Veralipride versus conjugated oestrogens: A double-blind study in the management of menopausal hot flushes

Summary

A double-blind, randomized study was carried out in 43 women, who had undergone spontaneous ménopause at least 6 months earlier, to compare the effectiveness and tolerance of veralipride with that of a conjugated oestrogens preparation in the control of hot flushes. Twenty-one women received 100?mg veralipride per da-v and 22 were due to receive 1.25?mg per day of the hormone preparation over a period of 20 days but 3 women in the oestrogen group discontinued the trial without giving any reason. The number, duration and severity of hot flushes were assessed and scored at the start of the trial and during treatment. Statistical analysis of the results showed marked relief with both preparations but no significant difference between them in terms of effectiveness or tolerance. Veralipride, however, appeared to provide better control in patients who had complained of severe hot flushes initially.     

Dyslipidémies de la femme après 50 ans : le rôle de l’âge et de la ménopause

A high prevalence of cardiovascular risk factors is reported in postmenopausal women. The objective of this review was to determine whether the effect of the menopause on lipid profile remained after adjusting for age in middle age women. The results of 10 cross sectional studies and nine longitudinal studies added evidence of a worsening effect of the menopause on total cholesterol, LDL cholesterol and triglyceride plasmatic levels. This effect remained after adjustment for age. Menopausal estrogenic deficiency could be an explanation for those results, even if the hormonal replacement therapy effect on the lipid profile remains unclear.     

Quel(s) impact(s) de la vie hormonale féminine dans les troubles bipolaires ?

Estrogens and progesterone are involved in many aspects of brain function (modulation of neurotransmissions, neuronal survival, synaptic plasticity). In addition, some biomarkers involved in bipolar disorder are thought to be influenced by sex hormones. The links between the different hormonal periods of women's lives (pubertal, premenstrual syndrome, perinatal period, menopause) and the evolution of bipolar disorders are explored and some new lines of research presented.     

Hormonal replacement therapy (HRT) in postmenopause: a reappraisal

Hormone replacement therapy (HRT) is the most effective treatment currently available for vasomotor and urogenital symptoms and decreased libido. Because harmful effects were evidenced in some clinical trials, health authorities now consider that risk-benefit considerations do not favour the use of HRT for prevention of cardiovascular diseases and bone fractures in postmenopausal women. However, experimental and clinical studies indicate that adverse effects of HRT may largely depend on the estrogen and progesterone/progestin formulation, dosage, mode of administration, patient's age, associated diseases, and duration of treatment. All estrogen formulations and modes of administration have similar beneficial effects on vasomotor and urogenital symptoms and on bone structure. But cardiovascular and invasive breast cancer risks are higher with oral estrogen than with transdermal estradiol, and also higher with many progestin compounds than with micronized progesterone. The combination of transdermal estradiol+micronized progesterone appears to be effective and relatively safe if elementary precautions are taken, and seems to be presently the best choice for HRT in most postmenopausal women. In the author's--heterodox--opinion, HRT may also be a good therapeutic choice to prevent bone loss, since alternative medications, including raloxifene and bisphosphonates, may have dramatic harmful effects in some patients. It might also have beneficial effects on the development of coronary disease in young postmenopausal women. HRT requires careful adjustment to each individual patient and continuous monitoring of clinical evolution. In the future, this adjustment could benefit from genetic screening to maximize in each individual the ratio between positive and adverse effects.     

Projection de l’incidence du cancer du sein en 2018 en France

The objective of this work is to estimate the trends of the incidence of breast cancer until 2018, in the French context on the basis of an age cohort model. The model extrapolates the trend of incidence rate per generation and age, incorporates the effects of demographic changes in the female population in terms of size and age structure and simulates the impact of the withdrawal of the use of hormone therapy for menopause (HTM) under different assumptions. The results suggest a continuous growth in the number of incident cases that would increase from 49,814 to 64,621 between 2005 and 2018. Changes in incidence following the HTM use withdrawal, should be moderate and transient. The most important epidemiological parameters in explaining the future incidence of breast cancer remains the “cohort” effect that continues to have a significant impact until the extinction of cohorts for which the increase was more marked (birth years 1920 to 1945). This factor alone explains 18% of the growth in the number of incident cases in 2018, while the effect of population growth account for 6.6%, the cessation of HTM a 6.4% decrease and aging a 4.6% growth.