Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0600142 (hot flushes)
 1,242 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The majority of women experience a variety of symptoms at the time of the menopause, but these are frequently regarded as being unworthy of management by their doctors. Recent reports of a possible association between exogenous oestrogens and endometrial carcinoma have increased professional reluctance to prescribe oestrogens for menopausal symptoms. This report describes the initial 50 patients who have attended a special clinic established to manage symptomatic menopausal women; common complaints included hot flushes, lack of energy, altered temperament, dyspareunia and headache. Oestrogen therapy was effective in the alleviation of symptoms and the practical aspects of oestrogen use are discussed. It is recommended that with due recognition of its potential complications, oestrogen therapy should be made available to symptomatic menopausal women, and that it requires further study in regard to its place in the long-term prophylaxis of osteoporosis.
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PMID:Oestrogens and menopausal and postmenopausal women. 19 65

In a review of mental health aspects of menopause, emphasis is laid on the psychiatric morbidity that precedes any somatic menopausal symptoms. Only sweating and hot flushes are directly related to the menopause. Complaints such as irritability, headaches, fatigue, depression, and ''mental imbalance'' increase prior to the menopause and decrease after it. Various situational factors have been considered as possible precipitants of emotional disturbances: a child marrying, or having 3 or more children. However, studies indicate that women in the year of the menopause were less likely to develop an episode of mental illness requiring admission to a hospital than at other times. Estrogens do improve symptoms of flushes, dryness and sweats. Changes in emotional imbalance are less clear. Women who come for treatment of menopausal symptoms may frequently be suffering from depression which makes toleration of these symptoms more difficult.
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PMID:Mental health aspects. 95 92

Elective hysterectomy has become culturally patterned as a normal part of the life cycle with more than half of all American women destined for hysterectomy if current rates continue. In keeping with this widespread acceptance, both women and their doctors frequently express satisfaction with the operation. The sequelae that do occur appear to be serious in only a few women, though more minor disturbances do appear in a sizable number. Repeated or controlled studies indicate that hysterectomy may yield problems for some women in the following areas: rejection by male partners, hot flushes after conservation of ovarian tissue, severe hot flushes after ovariectomy, long-term psychourinary problems, weight changes, lingering fatigue and prolonged convalescence, painful intercourse, depression, sleep disturbances, and other psychiatric symptoms. Prospective studies using matched control groups are needed which follow patients at least 2 years postoperatively, as repeated studies have shown "sleeper effect" after hysterectomy with sequelae developing after the first 6 months or even after 1 year. The impact of varying surgical techniques and the long-term endocrine impact of hysterectomy need to be detailed as well as further study undertaken on the psychosomatic sequelae.
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PMID:Reactions to hysterectomy: fact or fiction? 105 27

Eighty previously treated postmenopausal women with metastatic breast cancer were randomized to receive fadrozole (CGS 16 949A), a new aromatase inhibitor, 1 or 4 mg orally per day. Seventy eight patients were evaluable for toxicity and response. Only mild to moderate toxicity, namely hot flushes (28%), nausea and vomiting (13%), fatigue (8%) and loss of appetite (5%) occurred. Complete response was documented in 10% and partial response in 13% of patients with 45% having a no change status for at least 2 months. The median time to treatment failure is 4.1 months. The median survival is 23.7 months. The median survival is 23.7 months. The response and survival in patients with estrogen receptor positive and estrogen receptor unknown disease were not significantly different. Neither response nor survival was significantly different between the patients receiving 1 or 4 mg of fadrozole per day. Fadrozole is a well tolerated, effective second line treatment for women with metastatic breast cancer.
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PMID:Fadrozole hydrochloride, a new nontoxic aromatase inhibitor for the treatment of patients with metastatic breast cancer. 138 48

