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Bone density and skin thickness changes in postmenopausal women on long term corticosteroid therapy
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FC4.22.05 CLINICAL AND LABORATORIAL EVALUATION IN ELDERLY WOMEN SUBMITTED TO LOW DOSES OF HORMONE REPLACEMENT THERAPY (HRT) Fonseca. AM; Massabki, JOP; Arie, MHA, Margarido, PFR; Hayashida, SAY, Bag&i, VR & Pinotti, JA Dept. Obigyn, SBo Paula University Medical School, SBo Paula, Brazil. Objective: To evaluate the clinical and laboratory findings before and after one year of low doses of HRT in elderly women. Methods: The mean age of the 30 elderly women studied was 65 years (range 60 75 years). The clinical symptoms were evaluated by Kuppermann Menopausal Index (KMI) and divided into mild (<19), moderate (20-35) and severe (> 35). The blood pressure (mmHg), height (m), Body Mass Index (kg/m’) and Bone Densitometry were analyzed. The laboratory findings were evaluated by measuring fasting glucose (mgidl), total cholesterol, HDL, LDL, VLDL and triglycerides. All the parameters were analyzed before and after 1 year of continuous low doses of HRT (0.3 mg of conjugated equine estrogens associated with 2.5 mg of medroxyprogesterone acetate). Results: Mean values 1Initial 1After 1 year
Total cholesterol (mgidl) 1240,5 1230,3 HDL (mgidl) 145 147 LDL (mgidl) 164 148 VLDL (mgidl) 31,2 35,2 Bone Densitometry (Ll L4) 0,730 0,734 Bone Densitometry (femur neck) 0,638 0,658 Trinlvcerides Imnidlj 156 176 Conclusions: There was an improvement of clinical symptomatology, lipids screening, bone densitometry, and a slight improvement in triglycerides.
FC4.22.07 BONE DENSITY AND SKIN THICKNESS CHANGES IN POSTMENOPAUSAL WOMEN ON LONG TERM CORTICOSTEROID THERAPY Y. R. Galea, M. Brincat, University of Malta, Medical School, Gwardamangia, Malta, MSD07. Introduction: Long term steroid therapy is complicated by osteoporosis and generalised thinning of the skin. These two complications of long term steroid therapy are routinely assessed at the menopause clinic of St Luke’s Hospital. Patients and methods: A cross-sectional study was performed on 164 postmenopausal women who had been on long term corticosteroid therapy. A longitudinal study on 38 postmenopausal women on long term steroid therapy was performed. Each woman had the skin thickness measured by high resolution ultrasound (22MHz) and the bone density measured by a DEXA-Norland 386. Results: The cross-sectional study showed that steroid therapy was associated with the thinnest skin measurements (0.83mm) obtained for all patients screened at the menopause clinic. Similarly low bone density measurement, lumbar spine (0.81g/cm)2, hip (0.71g/cm)2 were obtained for patients on long term standing therapy. Twelve women had sustained single or multiple fractures. Since the establishment of the bone density unit 38 patients who had been on long term steroid have been followed up after the administration of oral hormone replacement therapy [Prempak C 0.625 mg]. This longitudinal study revealed a constant increase in skin thickness [6% per year] and bone density [left hip 5%, Lumbar spine 4%]. Conclusion: In postmenopausal women taking long-term corticosteroids, skin thickness and bone density were both decreased, but the addition of HRT as add-back improved the situation dramatically. Skin thickness and bone density in women taking long-term corticosteroids were comparable to those in women who had sustained osteoporotic fractures. It is therefore suggested that HRT be used as add-back therapy in postmenopausal women taking long-term corticosteroid therapy.
