness. Nevertheless, women with a significantly higher symptom scoring tend to use both CAM and a conventional therapy (HRT).

"Symptom-specific or holistic": menopausal symptom management.

Our purpose in this study was to identify differences in menopausal symptom management among four major ethnic groups in the United States. This was a secondary analysis of the qualitative data from a larger Internet-based study. We analyzed data from 90 middle-aged women in the United States using thematic analysis. We extracted four themes during the data analysis process: (a) "seeking formal or informal advice," (b) "medication as the first or final choice," (c) "symptom-specific or holistic," and (d) "avoiding or pursuing specific foods." Health care providers need to develop menopausal symptom management programs while considering ethnic differences in menopausal symptom management.

Menopausal hormone therapy and risk of ovarian cancer in the European prospective investigation into cancer and nutrition.

The association between menopausal hormone therapy (HT) and risk of ovarian cancer was assessed among 126,920 post-menopausal women recruited into the European Prospective Investigation into Cancer and Nutrition. After an average of 9-year follow-up, 424 incident ovarian cancers were diagnosed. Cox models adjusted for body mass index, smoking status, unilateral ovariectomy, simple hysterectomy, age at menarche, number of full-term pregnancies, and duration of oral contraceptives were used. Compared with baseline never use, current use of any HT was positively associated with risk (HR [hazard ratio], 1.29; 95% CI [confidence interval], 1.01-1.65), while former use was not (HR, 0.96; 95% CI, 0.70-1.30). Current estrogen-only HT was associated with a 63% higher risk (HR, 1.63; 95% CI, 1.08-2.47), while current estrogen plus progestin was associated with a smaller and non-significant higher risk (HR, 1.20; 95% CI, 0.89-1.62). Use of tibolone was associated with a twofold greater risk (HR, 2.19; 95% CI, 1.06-4.50), but was based on small numbers. In conclusion, women who currently use HT have a moderate increased risk of ovarian cancer, and which may be stronger for estrogen-only than estrogen plus progestin preparations.

Adaptive senectitude: the prolongevity effects of aging.

In the past, it has been assumed that all the biological and medical changes that occur in old age are deleterious. It has therefore been concluded that treatment and prevention of such changes in old age should increase healthspan and delay death. However, accruing epidemiological and clinical trial evidence in older humans suggests that this is not the case. Some studies have shown that antioxidants and hormone supplements increase mortality, whereas high blood pressure, obesity, and metabolic syndrome are often associated with improved outcomes in very elderly people. Perhaps, some of these supposedly detrimental changes accompanying old age are in fact evolutionary adaptations to prolong life after reproduction in humans. Indeed, a form of reverse antagonistic pleiotropy or adaptive senectitude might be occurring. Some common biological and medical changes in old age might actually enhance longevity and represent novel targets for improving health in older people.

Changes in hormone therapy prescriptions among middle-aged women in Taiwan: implications for health needs at menopause.

BACKGROUND: From the 1990s until 2002, hormone therapy (HT) was a popular treatment for menopausal syndrome in middle-aged women. Since the Women's Health Initiatives (WHI) studies in 2002 warned that the risk of HT might exceed its benefits, there has been a reduction in its use worldwide, including in Taiwan. Many studies reported this decline, but few discussed whether HT may or may not fulfill menopausal women's health needs. This study examines the changes in HT prescriptions and other measures by menopausal women in Taiwan and the implications of these changes in relation to their needs. METHODS: This study analyzes annual and monthly rates of HT prescription and outpatient care utilization among Taiwanese women in the 45- to 64-year-old age group. It is based on medical claims data of the Taiwan National Health Insurance Programs from 2000 to 2004. RESULTS: The data showed that HT was the prevailing treatment for menopausal syndrome before the WHI publications. The rate of HT prescription increased annually, peaking in 2001 at 21.6%, but declined from 2002 to 9.7% in 2004. At the same time, the number of Taiwanese women seeking traditional Chinese medicine for the menopausal syndrome increased. CONCLUSION: HT prescriptions in Taiwan declined significantly after the WHI reports, demonstrating the elasticity of the need for HT. But utilization data in Taiwan showed that attendance at outpatient clinics at menopause remained constant and the use of traditional Chinese medicine increased. Further studies should investigate health needs from menopausal women's perspectives to develop appropriate measures to meet their needs.