A phase I study of NK 622 (toremifene citrate), a novel antiestrogen, was conducted in female patients with cancer. Patients received a single oral dosing or daily once oral dosing for five consecutive days. Any adverse effects were not experienced in the single dosing of 40 or 60 mg of NK 622. In the daily administration of 10, 20, 40, 60, 120, 240 and 480 mg/day, one of three patients who received 20 mg/day experienced grade 1 anorexia, three of four patients received 240 mg/day experienced adverse effects: Grade 1 leukopenia in one patient, Grade 1 general hot flush in one patient, and Grade 1 nausea, hot flush in the face and vertigo, Grade 2 anorexia, fatigue, dull headache and general hot flush in another one patient. These symptoms recovered to normal levels after treatment. Serum hormone levels were examined in postmenopausal patients, and a significant increase of the sex hormone binding globulin level was observed in the patients received 120 and 240 mg/day doses. Serum levels of NK 622 determined as free base (TOR) reached the peak levels in 2 to 4 hours after administration on the 1st and 5th day in daily treatment, while a metabolite N-demethyltoremifene (TOR-1) reached the peak level in 4 to 170 hours. Maximum serum levels and area under the concentration versus time curves of TOR and TOR-1 increased dose-dependently. These values also increased by repetition of the treatment. Half-lives of TOR and TOR-1 in serum ranged in 74.5 to 148.9 hours and 154.1 to 653.1 hours, respectively. From these results, it was concluded that safety and efficacy of NK 622 should be assessed by using 240 mg or less doses in clinical phase II studies where breast cancer patients received long term treatment with NK 622.
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PMID:[Phase I study of NK 622 (toremifene citrate)]. 146 43

During the past decade, the development of various gonadotrophin-releasing hormone (Gn-RH) agonists, which induce reversible hypo-oestrogenism has opened a new area in the medical management of endometriosis. In an open, multicentre phase III study, the efficacy, tolerance and safety of the Gn-RH agonist leuprorelin acetate were tested. The preliminary results of 104 women treated in seven German centres are presented. Pelvic endometriosis was diagnosed by laparoscopy and classified according to the American Fertility Society scoring system: 33% of patients had minimal, 22% mild, 28% moderate and 8% severe endometriosis and in 9% no pathological results were obtained. The patients' mean age was 30 +/- 6 years and 66 had infertility problems. Treatment was started within the first 3 days of the menstrual cycle and consisted of a subcutaneous injection of leuprorelin acetate 3.75 mg, repeated once monthly over 24 weeks. A follow-up period of 12 months after the last injection has been completed in 70 patients, including a second laparoscopy. At all visits, symptoms were evaluated, physical examinations performed, and blood samples collected for haematological screening, serum chemistry determinations and measurement of the gonadotrophins oestradiol and progesterone and leuprorelin acetate. The median score at laparoscopy fell from 12 before operation to 8 after operation and 2 after treatment with leuprorelin acetate. Of the total number of patients, 89% had improvements in their endometriosis, 8% a deterioration and 3% no change. Patients reported improvement in the following: dysmenorrhoea 93%, dyspareunia 62% and pelvic pain 70%. However, all women complained of at least one of the following symptoms: hot flushes 86%, sleep disturbance 62%, sweating 61%, headache 41%, nausea 32% and depression 20%. Fifty-five percent of patients reported additional side effects such as vaginal dryness, fatigue and lower abdominal pain. After the third injection, amenorrhoea persisted in 94% of the women. Four weeks after the first leuprorelin acetate injection median concentrations of oestradiol fell from 45 pg/ml to 11 pg/ml, follicle-stimulating hormone from 7 U/L to 3 U/L and luteinising hormone from 5 U/L to 1 U/L and remained almost unchanged over the observation period. During the 6 months' treatment, laboratory parameters showed no significant deviations from normal; only total cholesterol, high-density lipoprotein cholesterol and alkaline phosphatase increased. Treatment results were judged as good and satisfactory in 82% and 11% of cases, respectively. On the basis of this study, it can be concluded that leuprorelin acetate treatment is safe, well tolerated and effective in the medical management of endometriosis and endometriosis-related complaints.
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PMID:Treatment of endometriosis with leuprorelin acetate depot: a German multicentre study. 153 21