THURSDAY,
SEPTEMBER
FC4.23 HUMAN SEXUALITY FC4.23.01 SEXUAL BEHAVIOR AMONG ADOLESCENTS IN SWEDEN -A TEN-YEAR FOLLOW-UP STUDY E. EgnstrBm-Nordin (l), U. Hanson (l), T. TydCn (1) & (2) (1) Dept. of Women’s & Children’s Health, Uppsala University and Center of Clinical Research, Uppsala University, Central Hospital, V&e&, Sweden (2) Dept. of Public Health and Caring Sciences, Uppsala University, DGbelsgatan, Sweden Objectives: The aim of the study was to investigate the sexual behavior among high-school students in Sweden and compare it was a similar study performed ten years earlier. Another aim was to relate the findings to gender and education. Study Methods: A questionnaire was delivered to a random sample of classes (n=20) in senior high school, in two medium-sized cities in Sweden. The participation rate was 100% (n=408). Results: The results of the previous Swedish study are given in square brackets [ 1. The mean age was 16.5 years. 40% [54%] of the teenagers thought that the AIDS debate had affected their attitudes towards sex. 45% [47.5%] of the students had intercourse. There were some differences between gender and study programs. More teenagers in theoretical (90%) than in practical programs (64%) had used contraceptives at their first intercourse. More girls in practical programs (49%) had had intercourse compared to the girls in theoretical programs (34%). Daily smoking was more common in the practical (24%) than in the theoretical classes (14%). About one fourth of the teenagers were under the influence of alcohol at the time of first intercourse, this was a decrease compared to 1989. 23% of the teenagers were under the influence of alcohol at the time of first intercourse, this was a decrease among boys compared to 1989. 60% of the boys and 38.9% of the girls claimed that their parents had never talked to them about sex. The main source about sex was through newspapers and friends. Conclusion: The tendency that appeared ten years ago - that students attending practical programs put themselves more at health risks than do students at theoretical programs seems to continue. This could be turned to the best account for while planning for counseling and sex education.
FC4.23.02 SEXUAL SYMmOMS AT MENOPAUSE AND THEIR RELATIONSHIP WITH OTHER CLIMACTERIC COMPLAINTS R.E. Nauui (11, F. Polatti (l), .I. Baldaro Verde (2), A.R. Genazzani (3), (1) University of Pavia, Piazzale Golgi 2, Pavia, Italy, 27100, (2) Interdisciplinary Center for Research in Sexology, Genoa, Italy, (3) University of Piss, Piss, Italy. Objectives: Conflicting results have been reported regarding the effects of menopause and HRT on several aspects of sexuality. The present study aimed at investigating sexual symptoms in relation to the presence of vasomotor, psychological and physical climacteric complaints. Study Methods: A Visuo-Analogic Scale (score from 0 to 10) comprising 38 items was filled in by 355 postmenopausal women (age range: 46-60 yrs) recruited from several clinics located in different parts of Italy. Results: The major findings were: a) vaginal dryness was significantly higher in women suffering from loss of interest in things (p<.OOl), panic (p<.O2), sleep difficulties (p<.OO4), loss of fitness (p<.O4), involuntary loss of urine (pc.04); b) fear for intimacy was significantly higher in women suffering from breathlessness (p<.O2), anxiety (p<.O4), loss on interest in things (p<.OO2), depression (p<.OO6), feeling like being on your own (p<.Ol), panic (p<.OO5), inability to concentrate (p<.O2), headache (p<.O2), fatigue (p<.OO3), weight gain (p<.O4), increased hair on the face (p<.OOl), loss of fitness (p<.OO7), involuntary loss of urine (pc.02); c) need for tenderness was significantly higher in women suffering from increased urinary frequency (p<.O2), itch/burning in the genital area (p<.Ol), involuntary loss of urine (p<.O2), recurrent vaginal infections (pc.01); d) reduction of sexual pleasure was significantly higher in women suffering from loss of interest in things (p<.OO8), depression (p<.O5), feeling suddenly hungry (p<.O4), increased hair on the face (p<.OOl), loss of fitness (p<.OO5), recurrent vaginal infections (p<.O.O4); e) pain during intercourse was significantly higher in women suffering from anxiety (p<.O4), loss of interest (p<.OO2), depression (p<.OO4), feeling like being on your own (p<.Ol), panic (p<.O3), inability