Hormone therapy discontinuation: physician practices after the Women's Health Initiative.

OBJECTIVE: No guidelines or randomized trials address best practices for hormone therapy (HT) discontinuation. METHODS: We conducted a survey study to explore HT discontinuation practices at Group Health and Harvard Vanguard, large integrated health systems in the Northwest and Northeast United States, focusing on differences between specialties and study site. RESULTS: The response rate to the written questionnaire (mailed between December 2005 and May 2006) was 78.5% (736/928); this article reports the results for 483 eligible physicians. To discontinue oral HT, most physicians (91%) advised tapering, not immediate cessation (8%), and most (60%) suggested decreasing both dose and days per week. Almost 60% of physicians reported no experience with tapering patches. Harvard Vanguard physicians were more likely than Group Health physicians to encourage discontinuing HT and less likely to recommend resuming HT when a woman's symptoms returned after discontinuing HT. Physicians were most strongly influenced by their own experience (48%), advice from colleagues (25%), and the woman's preference (19%) when choosing a discontinuation strategy; only 2% relied on research evidence. Physicians endorsed various approaches to manage symptoms after HT discontinuation, most often behavioral changes (44%) and increased exercise (37%), and these approaches were more often endorsed by Harvard Vanguard physicians and obstetrician/gynecologists than Group Health physicians or family practitioners or internists. CONCLUSIONS: Two health plans in the Northwestern and Northeastern United States have no standard protocol for HT discontinuation. Physicians customized approaches, influenced by their location, colleagues, and specialty. Research is needed to guide approaches to HT discontinuation.

Changes by age in breast cancer incidence, mammography screening and hormone therapy use in France from 2000 to 2006.

BACKGROUND: In 2003, US breast cancer incidence rates fell. Recent French data reveal also a decline in 2005-2006. This study aims to present the trends in breast cancer incidence by age and to identify the respective impact of mammography screening and use of hormone replacement therapy (HRT) in the French context. METHODS: Breast cancer incidence rates were calculated from the new cases of breast cancer among affiliates of the general scheme of the French National Health Fund between 2000 and 2006. Data concerning HRT and mammograms were extracted from the reimbursement databanks of the National Health Fund and from the National Screening Programme. RESULTS: Breast cancer incidence decreased between 2003 and 2006 only for women aged 50 or above. The strongest declines were observed among the 55-59 and 60-64-year-old groups (12.9 and 7.7%, respectively). We observed a slight decline in the age groups of 50-54 and 65-69 (0.7 and 2.1%, respectively). Volumes of mammograms increased continuously between 2000 and 2006 from 1,600,000 to 3,470,000 for women aged 50-74 years old. In 2004, the National Screening Programme achieved complete geographic coverage. At the same time, the number of HRT users has dropped by 62% between 2001 and 2006. We observed the highest prevalence of HRT and the highest decrease in breast cancer incidence rates in the age group of 55-59. CONCLUSIONS: The recent reduction in breast cancer incidence in France for women aged 50 years or above, in 2005-2006, was accompanied by a substantial reduction in HRT prescriptions after 2002 for all age groups. The drop in HRT parallels the drop in breast cancer incidence for the women between the ages of 55-59 and 60-64. The high-level of development of screening in France during the same period could not account for the reduction in breast cancer incidence.

Agreement of self-reported estrogen use with prescription data: an analysis of women from the Kuopio Osteoporosis Risk Factor and Prevention Study .

