Enhancing Women's Quality of Life in Areas From Post Menopause to Fertility to Breast Cancer Reduction

Main Category: Menopause
Also Included In: Women's Health / Gynecology;  Fertility;  Breast Cancer
Article Date: 06 Jun 2005 - 10:00 PDT

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A variety of treatments that enhance the quality of life for women may soon be available, according to new research being presented today in San Diego at ENDO 2005, the 87th Annual Meeting of The Endocrine Society.

The four new studies, which will be featured at a press conference at the San Diego Convention Center on Sunday, June 5 at 10:00 a.m., discuss potential therapies to enhance the quality of life in middle-aged and post-menopausal women, enhancing the chances for young women to remain fertile after aggressive therapy for various types of leukemia and reducing the aggressive growth of breast cancer.

New Methods May Preserve Fertility for Girls Receiving Cytotoxic Therapy Girls who had received their first period and were receiving toxic therapies for certain diseases, including leukemia and Hodgkins disease, were treated successfully for protection of the ovaries during treatments.

The purpose of the pilot study, as conducted by Dr. Marta Snajderova at the University Hospital-Motol, Prague, Czech Republic was to review clinical results in ovary protection by combining the gonadotropin-releasing hormone GnRH agonist and GnRH antagonist before and during high dose toxic therapy. Using the protocol in the study, a rapid cell desensitization could be achieved in all patients within 96 hours, allowing start of cancer treatment without any delay. More than two-thirds of girls resumed their periods after the end of cancer treatment. All menstruating girls in the study now have regular menstrual cycles 28-30 days long.

"The combination of GnRH-agonist and GnRH-antagonist makes it possible to achieve a rapid, reliable and cost-effective suppression of pituitary-gonadal axis, protecting the ovaries during the treatment," said Snajderova. "If these preliminary data are consistent in a larger group of patients, the GnRH- agonist and GnRH-antagonist co-treatment should be considered in every young fertile woman receiving cytotoxic treatment for further fertility preservation."

Effects of Hormones on Breast Cancer

Evidence suggests that estrogen and inflammatory mediators play important roles in the growth and progression of breast cancer. Activity of aromatase, an enzyme that converts androgens to estrogens, can therefore result in high local levels of estrogen production that stimulates tumor growth.

Immunoreactivity for aromatase in human breast tumors is highly correlated with that of COX-2, the rate-determining enzyme in prostanoid biosynthesis, according to this research conducted by Dr. Daniel Hardy, UT Southwestern Medical Center in Dallas.

"Non-antibody proteins that act as intercellular mediators contributes to the increase in expression in breast cancer," said Dr. Hardy. "And, progesterone receptors play a dominant protective role in breast cancer cells by antagonizing activation of COX-2, resulting in decreased expression."

Soy Treatments May Improve Quality of Life in Post-Menopausal Women A study by Dr. Kendall Dupree of Johns Hopkins University looked into the effects of soy on quality of life in post-menopausal women. Complementary and alternative therapies are being used frequently in the United States. Studies of post-menopausal women indicate that estrogen replacement improves physical, psychosocial and vascular symptoms. Because of the reduction in use of hormone replacement therapy, many women are choosing soy as an alternative. Soy is a phytoestrogen, which is a naturally occurring estrogen found in plants. It contains isoflavanoids called genistein and daidzein. These isoflavanoids are similar to estrogen chemically and are capable of binding to estrogen receptors and exerting an excitatory or inhibitory effect.

The study looked to demonstrate that when administered in adequate doses to post-menopausal women, isoflavones will result in improved menopausal symptoms and related quality of life.

The study looked at data on 35 post-menopausal women not on hormone replacement therapy for at least six months prior to beginning the study. Participants completed a three-month clinical trial and were randomized to the active product, commercially available as Revival, with 160mg of total isoflavones vs. a placebo. Each participant completed the MENQOL (Menopause- Specific Quality of Life Questionnaire) at baseline, six weeks and three months.

Researchers found that women taking the active compound experienced significant improvement in their vasomotor symptoms, psychosocial symptoms and physical function by 36%, 40% and 30 % respectively, compared to the placebo. "We conclude that post-menopausal women taking isoflavones with high concentrations of genistein experience improvement in their menopausal symptoms and therefore have an improved quality-of-life, as reflected by the self-administered MENQOL questionnaire," said Dupree.

The Effects of Androgens During Menopause

Dr. Jiangang Chen, University of California at Davis, and colleagues announced that they have made headway in understanding the importance of endogenous androgens and the benefits and risks of exogenous androgen replacement therapy in women during menopausal transition through a newly developed cell-based androgen bioassay in serum sampled from 100 mid-aged women (42-58 years old) from SWAN (Study of Women's Health Across the Nation).

Circulating androgens are known to improve quality of life in regard to a meaningful, intimate sexual relationship. To date, our understanding of the importance of naturally occurring androgens and the benefits and risks of androgen replacement therapy in women during menopause is incomplete.

This study investigated the relationship of circulating testosterone measured by immunoassay to the bioactivity of androgens measured by the newly developed cell based androgen bioassay. The resulting data support the concept that free or bioavailable androgens are increased above what is predicted by free testosterone in women with lower levels of sex hormone binding globulin (SHBG). Therefore, a direct measure of bioactive androgens may provide a different and possibly superior explanation for some decreases in SHBG.

The findings also suggest the importance of adrenal steroid secretion during menopause that may explain some differences in menopausal symptoms and health outcomes among middle-aged women.

Growth Hormones Assist Post-Menopausal Women

A study led by Drs. Arthur Weltman and colleagues at the University of Virginia and Dr. Johannes Veldhuis, Mayo School of Graduate Medical Education found that the administration of the growth hormone recombinant human GHRH- 1,44-amide taken for three months can enhance the quality of life in post- menopausal women.

Earlier studies have indicated that twice-daily sc administration of a high dose of recombinant human GHRH-1,44-amide (GHRH) taken for 90 days can alter body composition in healthy older men. Drs. Weltman and Veldhuis set out to establish whether this is also true in post-menopausal women. To this end, 10 post-menopausal volunteers underwent a baseline study and then received 1 mg of GHRH twice daily for three months.

"At the conclusion of the study, there were no systemic adverse events, although most subjects experienced local skin reactivity at the dose of 1 mg injected subcutaneously twice per day. We concluded that a three-month regimen of GHRH supplementation in post-menopausal women can stimulate GH and IGF-I production, reduce abdominal visceral fat and improve selected measures of physical performance," said Dr. Weltman.

Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 12,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at http://www.endo-society.org.

The Endocrine Society
http://www.endo-society.org

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