Abstract:
:Identifying appropriate candidates for menopausal hormone therapy (HT) is challenging given the complex profile of risks and benefits associated with treatment. Most professional societies agree that HT should not be used for chronic disease prevention. Recent findings from the Women's Health Initiative and other randomized trials suggest that a woman's age, proximity to menopause, underlying cardiovascular risk factor status, and various biological characteristics may modify health outcomes with HT. An emerging body of evidence suggests that it may be possible to assess individual risk and therefore better predict who is more likely to have favorable outcomes versus adverse effects when taking HT. Thus, once a woman is identified as a potential candidate for HT due to moderate-to-severe menopausal symptoms or other indications, risk stratification may be an important tool for minimizing patient risk. This individualized approach holds great promise for improving the safety of HT. We review here the evidence for this approach, focusing on vascular health because of limited data on other outcomes. The ultimate goal of this research is to develop a personalized risk/benefit prediction model to be used when a woman seeks therapy for symptom management. Patient centered outcomes including quality of life and sense of well-being should also be incorporated and will directly impact the benefit: risk ratio and compliance. Additional research on hormone dose, formulation, and route of delivery will be important for improving this model.
journal_name
Semin Reprod Medjournal_title
Seminars in reproductive medicineauthors
Wild RA,Manson JEdoi
10.1055/s-0034-1384626subject
Has Abstractpub_date
2014-11-01 00:00:00pages
433-7issue
6eissn
1526-8004issn
1526-4564journal_volume
32pub_type
杂志文章,评审abstract::HOX genes, encoding homeodomain transcription factors, are dynamically expressed in endometrium, where they are necessary for endometrial growth, differentiation, and implantation. In human endometrium, the expression of HOXA10 and HOXA11 is driven by sex steroids, with peak expression occurring at time of implantatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1242996
更新日期:2010-01-01 00:00:00
abstract::Historically, progesterone functions to regulate gene expression via two nuclear progesterone receptors (PR-B and PR-A). Yet, actions of progesterone independent of gene regulation have been observed for decades. These are based on progesterone induced cellular events that occur too rapidly to involve gene transcripti...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1552583
更新日期:2015-05-01 00:00:00
abstract::Exposure to gonadotoxic agents for treating cancer and other diseases or postponement of maternity jeopardize the prospects of genetic parenthood and are major factors driving the development of fertility preservation technologies. Although its mainstays, cryopreservation and vitrification, have been adopted from infe...
journal_title:Seminars in reproductive medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1055/s-0029-1241051
更新日期:2009-11-01 00:00:00
abstract::Since 2004, assisted conception is encompassed by the European Directive on the Quality and Safety of Tissues and Cells (2004/23/EC). The aim of a standard for quality and safety is to minimize risks of errors, contamination, and accidents and to maximize efficiency of use. This article presents a case study of the im...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0032-1311521
更新日期:2012-06-01 00:00:00
abstract::Controlled ovarian stimulation (COS) is widely used in assisted reproduction techniques (ART). However, hormonal treatment induces endometrial alterations that may alter implantation rates compared with natural cycles. Endometrial alterations have been observed by histological and biochemical techniques. The recent de...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-991043
更新日期:2007-11-01 00:00:00
abstract::The medical treatment of endometriosis is a critical aspect of the therapeutic approach to this disease. Past methods have been based upon systemic hormonal alterations, resulting in suppression of this estrogen-responsive disorder. Treatments such as danazol, progestogens, oral contraceptives, GnRH-agonists, and gest...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2003-41327
更新日期:2003-05-01 00:00:00
abstract::Puberty is a fundamental developmental event in the lifespan of any individual, when sexual and somatic maturation is completed, and reproductive capacity is achieved. While the tempo of puberty is under strong genetic determination, it is also modulated by a wide array of internal and environmental cues, including, p...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-3400967
更新日期:2019-07-01 00:00:00
abstract::Endocrine-disrupting chemicals generally function as steroid receptor signaling antagonists or agonists that influence development to promote adult-onset disease. Exposure to the endocrine disruptors during the initiation of male reproductive tract development interferes with the normal hormonal signaling and formatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1237428
更新日期:2009-09-01 00:00:00
abstract::Trophoblast cells of the murine placenta are derived from the trophectoderm (TE) cells of the preimplantation embryo. Establishment of the TE cell lineage is the result of a cell segregation event early in blastomere division. Models of cell lineage segregation suggest it is driven by the internalization of spatial in...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1570025
更新日期:2016-01-01 00:00:00
abstract::Women with polycystic ovary syndrome (PCOS) most often seek treatment for reduction of hair growth and/or acne, restoration of menstrual cyclicity, and infertility. In addition, these patients are increasingly seeking advise and treatment for the metabolic abnormalities related to PCOS (e.g., insulin resistance and ty...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2003-43305
