Effect of estradiol with or without micronized progesterone on cholinergic-related cognitive performance in postmenopausal women.

Introduction: Women are at a higher risk of developing Alzheimer's disease (AD), and the decline in estrogens post-menopause is thought of as a factor increasing this risk. Estradiol (E2) is important in supporting cholinergic neuronal integrity, and cholinergic functioning may be negatively impacted following the loss of E2 post-menopause. The use of exogenous E2 has been observed to enhance cholinergically mediated cognitive performance in healthy post-menopausal women, which indicates a potentially protective mechanism.

Executive Summary of the reVITALize Initiative: Standardizing Gynecologic Data Definitions.

Effective care coordination across the women's health continuum is critically important. Unlike obstetric care, which tends to be more episodic and limited to pregnant and postpartum women, women receive health care, whether around pregnancy or for nonobstetric issues, in a variety of care settings by members of multiple health disciplines. Having access to standardized clinical data is imperative to providing optimal patient care.

Chronic Actinomyces Infection Caused by Retained Cervical Cerclage: A Case Report.

Background: Historically, Actinomyces infection has been associated primarily with the intrauterine device. Recently, case reports associating Actinomyces with other implants have been described, including nonwoven polypropylene mesh used for urethral slings and Mersilene cerclage placements. However, there are no reported cases of chronic Actinomyces infections associated with retained Mersilene cerclage.

Strategies for improving perinatal depression treatment in North American outpatient obstetric settings.

Objective: To identify core barriers and facilitators to addressing perinatal depression and review clinical, programmatic, and system level interventions that may optimize perinatal depression treatment.

Method: Eighty-four MEDLINE/PubMed searches were conducted using the terms perinatal depression, postpartum depression, antenatal depression, and prenatal depression in association with 21 other terms. Of 7768 papers yielded in the search, we identified 49 papers on barriers and facilitators, and 17 papers on interventions in obstetric settings aimed to engage women and/or providers in treatment.

Progression of female reproductive stages associated with bipolar illness exacerbation.

Objectives: Late perimenopause and early postmenopause confer an increased risk of depression in the population, yet bipolar disorder mood course during these times remains unclear.

Methods: Clinic visits in 519 premenopausal, 116 perimenopausal (including 13 women transitioning from perimenopause to postmenopause), and 133 postmenopausal women with bipolar disorder who received naturalistic treatment in the multisite Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study over 19.8 ± 15.

Estradiol treatment altered anticholinergic-related brain activation during working memory in postmenopausal women.

Estradiol has been shown to affect cholinergic modulation of cognition in human and nonhuman animal models. This study examined the brain-based interaction of estradiol treatment and anticholinergic challenge in postmenopausal women during the performance of a working memory task and functional MRI. Twenty-four postmenopausal women were randomly and blindly placed on 1mg oral 17-β estradiol or matching placebo pills for three months after which they participated in three anticholinergic challenge sessions.

Increased memory load-related frontal activation after estradiol treatment in postmenopausal women.

Prior research shows that menopause is associated with changes in cognition in some older women. However, how estrogen loss and subsequent estrogen treatment affects cognition and particularly the underlying brain processes responsible for any cognitive changes is less well understood. We examined the ability of estradiol to modulate the manipulation of information in working memory and related brain activation in postmenopausal women.

Correlation of serum androgens with anthropometric and metabolic indices in healthy, nonobese postmenopausal women.

Objective: The role of testosterone in the regulation of metabolic and physiological function in men is well defined, but its role in women remains enigmatic. Thus, the present study sought to assess the contribution of endogenous circulating androgens to the regulation of metabolic function, body morphometry, and physical function in normal naturally postmenopausal women.

Methods: Using a cross-sectional design, we measured serum androgens in a cohort of 29 naturally postmenopausal women and correlated the results with metabolic, morphometric, and functional outcome parameters.

Trends in the academic workforce of obstetrics and gynecology.

Objective: The objective was to report results from the seventh survey that monitored trends in numbers of full-time department faculty and from a first survey on the current and anticipated numbers of part-time faculty.