OBJECTIVE: Self-reported data are usually used for the evaluation of the effects of hormone therapy in population studies. We examined the agreement between self-reported hormone therapy use and nationwide prescription data from the Social Insurance Institution of Finland to evaluate the accuracy of self-reports. DESIGN: The 10-year questionnaire of the population-based Kuopio Osteoporosis Study was sent in 1999 to 12,562 women aged 57 to 67 years; 11,377 women who completed questionnaires were eligible for analysis. We asked women whether they had been taking estrogen hormone therapy as a gel, plaster, or tablet for the treatment of climacteric symptoms or osteoporosis and if the answer was yes, to specify the brand and duration of treatment for each year from 1994 to 1999. RESULTS: Among the 11,377 women, 3,105 (27.3%) reported the use of an estrogen-based preparation in 1996 to 1999, and 97.6% were confirmed by Social Insurance Institution of Finland to have been prescribed hormone therapy during that time. In these women the median duration of use was 32 months (range, 1-41), according to Social Insurance Institution of Finland data. An additional 1,738 women had been prescribed hormone therapy for short periods, but those women did not report it. The duration of self-reported hormone therapy use was compared to the duration of prescriptions. A difference of 3 months or less per year was observed in 63.4% to 77.0% of women during the years 1996-1998. CONCLUSIONS: A postal inquiry is a reliable method of recording long-term hormone therapy use.

Healthcare seeking and treatment for menopausal symptoms in the United States.

OBJECTIVES: A population-based study was used to describe healthcare seeking behavior for menopausal symptoms and treatment among women 40-65 years old in the United States. METHODS: Participants were recruited into the Menopause Epidemiology Study from the KnowledgePanel(SM), which is selected by random digit dialing and probability sampling from the US population. From this source, 6201 women 40-65 years old were contacted and 4402 women participated. From the 3135 peri- and postmenopausal women, detailed information was obtained on menopausal symptoms, healthcare seeking, medication usage, and symptom relief from the medication. RESULTS: Many women (60%) reported seeking health care for their menopausal symptoms. More than half of these women sought health care in the past 12 months. Vasomotor symptoms were the most frequently reported menopause symptoms across all races/ethnicities, and the most common symptoms discussed with a health care professional. One-third of the women (34%) used only hormone therapies, 12% used complementary and/or alternative medicines, and 16% used both for treatment of menopausal symptoms. CONCLUSIONS: This study has shown that a large number of women consult healthcare providers for menopausal symptoms, indicating these symptoms are bothersome. Yet, in the United States, there is considerable variation in the symptomatology, healthcare seeking, and use of therapies for menopausal symptoms across cultures. To alleviate these symptoms women have tried alternative treatments as well as hormone therapies, yet many women did not get complete relief of specific symptoms.

Osteoporosis treatment for patients with stroke.

PURPOSE: Little is known about the frequency of use of medications to maintain bone health for patients with stroke. This study was undertaken at an urban academic rehabilitation center to determine the prevalence of use of agents that could reduce bone loss in the stroke population. METHOD: A clinical database was searched for all patients 18 years old and over with stroke. The sample included 1,219 inpatients and 2,776 outpatients. Demographic information (age, gender, and race) and medications were obtained for each patient. RESULTS: Among inpatients with stroke, 7.1% were taking osteoporosis medications (bisphosphonates, calcitonin, parathyroid hormone, or hormone replacement therapy), 11.3% were taking calcium supplements, 5.9% were taking vitamin D supplements, and 45.1% were taking multivitamin supplements. Among outpatients with stroke, 5.7% were taking osteoporosis medication, 5.8% were taking calcium supplements, 2.2% were taking vitamin D supplements, and 16.0% were taking multivitamin supplements. Patients being treated with specific osteoporosis therapies tended to be older and female by calculated odds ratios. The use of multivitamins was not related to age, gender, or race. CONCLUSION: Overall, relatively few stroke patients were taking osteoporosis medications or supplements. There is a need to increase the recognition, prevention, and treatment of bone loss in this high-risk population.

Evolving practice patterns and attitudes toward hormone therapy of obstetrician-gynecologists.

