The use of herbal preparations to alleviate climacteric disorders and risk of postmenopausal breast cancer in a German case-control study.

Background: The use of herbal preparations (HEP) to alleviate climacteric disorders is expected to increase as women seek alternatives to menopausal hormone therapy to avoid the associated breast cancer risk. Data are sparse on the long-term effects of HEP containing phytoestrogens and black cohosh on breast cancer risk.

Methods: Within a German case-control study, associations between patterns of HEP use and incident breast cancer were investigated in 10,121 postmenopausal women (3,464 cases, 6,657 controls).

Menopausal hormone therapy and risk of clinical breast cancer subtypes.

Background: Breast cancer is a heterogeneous disease with subtypes that may vary in their etiologies. Menopausal hormone therapy has been associated more strongly with lobular and tubular than ductal histologic types and with tumors that are smaller, hormone receptor-positive, and of lower grade. At the same time, correlations have been observed between histology and clinical characteristics.

[Does hormonal contraception increase the risk for tumors?].

A non-contraceptive benefit of oral hormonal contraceptives (OC) is a diminished risk for certain benign as well as malignant tumours, such as benign breast tumours, uterine fibroids and ovarian cysts. Endometriosis itself is not positively influenced by OC, but dysmenorrhea is decreased. Modern low-dose OC do not increase the risk of liver cell adenomata or carcinomata.

[Contraception in women with special problems].

Thromboembolic, cardiovascular and cerebrovascular events are age-dependent. They are extremely rare in young women. In contrast to the progestogen-only pills, oral contraceptives (OC) increase the risk of venous thrombosis.

[Contraception in adolescence and perimenopause].

The risk-benefit-ratio of hormonal contraception (OC) is positive in adolescents as well as in women over 40 years of age if some essential rules are respected. In adolescents, the acquirement of a normal peak bone mass has to be guaranteed by the use of the OC. The dosage of the OC has to be adapted individually to the basic hormonal situation.

[Long-cycle treatment in oral contraception].

Surveys show that most women desire a change in their menstrual pattern in the sense that they would prefer less menstruations or even amenorrhea. On this behalf, there is no difference between women having spontaneous natural cycles and women taking the pill. The main reasons are less menstrual bleedings, better hygienic conditions, a better quality of life and less blood loss.

[Oral contraception - doses and way of administration].

Since the correlation between the amount of Ethinylestradiol (EE) and the thromboembolic risk has been recognized, the development of new oral contraceptives (OC) has been characterized by a constant lowering of the EE dosage. The consecutive decrease of ovulation inhibition has been compensated by the introduction of potent progestagens. Therefore, the contraceptive safety has been maintained in presence of less side-effects.

Risk of different histological types of postmenopausal breast cancer by type and regimen of menopausal hormone therapy.

In a large population-based case-control study in Germany, including 3,464 breast cancer cases aged 50-74 at diagnosis and 6,657 population based and frequency matched controls, we investigated the effects of menopausal hormone therapy (HT) by type, regimen, timing and progestagenic constituent on postmenopausal breast cancer risk overall and according to histological type. Data were collected by face-to-face interviews. Logistic and polytomous logistic regression analysis were used to estimate odds ratios (OR) and 95%-confidence intervals (95% CI).

Good agreement between physician and self-reported hormone therapy data in a case-control study.

Objective: In a population-based case-control study examining the effects of postmenopausal hormone therapy (HT) on breast cancer risk, the authors conducted a validation study comparing prescription data from gynecologists with self-reports.

Study Design And Setting: The study was conducted in the Rhein-Neckar and Hamburg regions of Germany from 2002 to 2005. A total of 224 cases and 225 controls, stratified by region, age, and hormone use were randomly selected for the validation study.

Test-retest reliability of self-reported reproductive and lifestyle data in the context of a German case-control study on breast cancer and postmenopausal hormone therapy.

Purpose: Studies using survey questionnaires to collect epidemiologic data rely on the accuracy of participants' self-reporting. As part of the quality control protocol for a large population-based case-control study of the association between postmenopausal hormone therapy (HT) and breast cancer in German women (the Mammakarzinom-Risikofaktoren-Erhebung [MARIE] study), the authors used test-retest to evaluate the reliability of women's self-reporting of a number of putative breast cancer risk factors, including HT, reproductive history, family history, and lifestyle.

Methods: Of those women interviewed between November 2002 and July 2003, 62 cases and 61 controls were re-interviewed an average of 10 months later, using a shortened version of the original study questionnaire.

The selective estrogen receptor-beta agonist biochanin A shows vasculoprotective effects without uterotrophic activity.

Objective: Current hormone therapy in postmenopausal women is associated with uterotrophic activity and cancer-promoting effects. In this experimental study, we compared the effects of the selective estrogen-receptor (ER) beta agonist biochanin A, and the selective ERalpha agonist ethinylestradiol, on the development of intimal hyperplasia after balloon injury and on uterus morphology.

Design: Female F344 rats with or without prior ovariectomy were used for aortic denudations.

The phytoestrogen biochaninA weakens acute cardiac allograft rejection without affecting the reproductive system.

Background: Since the two estrogen receptor isoforms ERalpha and ERbeta have been discovered it is unclear by which receptor immunomodulating or feminizing effects are mediated. In this study, the effects of the two selective ERalpha- and ERbeta-agonists ethinylestradiol and biochaninA, respectively, on acute cardiac allograft rejection, uterus growth, vascular adhesion molecule and MHC-II expression were investigated and verified using in vitro cell culture.

Methods: Heterotopic Lewis to ovarectomized F344 cardiac transplantations were performed.

Laparoscopic oophoropexy for the treatment of recurrent torsion of the adnexa in pregnancy: case report and review.

Objective: To introduce a new surgical approach, oophoropexy to prevent recurrent adnexal torsion.

Design: Case report and review of the literature.

Setting: The obstetrics and gynecology department of a university hospital.

[Endocrinology of climacteric and postmenopause].

Climacterium is the transition from a cyclical ovarian function with ovulation to primarily irregularities and ultimately cessation of follicular maturation with its cyclical production of estrogens and progestins. The reason is the decline in follicle count and the decreasing sensitivity of follicles to pituitary gonadotropins. In this transition a phase of elevated androgen action is found in early menopause ultimately in late menopause the ovarian androgen production decreases while the androgen production through the adrenal glands is maintained and especially prohormones which are metabolished peripherally to active androgens and estrogens are produced.