Showing papers by "Henry G. Burger published in 2008"
TL;DR: Testosterone therapy, relative to placebo, selectively lessened visceral fat accumulation without change in total body FM and increased total body FFM and total body and thigh skeletal muscle mass.
Abstract: Background: Trials of testosterone therapy in aging men have demonstrated increases in fat-free mass (FFM) and skeletal muscle and decreases in fat mass (FM) but have not reported the impact of baseline body composition. Objective: The objective of the study was to determine the effect, in nonobese aging men with symptoms of androgen deficiency and low-normal serum testosterone levels, of testosterone therapy on total and regional body composition and hormonal and metabolic indices. Methods: Sixty healthy but symptomatic, nonobese men aged 55 yr or older with total testosterone (TT) levels less than 15 nm were randomized to transdermal testosterone patches or placebo for 52 wk. Body composition, by dual-energy x-ray absorptiometry (FM, FFM, skeletal muscle) and magnetic resonance imaging (abdominal sc and visceral adipose tissue, thigh skeletal muscle, and intermuscular fat) and hormonal and metabolic parameters were measured at wk 0 and 52. Results: Serum TT increased by 30% (P = 0.01), and LH decreased ...
261 citations
TL;DR: Estradiol appears to be a useful treatment for women with schizophrenia and may provide a new adjunctive therapeutic option for severe mental illness.
Abstract: Context Accumulating evidence suggests that estrogens may have therapeutic effects in severe mental illnesses, including schizophrenia, via neuromodulatory and neuroprotective activity. Objective To compare the efficacy of adjunctive transdermal estradiol with that of adjunctive placebo in the treatment of acute psychotic symptoms. Design Randomized, double-blind study. Setting Patients were recruited from inpatient acute hospital wards and outpatient clinics of 2 metropolitan Melbourne general hospitals. Participants One hundred two women of childbearing age with schizophrenia. All participants were in an acute or chronic phase of their illness; 73 participants were outpatients and the rest were inpatients. Intervention Patients were randomized to receive 100 μg of transdermal estradiol (n = 56) or transdermal placebo (n = 46) for 28 days. Main Outcome Measures Psychopathological symptoms were assessed weekly with the Positive and Negative Syndrome Scale. Results The addition of 100 μg of transdermal estradiol significantly reduced positive ( P P Conclusion Estradiol appears to be a useful treatment for women with schizophrenia and may provide a new adjunctive therapeutic option for severe mental illness. Trial Registration clinicaltrials.gov Identifier:NCT00206570
213 citations
TL;DR: No specific endocrine change was characteristic of either the early or late menopausal transition, confirming the observations of previous studies regarding the unpredictability of cycle characteristics and hormone changes with the approach of menopause.
Abstract: The menopausal transition is the stage in reproductive life commonly defined as commencing with the onset of menstrual irregularity. Classic studies of the endocrinology of the transition postulated the existence of inhibin in women to explain the observed increase in follicle-stimulating hormone (FSH) levels without a significant decrease in estradiol (E2). Descriptions were provided of cycle characteristics during the transition, emphasizing the unpredictability of the endocrine changes rather than the occurrence of an orderly and progressive decline in ovarian function. Women older than the age of 45 exhibited menstrual irregularity when the average number of primordial follicles per ovary decreased to approximately 100. Inhibin B is a major regulator of FSH secretion and a product of small antral follicles. Its levels respond to the early follicular phase increase and decrease in FSH. The age-related decrease in ovarian primordial follicle numbers, which is reflected in a decrease in the numbers of small antral follicles, leads to a decrease in inhibin B, which in turn leads to an increase in FSH, hypothesized to act as a stimulus to the maintenance of circulating E2 in the follicular phase until late in the transition. Concurrently, the concentrations of testosterone do not change significantly. Early follicular phase FSH levels in women reporting menstrual irregularity fluctuate markedly, with a more uniform increase in levels when no menses have occurred for at least 3 months. Anovulatory cycles occur at increased frequency in the last 30 months before final menses or menopause. In ovulatory cycles, FSH shows little, if any, increase, but anovulatory cycles are usually characterized by low levels of inhibin B, markedly increased levels of FSH, and low levels of E2. Thus, the heterogeneity of follicular phase FSH represents a mixture of ovulatory and anovulatory cycles. Longitudinal data indicate that both ovulatory and anovulatory cycles occur after entry into both the early and late menopausal transition and that ovulatory cycles occur even after final menses. There is no endocrine marker of menopause, which may be primarily an endometrial event. Using the hormonal concentrations in ovulatory cycles observed in women in mid-reproductive age as controls and comparing such concentrations in late reproductive age women older than 45 either continuing to cycle regularly or having entered the early or late menopausal transition, a gradual increase in follicular phase FSH and E2 and a decrease in inhibin B were observed in ovulatory cycles. Anovulatory cycles showed markedly increased FSH with low E2 and inhibin B. No specific endocrine change was characteristic of either the early or late menopausal transition, confirming the observations of previous studies regarding the unpredictability of cycle characteristics and hormone changes with the approach of menopause. Antimullerian hormone correlates with follicle numbers and shows a large age-related decrease to reach undetectable levels at menopause. Thus, the marked decrease in follicle numbers during late reproductive age appears to predispose to erratic and unpredictable cycle characteristics, with normal ovulatory cycles continuing to occur episodically. There is no specific endocrine marker of the early or late transition, making measurements of FSH or E2 unreliable in attempting to stage an individual with regard to approaching menopause.