OBJECTIVE: The objective of this study was to examine the opinions and prescribing practices of obstetrician-gynecologists regarding hormone therapy (HT) and the results from the Women's Health Initiative. DESIGN: Surveys were sent to 2,500 randomly selected American College of Obstetrics and Gynecology fellows during December 2004 to March 2005; their responses are compared with those from a survey conducted in November to December 2003. RESULTS: Respondents remained skeptical of the combined HT results (49.1% did not find the results convincing). Compared with the 2003 survey, men were more skeptical (58.8% did not consider the findings convincing in 2004 vs 53.4% in 2003, P = 0.045), and women were somewhat less skeptical (39.5% did not consider the findings convincing in 2004 vs 45.3% in 2003, P = 0.056). There was less skepticism about the estrogen-only trial, although 4 of 10 did not find the results convincing. Men were more skeptical than women; a majority of men disagreed with the decisions to stop the trials. Physicians who completed their residency more recently were more likely to accept the trial results. Respondents reported a reduction in HT prescription practice relative to the year 2000, but 62.7% reported they did not expect their prescribing practices to change further in the near future. The proportion of respondents who considered alternative therapies to HT as viable treatment options increased between 2003 and 2004 (37.1% vs 28.1%, P < 0.001). There was strong support for the use of HT for vasomotor symptoms, vaginal dryness, and osteoporosis, but most physicians did not consider HT useful for cardiovascular disease or dementia. CONCLUSIONS: Many obstetrician-gynecologists continue to express skepticism about the results and conduct of the Women's Health Initiative trials. The survey could not determine the reasons for skepticism.

Beliefs about medicines among Swedish pharmacy employees.

OBJECTIVE: The aim of this study was to describe the beliefs about medicines among pharmacy employees. A further aim was to analyse whether these beliefs were associated with any background characteristics, such as age, professional category or medication use. METHOD: The study subjects were pharmacy employees at 24 community pharmacies in Göteborg, Sweden. The participating pharmacies had a total of 372 employees (pharmacists, dispensing pharmacists, and pharmacy technicians). Data was collected at the weekly pharmacy information meetings with a questionnaire comprising background questions and the Beliefs about Medicines Questionnaire (BMQ). The general part of the BMQ was used. For each statement in the BMQ, respondents marked their degree of agreement on a five-point Likert scale (1=strongly disagree, 2=disagree, 3=uncertain, 4=agree and 5=strongly agree). MAIN OUTCOME MEASURE: The three subscales of BMQ General: General Harm, General Overuse and General Benefit. RESULTS: The majority of the 292 respondents were dispensing pharmacists. More than half of the respondents were aged 45 years or older and had worked in a pharmacy for 20 years or more. Compared to the other professional categories, a higher proportion of dispensing pharmacists stated that they currently used traditional medicines. The pharmacy employees had a mean score for General Benefit of 4.31 and a mean score for General Harm of 1.81. Pharmacists and dispensing pharmacists in general regarded medicines as somewhat more beneficial, whereas pharmacy technicians viewed medicines as slightly more harmful. Those who had worked in a pharmacy for 30-34 years regarded medicines as less harmful compared to those who had worked 0-4 years. Compared to non-users, current users of prescription drugs regarded medicines as more beneficial. When controlling for background characteristics, no confounders were detected for any of the three subscales (ANCOVA analyses). CONCLUSION: Results of the study of 292 Swedish pharmacy employees show that they regard medicines as beneficial rather than harmful and that there are differences in beliefs between the professional categories. However, the reasons for these differences remain unclear. Nevertheless, the positive beliefs among pharmacy employees may have an impact on the communication with clients and, eventually, clients' adherence to medicines.

Postmenopausal hormone therapy: who now takes it and do they differ from non-users?