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FC4.22.05 CLINICAL AND LABORATORIAL EVALUATION IN ELDERLY WOMEN SUBMITTED TO LOW DOSES OF HORMONE REPLACEMENT THERAPY (HRT) Fonseca. AM; Massabki, JOP; Arie, MHA, Margarido, PFR; Hayashida, SAY, Bag&i, VR & Pinotti, JA Dept. Obigyn, SBo Paula University Medical School, SBo Paula, Brazil. Objective: To evaluate the clinical and laboratory findings before and after one year of low doses of HRT in elderly women. Methods: The mean age of the 30 elderly women studied was 65 years (range 60 75 years). The clinical symptoms were evaluated by Kuppermann Menopausal Index (KMI) and divided into mild (<19), moderate (20-35) and severe (> 35). The blood pressure (mmHg), height (m), Body Mass Index (kg/m’) and Bone Densitometry were analyzed. The laboratory findings were evaluated by measuring fasting glucose (mgidl), total cholesterol, HDL, LDL, VLDL and triglycerides. All the parameters were analyzed before and after 1 year of continuous low doses of HRT (0.3 mg of conjugated equine estrogens associated with 2.5 mg of medroxyprogesterone acetate). Results: Mean values 1Initial 1After 1 year
Total cholesterol (mgidl) 1240,5 1230,3 HDL (mgidl) 145 147 LDL (mgidl) 164 148 VLDL (mgidl) 31,2 35,2 Bone Densitometry (Ll L4) 0,730 0,734 Bone Densitometry (femur neck) 0,638 0,658 Trinlvcerides Imnidlj 156 176 Conclusions: There was an improvement of clinical symptomatology, lipids screening, bone densitometry, and a slight improvement in triglycerides.
FC4.22.07 BONE DENSITY AND SKIN THICKNESS CHANGES IN POSTMENOPAUSAL WOMEN ON LONG TERM CORTICOSTEROID THERAPY Y. R. Galea, M. Brincat, University of Malta, Medical School, Gwardamangia, Malta, MSD07. Introduction: Long term steroid therapy is complicated by osteoporosis and generalised thinning of the skin. These two complications of long term steroid therapy are routinely assessed at the menopause clinic of St Luke’s Hospital. Patients and methods: A cross-sectional study was performed on 164 postmenopausal women who had been on long term corticosteroid therapy. A longitudinal study on 38 postmenopausal women on long term steroid therapy was performed. Each woman had the skin thickness measured by high resolution ultrasound (22MHz) and the bone density measured by a DEXA-Norland 386. Results: The cross-sectional study showed that steroid therapy was associated with the thinnest skin measurements (0.83mm) obtained for all patients screened at the menopause clinic. Similarly low bone density measurement, lumbar spine (0.81g/cm)2, hip (0.71g/cm)2 were obtained for patients on long term standing therapy. Twelve women had sustained single or multiple fractures. Since the establishment of the bone density unit 38 patients who had been on long term steroid have been followed up after the administration of oral hormone replacement therapy [Prempak C 0.625 mg]. This longitudinal study revealed a constant increase in skin thickness [6% per year] and bone density [left hip 5%, Lumbar spine 4%]. Conclusion: In postmenopausal women taking long-term corticosteroids, skin thickness and bone density were both decreased, but the addition of HRT as add-back improved the situation dramatically. Skin thickness and bone density in women taking long-term corticosteroids were comparable to those in women who had sustained osteoporotic fractures. It is therefore suggested that HRT be used as add-back therapy in postmenopausal women taking long-term corticosteroid therapy.