Methods: A faculty workforce survey, drafted in the same format as the prior published questionnaire, was sent electronically to chairs of obstetrics and gynecology at all 125 U.S.

Evaluation of extended and continuous use oral contraceptives.

Oral contraceptives are classically given in a cyclic manner with 21 days of active pills followed by 7 days of placebo. In the past 4 years, new oral contraceptives have been introduced which either shorten the placebo time, lengthen the active pills (extended cycle), or provide active pills every day (continuous). These concepts are not new; extended and continuous pills were first studied in the 1960s and 1970s and have been provided in an off-label manner by gynecologists to treat menstrual disorders, such as menorrhagia and dysmenorrhea, and gynecologic disorders, such as endometriosis.

Effects of oral and transdermal hormonal contraception on vascular risk markers: a randomized controlled trial.

Objective: To compare the effects of oral and transdermal contraceptives containing similar hormone formulations on vascular risk markers.

Methods: We conducted a randomized, investigator-blinded, crossover, clinical trial with 24 healthy women, aged 18-35 years, who received 2 months of transdermal or oral contraceptive, 2 months washout, then 2 months of the alternative medication. The transdermal contraceptive contained 0.

Effect of depomedroxyprogesterone acetate on coagulation parameter: a pilot study.

Objective: Recent studies have shown changes in coagulation factors, suggesting an increased risk of thrombotic events, in women on progestin-containing contraceptives. To investigate this, we studied the effects of injectable depomedroxyprogesterone acetate (DMPA), given as a contraceptive, on coagulation and inflammation markers.

Design: Prospective nonrandomized study.

Perceived infertility-related stress correlates with in vitro fertilization outcome.

To determine the effect of perceived infertility-related stress on IVF outcome, all couples undergoing their first cycle of IVF were administered the Fertility Problem Inventory from May 2002 and April 2005 at our institution. Couples who conceived during their first cycle of IVF had significantly higher measures of need for parenthood and loss of sexual enjoyment, compared with couples who did not conceive. Couples who achieved ongoing pregnancies had higher scores on measures of a negative view of a child-free lifestyle, need for parenthood, and total stress than those who did not.

Endometrial histology following 1 year of a continuous daily regimen of levonorgestrel 90 micro g/ethinyl estradiol 20 micro g.

Objective: The objective of this study was to evaluate the effect of a continuous daily regimen of levonorgestrel (LNG) 90 micro g/ethinyl estradiol (EE) 20 micro g on endometrial histology.

Methods: This was a substudy of a large phase 3 trial conducted in six sites in North America. Healthy and sexually active women aged between 18 and 49 years took LNG 90 micro g/EE 20 micro g daily for 1 year.

Evaluation of a continuous regimen of levonorgestrel/ethinyl estradiol: phase 3 study results.

Objective: This study was conducted to evaluate the safety and efficacy of a continuous daily regimen of levonorgestrel (LNG) 90 microg/ethinyl estradiol (EE) 20 microg (continuous LNG/EE).

Methods: Healthy women aged 18-49 years with regular menstrual cycles for 3 months enrolled in this single-treatment open-label study and took one pill of LNG 90 microg/EE 20 microg daily for 12 months.

Results: For the 2134 subjects enrolled, the Pearl Index method failure was 1.

A longitudinal study of the effects of free testosterone and other psychosocial variables on sexual function during the natural traverse of menopause.

Objective: This study examines the effect of free T levels on sexual function during the natural traverse of menopause. Other psychosocial variables, which may also contribute to change in sexual function, are studied-including participant's job satisfaction, satisfaction with financial resources, confidence in ability to manage symptoms, stressful life events, exercise, body image, and quality of personal relationships.

Design: Prospective clinical study.

Postmenopausal uterine bleeding profiles with two forms of continuous combined hormone replacement therapy.

Objective: This study was designed to compare the bleeding profiles of conjugated equine estrogens 0.625 mg in combination with 2.5 mg medroxyprogesterone acetate (Prempro; CEE/MPA group), the most widely prescribed continuous combined hormone replacement therapy (CCHRT) in the United States, with 17beta-estradiol 1 mg combined with 0.