197 citations
TL;DR: This book aims to provide a history of skateboarding in Europe from 1989 to 2002, with a focus on the period between 1991 and 2002.
Abstract: We live in an era when the population is continually aging; at the time of writing, more than 30% of women in the western World are aged 50 years or over. The controversy surrounding the pros and c...
106 citations
TL;DR: It is concluded that in postmenopausal women, treatment with combined estradiol and testosterone implants was more effective in increasing bone mineral density in the hip and lumbar spine thanEstradiol implants alone.
96 citations
TL;DR: Analysis of data from the Melbourne Women's MidLife Health Project and related studies showed that endocrinologically normal ovulatory cycles could be observed in women who had already experienced cycle irregularity, even more than 3 months of amenorrhea, and could occur close to or at the time of FMP.
82 citations
TL;DR: The findings suggest that FSH-to-inhibin B ratios and antimüllerian hormone are distinct early indicators of the menopause transition and are likely to be useful biomarkers of impending menoppause.
Abstract: Objective:To characterize menstrual cycles in women in late reproductive age and the menopause transition, based on changes in serum hormone levels.Design:Serum levels of estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone, inhibin A, inhibin B, and antimullerian
58 citations
TL;DR: Findings, although not conclusive, suggest that both inhibin B and anti-Mullerian hormone may be preferable to FSH for predicting STRAW stage with respect to the onset and progression of the menopausal transition.
Abstract: To date, the endocrine changes accompanying female reproductive aging have been quite variable and unpredictable. The first standardized guidelines were drawn up at the Stages of Reproductive Aging Workshop (STRAW) in 2001. The present investigators attempted to describe comprehensively the endocrinological features associated with STRAW stages. Healthy women 21-35 and 45-55 years of age submitted 3 blood samples each week during a single menstrual cycle. The 21 younger women served as mid-reproductive age (MRA) controls with regular menstrual cycles. The 56 older women were classified at STRAW stage 3, late reproductive age (LRA) with regular cycles (n = 16); STRAW stage 2, early menopause transition (EMT) with cycles of varying length (n = 17); and STRAW stage 1, late menopause transition (LMT) with at least 1 intermenstrual interval of 60 days or longer (n = 23). The numbers of anovulatory cycles were 9, 1, 0, and 2, respectively, in the LMT, EMT, LRA, and MRA groups. Ovulatory-cycle levels of follicle-stimulating hormone (FSH), luteinizing hormone, and estradiol all increased with the progression of STRAW stage. Mean luteal-phase levels of serum progesterone declined. Early-cycle (ovulatory and anovulatory) levels of inhibin B declined steadily across STRAW stages, and it was largely undetectable during elongated ovulatory and anovulatory cycles in the menopausal transition. Levels of anti-Mullerian hormone decreased markedly by as much as 15-fold across the STRAW stages. These findings, although not conclusive, suggest that both inhibin B and anti-Mullerian hormone may be preferable to FSH for predicting STRAW stage with respect to the onset and progression of the menopausal transition.
34 citations
TL;DR: It is shown that in 58 postmenopausal women with at least 14 hot flushes per week, their daily diet supplemented with soy flour could reduce flushes compared with wheat flour over 12 weeks when randomised and double blind.
7 citations