THURSDAY,
SEPTEMBER
FC4.23 HUMAN SEXUALITY FC4.23.01 SEXUAL BEHAVIOR AMONG ADOLESCENTS IN SWEDEN -A TEN-YEAR FOLLOW-UP STUDY E. EgnstrBm-Nordin (l), U. Hanson (l), T. TydCn (1) & (2) (1) Dept. of Women’s & Children’s Health, Uppsala University and Center of Clinical Research, Uppsala University, Central Hospital, V&e&, Sweden (2) Dept. of Public Health and Caring Sciences, Uppsala University, DGbelsgatan, Sweden Objectives: The aim of the study was to investigate the sexual behavior among high-school students in Sweden and compare it was a similar study performed ten years earlier. Another aim was to relate the findings to gender and education. Study Methods: A questionnaire was delivered to a random sample of classes (n=20) in senior high school, in two medium-sized cities in Sweden. The participation rate was 100% (n=408). Results: The results of the previous Swedish study are given in square brackets [ 1. The mean age was 16.5 years. 40% [54%] of the teenagers thought that the AIDS debate had affected their attitudes towards sex. 45% [47.5%] of the students had intercourse. There were some differences between gender and study programs. More teenagers in theoretical (90%) than in practical programs (64%) had used contraceptives at their first intercourse. More girls in practical programs (49%) had had intercourse compared to the girls in theoretical programs (34%). Daily smoking was more common in the practical (24%) than in the theoretical classes (14%). About one fourth of the teenagers were under the influence of alcohol at the time of first intercourse, this was a decrease compared to 1989. 23% of the teenagers were under the influence of alcohol at the time of first intercourse, this was a decrease among boys compared to 1989. 60% of the boys and 38.9% of the girls claimed that their parents had never talked to them about sex. The main source about sex was through newspapers and friends. Conclusion: The tendency that appeared ten years ago - that students attending practical programs put themselves more at health risks than do students at theoretical programs seems to continue. This could be turned to the best account for while planning for counseling and sex education.
FC4.23.02 SEXUAL SYMmOMS AT MENOPAUSE AND THEIR RELATIONSHIP WITH OTHER CLIMACTERIC COMPLAINTS R.E. Nauui (11, F. Polatti (l), .I. Baldaro Verde (2), A.R. Genazzani (3), (1) University of Pavia, Piazzale Golgi 2, Pavia, Italy, 27100, (2) Interdisciplinary Center for Research in Sexology, Genoa, Italy, (3) University of Piss, Piss, Italy. Objectives: Conflicting results have been reported regarding the effects of menopause and HRT on several aspects of sexuality. The present study aimed at investigating sexual symptoms in relation to the presence of vasomotor, psychological and physical climacteric complaints. Study Methods: A Visuo-Analogic Scale (score from 0 to 10) comprising 38 items was filled in by 355 postmenopausal women (age range: 46-60 yrs) recruited from several clinics located in different parts of Italy. Results: The major findings were: a) vaginal dryness was significantly higher in women suffering from loss of interest in things (p<.OOl), panic (p<.O2), sleep difficulties (p<.OO4), loss of fitness (p<.O4), involuntary loss of urine (pc.04); b) fear for intimacy was significantly higher in women suffering from breathlessness (p<.O2), anxiety (p<.O4), loss on interest in things (p<.OO2), depression (p<.OO6), feeling like being on your own (p<.Ol), panic (p<.OO5), inability to concentrate (p<.O2), headache (p<.O2), fatigue (p<.OO3), weight gain (p<.O4), increased hair on the face (p<.OOl), loss of fitness (p<.OO7), involuntary loss of urine (pc.02); c) need for tenderness was significantly higher in women suffering from increased urinary frequency (p<.O2), itch/burning in the genital area (p<.Ol), involuntary loss of urine (p<.O2), recurrent vaginal infections (pc.01); d) reduction of sexual pleasure was significantly higher in women suffering from loss of interest in things (p<.OO8), depression (p<.O5), feeling suddenly hungry (p<.O4), increased hair on the face (p<.OOl), loss of fitness (p<.OO5), recurrent vaginal infections (p<.O.O4); e) pain during intercourse was significantly higher in women suffering from anxiety (p<.O4), loss of interest (p<.OO2), depression (p<.OO4), feeling like being on your own (p<.Ol), panic (p<.O3), inability
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