BACKGROUND: Considerable changes in hormone therapy use have taken place in the last few years. AIMS: To determine current usage of postmenopausal hormone therapy and assess the trend and rate of change in hormone therapy usage over the last 13 years. Additionally, to assess differences between current users and non-users for health-related and risk factor variables. METHODS: Questions regarding hormone therapy use have been included in an annual face to face population health survey of South Australians eight times since 1991. In 2004, additional questions on health status and quality of life were included. RESULTS: In 2004, current use of hormone therapy was 15.4, 19.8 and 31.2% in all women over 40, 50 and 50-59 years, respectively. Ever use of hormone therapy among all women over 50 years was 46.5% with a mean duration of use of 7.46 years. Hormone therapy users did not differ from non-users in chronic disease indicators, body mass index, complementary medicine or therapist use, other health service use, socioeconomic status or quality of life. Increased hormone therapy use was associated with higher income, better educated, employed and married women in their sixth decade. Current use has varied over the years, with an increase to 2000, but a drop in 2003 and 2004. CONCLUSION: Apart from menopausal symptoms, there is no evidence to support differences between users and non-users in terms of quality of life or health characteristics, requiring more appropriate selection of women for hormone therapy.

[The influence of hygiene and health habits on the concentration of some ions in saliva of postmenopausal women]. / Wplyw nawyków higieniczno-zdrowotnych na zawartosc wybranych jonow w slinie kobiet po menopauzie.

PURPOSE: The study was designed to evaluate the influence of tooth-brushing, milk consumption, hormone therapy, allergy, and cigarette smoking on the content of fluoride, calcium, magnesium and phosphorus in saliva. MATERIAL AND METHODS: Unstimulated saliva samples were collected from 100 women aged 48-70 years. Biochemical analysis was done to measure ion content. A questionnaire was used to determine hygiene and health habits. Correlation analysis was done to determine the relationships between parameters. CONCLUSIONS: A significant correlation was observed between ion content in saliva and frequency of tooth-brushing, smoking, and use of oral contraceptives. More frequent tooth-brushing was associated with reduced salivary content of calcium and phosphorus. Significantly higher salivary calcium levels were observed in smokers than non-smokers. Oral contraceptives produced significantly higher concentrations of fluoride ions in saliva. No correlation was noted between ion content in saliva and milk consumption, hormone replacement therapy (HRT), or allergy.

[Menopause, hormone therapy and alternative medicine:. A cross-sectional study in Roskilde County in 1998]. / Overgangsalder, hormontilskud og naturmedicin. Tvaersnitsundersogelse i Roskilde Amt 1988.

INTRODUCTION: The aim of this study was to determine how many women use alternative medicine to alleviate menopausal symptoms and how often they feel relieved of those symptoms. We also examined whether there was a negative correlation between the use of alternative medicine and the use of hormone therapy, as well as whether there was any correlation between the use of alternative medicine and self-rated health status. MATERIALS AND METHODS: An anonymous postal questionnaire was sent to 5,300 women older than 44 years in Roskilde County, Denmark. The public health insurance in Roskilde County picked 100 woman at random for each of the 53 general practitioners, who entered the survey in 1998. 72% answered the questionnaire. RESULTS: 24% (95%; C.I. 22-26%) used alternative medicine either formerly or currently. 54% felt that their symptoms had been relieved by the alternative medicine. More women who had formerly used hormone therapy were using alternative medicine currently or formerly (OR 2.5; 95% C.I. 1.9-3.4 for ages 45-59 and OR 3.9; 95% C.I. 2.6-6.0 for ages 60+) than women who had never used hormone therapy. Some women were using alternative medicine and hormone therapy at the same time, although fewer current users of hormone therapy aged 45-59 years were also using alternative medicine (OR 0.5; 95% C.I. 0.3-0.8) than were those who never had used hormone therapy. Fewer former users of alternative medicine reported good plus very good (OR 0.7; 95% C.I. 0.6-0.9) or very good (OR 0.6; 95% C.I. 0.5-0.8) self-rated health status than those who had never used alternative medicine. DISCUSSION: Women who had formerly used hormone therapy used alternative medicine more often than women who had never used hormone therapy. Women who had formerly used alternative medicine tended to report lower self-rated health status than women who had never used alternative medicine.