Acta Obstetricia Et Gynecologica Scandinavica

Samsioe, Göran; Bryman, Inger; Ivarsson, Elisabeth

doi: 10.3109/00016348509157139pmid: 3160210

Abstract. The female climacteric is known from the literature for centuries. Certain signs are obvious, but some symptoms are deliberately concealed by many women as they are regarded askance by herself and by society at large. Only very recently did knowledge of the psychological and physiological processes involved in the female climacteric reach the point of medical science. This has been accompanied by a more open attitude on the part of society towards climacteric problems of various kinds. The number of newspaper articles dealing with the climacteric, books with advice for climacteric women and courses on the management of climacteric symptoms is steadily growing. The fear for and the fear of climacteric symptoms have therefore declined among the population and a substantial number of women now consult their doctors to obtain relief. For Sweden, only the last decade has involved programmes for climacteric women. Such programmes comprise not only hormonal replacement therapy but also in addition attempts to increase knowledge among women and in society as well as efforts to obtain a social, psychological and physical wellbeing.

Nilsson, Lars

doi: 10.3109/00016348509157140pmid: 3925705

Abstract. Follicular function starts in the foetal ovary in the 20th week of gestation and continues until or shortly past the menopause. Luteal steroid production occurs only during the fertile period. After the menopause only stromal steroid production continues in the ovary and is probably increased by the increase in gonadotropin levels. The changes in hormonal levels and effects in the pre‐, peri‐ and postmenopausal years are described as a function of these changes.

Hällström, Tore; Samuelsson, Sverker

doi: 10.3109/00016348509157141pmid: 3859970

Abstract. A representative sample of 899 middle‐aged urban Swedish women underwent a psychiatric interview on two occasions with 6 years between studies (waves). The point prevalence of all mental disorders was 39.9% at the first wave and 39.0% at the second. The corresponding one‐year onset rates of all mental disorders were 18.0% and 14.2%. No significant differences were found between ages or between waves. Major depressive episodes accounted for about half of the psychiatric morbidity. Those women whose menopause started early were more often mentally impaired than others and they also tended to have been more often impaired even before the climacteric (ages 30‐39).

Bäckström, Torbjörn; Bixo, Mari; Hammarbäck, Stefan

doi: 10.3109/00016348509157142pmid: 3859971

Abstract. Ovarian steroid hormones are frequently used in clinical practice. Postmenopausal replacement therapy and oral contraception are both based on the effects of the ovarian steroids. Mental side effects have often been reported, especially in relation to oral contraceptives. In that context it is of course of importance to collect knowledge about the influence ovarian steroid hormones have on the brain. The present review discusses the natural hormones estradiol and progesterone and some of their metabolites. Knowledge of the effects of synthetic estrogen and progestagen derivatives is very limited and will be mentioned only briefly.

Schoultz, Bo

doi: 10.3109/00016348509157143pmid: 3859972

Abstract. Estrogen substitution around the menopause has rapidly become a major indication for hormonal treatment and its benefits are obvious to the clinician. A prompt relief of vasomotor symptoms generally occurs during treatment and nervous and sexual disorders often improve considerably. Regardless of which one of the numerous estrogen treatment regimens available is used, it enables many women to cope better with their daily life. On the other hand all estrogens, when given in sufficient therapeutic amounts, will also produce a systemic metabolic response. Effective estrogen treatment thus gives rise to a multitude of biological effects in many different organs and systems. At present, one main problem is the difficulty of quantifying both beneficial effects and hazards. Furthermore it is often difficult to distinguish the valid symptoms of estrogen deficiency from those of ageing and the effects of social, environmental and emotional problems of the middle‐aged woman.

Staland, B.

doi: 10.3109/00016348509157144pmid: 3859973

Abstract. Nearly 5 years' experience of continuous treatment with a preparation consisting of natural estrogens combined with norethisterone acetate is presented. The effect on both climacteric symptoms and hormonal parameters was good, even though the endometrium remained atrophic or became so. This was the case even when the endometrium was hyperplastic and/or atypical prior to treatment. This treatment appears to be better than those in common use—at least in selected cases.

Lapidus, Leif; Bengtsson, Calle; Lindquist, Olof

doi: 10.3109/00016348509157145pmid: 3859974

Abstract. A longitudinal population study of 1 462 women initially aged 38‐60 has been proceeding in Gothenburg, Sweden since 1968. The results presented in this paper deal with menopausal age in relation to cardiovascular disease and overall mortality and refer to the initial 12‐year follow‐up period. The risk ratios concerning early menopausal age for all the various cardiovascular end‐points studied were increased, except for new events of ECG changes suggestive of ischaemic heart disease. However, none of the risk ratios studied between menopausal age on the one hand and the 12‐year incidences of myocardial infarction, angina pectoris, or stroke, on the other, was significantly increased when women who had reached the menopause at the age of 40, 45, or 50 were compared with the rest of the participants in the population study. When early menopause was related to the overall mortality, the risk ratio was increased only for women who had reached the menopause at the age of 50, but not sufficiently to be statistically significant. When reviewing the literature, it is obvious that the results from previous studies are discrepant and do not permit of any generalized conclusion as to whether there is a correlation between early menopause and ischaemic heart disease or not. Nor is our longitudinal study conclusive in this respect.

Lindquist, Olof; Bengtsson, Calle; Lapidus, Leif

doi: 10.3109/00016348509157146pmid: 3874513

Abstract. There are still contradictory opinions as to whether there is an association between menopausal age and ischaemic heart disease or not. There is, however, no doubt about the existence of a number of relationships between menstrual status and different risk factors for ischaemic heart disease. Thus, smoking will give rise to an earlier menopause, while the menopause will give rise to increased serum cholesterol and serum triglyceride levels but seems to influence arterial blood pressure and body weight in the opposite way. The relationships between the menopause and risk factors for ischaemic heart disease are complex, which may be one reason for the contradictory results when relating menopausal age to the incidence of ischaemic heart disease.

Crona, N.; Silfverstolpe, G.; Samsioe, G.

doi: 10.3109/00016348509157147pmid: 3859975

Abstract. The widespread use of exogenous sex steroids for contraception, treatment of climacteric deficiency symptoms, etc., has led to the development of new compounds and combinations. Before new combinations of exogenous sex steroids or new steroidal compounds are introduced in clinical practice, evaluation of possible adverse metabolic effects should be mandatory.

Mattsson, Lars‐Åke; Samsioe, Göran

doi: 10.3109/00016348509157148pmid: 3859976

Abstract. Twenty‐six peri‐ and postmenopausal women were treated with daily dose of 2 mg 17‐β‐estradiol, 1 mg estriol and 1 mg norethisterone‐acetate in a continuous regimen for 12 months. Clinical parameters such as vasomotor symptoms, bleeding patterns and histopathology were recorded. Blood samples were collected before, after 3 months and after 12 months of treatment and were analysed for estradiol‐17‐β, estrone, androstenedione in serum and lipoprotein lipids.