Cyproterone acetate (CPA) has been discovered more than 25 years ago and it was the first antiandrogen suitable for clinical use. CPA inhibits the action of endogenous and exogenous androgens at all androgen target organs; these include the prostate, seminal vesicles, testes, and the vas deferens. However, this antiandrogen also antagonizes less sex-specific effects of androgens, for example ossification of the epiphyseal cartilage, sebaceous gland function and skin thickness. Indications for CPA: Prostate cancer, androgen induced disorders of the skin (acne, seborrhoea, hirsutism, alopecia), precocious puberty and sexual disorders in men. Concerning sexual deviations clinical trials started in 1966. CPA leads to loss of libido and the ability to achieve erection, followed by the inability to achieve orgasm, after about 14 days of treatment (100-200 mg daily orally or 300 mg weekly i.m.). These effects are reversed in the same order as the onset. About 75 to 80% of patients respond to this therapy. CPA is generally well tolerated. Tiredness, lack of drive, listlessness and depressive moods have been reported as non-specific side-effects. Slight gynecomastia occurs in about 20% of patients. There are no good alternatives in this indication. Pure antiandrogens are unsuitable, because these are unable to inhibit libido sufficiently. Tranquilizers are not very effective, high doses of estrogens are associated with severe (cardiovascular) side effects. Orchidectomy is an irreversible intervention, LHRH analogues are associated with hot flushes and the initial increase in testosterone (flare phenomenon).
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PMID:Cyproterone acetate in the treatment of sexual disorders: pharmacological base and clinical experience. 183 80

A double blind, crossover study was used to test the effect of transdermal oestrogen therapy (Estraderm) in 22 women with climacteric complaints. The number and intensity of hot flushes were both reduced by approximately 80% (p less than 0.0025). Some improvement was also seen as regards general wellbeing, disturbed sleep and tiredness. We noted a significant increase in serum oestradiol to premenopausal follicular phase levels, and a decrease in FSH values. Systolic blood pressure was lowered during active treatment (p less than 0.025), a smaller reduction of diastolic pressure was not significant. Body weight remained unchanged. Some patients reported tender breasts, and some reported slight irritation of the skin. Neither condition necessitated withdrawal of treatment. It is concluded that Estraderm is effective and suitable for treatment of climacteric complaints.
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PMID:[Transdermal estrogen treatment. A placebo controlled study]. 194 34

The present investigation was undertaken to establish the relation between climacteric symptoms, ovarian function, ageing, and psychological factors. The subjects were as follows; 1,270 women who received a screening test for cervical cancer and 247 women following hysterectomy. The methods of investigation were Kupperman menopausal index (K-index), Cornell Medical Index (CMI) and YG character questionnaire (YG test). The following results were obtained: 1) the K-index increased until 39 years of age and was constant after 40 years. Five symptoms (chills, nervousness, melancholia, excitability and vertigo) were not influenced by ageing, and seven symptoms (panting, hypesthesia, insomnia, wakefulness, fatigue, palpitation and formication) increased with age. Hot flushes, perspiration, numbness, shoulder stiffness, lumbago, and headache, occurred at peak frequency in the climacteric period. 2) In hot flushes, perspiration, numbness, hypesthesia, shoulder stiffness, lumbago, and formication, a significant difference was found between the control and those patients who had received bilateral oophorectomy. 3) The K-index and CMI score were significantly correlated, and six symptoms (palpitation, panting, excitability, vertigo, wakefulness and formication) in particular were related to CMI. 4) The K-index was lowest in the patients indicated to be the D type by the YG test, and was highest in the patients of the B.E type. Six symptoms (excitability, palpitation, panting, melanchoria, hypesthesia and formication) were thought to be associated with the character of the patients. Results showed that four symptoms (hot flushes, perspiration, numbness, shoulder stiffness and lumbago) were closely related to ovarian function, and three symptoms (panting, excitability, and palpitation) depended largely on mental factors. The relationship between vasomortor symptoms and gonadotropin was investigated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Study on climacteric symptoms in relation to ovarian function ageing and psychologic factors]. 249 39

Two hundred perimenopausal women who suffered from several symptoms and signs of menopause participated in this 3-year prospective study. Because they were still menstruating more or less regularly, these women were afraid of becoming pregnant and asked for contraception as well as hormone replacement therapy (HRT). Therefore the HRT chosen was a low dose triphasic oral contraceptive. The patient population was divided into two groups; one group (100 women) took the triphasic contraceptive as HRT and the other group served as controls (100 women). During the three years of this study this form of HRT was demonstrated to prevent conception and bone-mass loss, combat vaginal dryness and sexual disturbances, eliminate hot flushes and profuse sweating, correct breast atrophy, and prevent or improve psycho-functional disturbances, such as depressive mood, loss of concentration, insomnia, nervousness, palpitations and fatigue. It was concluded, based on the results of this study, that the triphasic oral contraceptive is the treatment of choice in the prevention and treatment of menopausal symptoms during the perimenopause--when contraception is still required.
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PMID:Hormone replacement therapy in perimenopausal women with a triphasic contraceptive compound: a three-year prospective study. 286 16


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