更新日期:2003-08-01 00:00:00
abstract::Prior to the advent of modern minimally invasive surgery techniques, the primary surgical management of symptomatic leiomyomata for women desiring future fertility or uterine conservation was through laparotomy. Today, many cases of intramural and subserous leiomyomata are managed with laparoscopic myomectomy and sele...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2004-828621
更新日期:2004-05-01 00:00:00
abstract::Obesity is a pandemic and is associated with multiple medical problems including subfertility. Male obesity has been associated with altered semen parameters and reproductive hormonal levels, including a reduced testosterone:estradiol (T:E₂) ratio. Treatment methods employed for obesity-related male subfertility inclu...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1345272
更新日期:2013-07-01 00:00:00
abstract::Pelvic pain, acute or chronic, accounts for more than 10% of referrals to gynecologists. Pain accounts for more than 40% of gynecologic diagnostic laparoscopies. Predicting operative findings is critical in planning surgical interventions, as well as preoperative and postoperative medical therapy. Ultrasound is useful...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1076144
更新日期:2008-05-01 00:00:00
abstract::In vitro maturation of oocytes is a safe and effective treatment offered in some fertility centers for assisted reproduction, where immature oocytes are retrieved from unstimulated ovaries. Therefore, the procedure avoids ovarian stimulation with expensive gonadotropins, side effects of the medications, and risks such...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2005-872452
更新日期:2005-08-01 00:00:00
abstract::Anejaculation within the context of a male infertility evaluation can be a distressing condition for patients. A variety of causes for anejaculation have been identified, and although the condition cannot be reversed, in many cases a minimally invasive treatment is feasible, allowing the patient to pursue his desire f...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1202307
更新日期:2009-03-01 00:00:00
abstract::Obesity-related infertility is one of the most common problems of reproductive-age obese women who desire childbearing. The various types of bariatric surgeries have proved effective in controlling excessive weight gain, improving fertility, and preventing certain maternal and fetal complications in these women. This ...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1328880
更新日期:2012-12-01 00:00:00
abstract::Contraceptive vaginal rings (CVRs) contain sex steroids that diffuse through a plastic polymer ring at a constant rate and are absorbed directly through the vaginal epithelium into the systemic circulation. This delivery system provides many advantages over oral contraceptives (OCs), including avoidance of the first-p...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2001-18646
更新日期:2001-12-01 00:00:00
abstract::Female genital tract microbiota play a crucial role in maintaining health. Disequilibrium of the microbiota has been associated with increased risk of pelvic infections. In recent years, culture-independent molecular techniques have expanded understanding of the composition of genital microbiota and the dynamic nature...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1361822
更新日期:2014-01-01 00:00:00
abstract::Induction and patterning of the testis occurs over a brief window of time. Before male-specific morphogenesis, the gonad primordium is bipotential and capable of developing into either an ovary or testis. However, expression of the transcription factor SRY initiates male development and induces patterning, proliferati...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1108005
更新日期:2009-01-01 00:00:00
abstract::The constructs and the provision of preconception and obstetrical care have historically been based on the assumption of heterosexuality, and have often excluded lesbian women. However, due to significant strides in lesbian, gay, bisexual, transgender, and queer (LGBTQ) civil rights, more lesbian women desire to creat...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1606385
更新日期:2017-09-01 00:00:00
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journal_title:Seminars in reproductive medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1055/s-2002-23515
更新日期:2002-02-01 00:00:00
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journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1042957
更新日期:2008-03-01 00:00:00
abstract::The maternal-fetal environment plays an important role in developmental programming of adult disease. Metabolic and hormonal dysfunction during human fetal development accompanies gestational diabetes as a common occurrence in mothers with polycystic ovary syndrome (PCOS), while human fetal androgen excess from congen...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1371087
更新日期:2014-05-01 00:00:00
abstract::Aging has dramatic effects on the reproductive system in women. Undoubtedly, the most notable changes in the neuroendocrine axis arise from the loss of ovarian function, and thus, the loss of negative feedback on the hypothalamus and pituitary. Progressive decreases in inhibin B and inhibin A result in an early increa...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-984740
更新日期:2007-09-01 00:00:00
abstract::Assisted reproductive techniques have revolutionized the treatment of male reproductive failure, allowing biological fatherhood to be achieved by many men that nature would have never permitted. As we are able to help more and more couples with our therapies, the genetic basis of the man's spermatogenic, anatomical, o...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1307418
更新日期:2012-04-01 00:00:00
abstract::During the menstrual cycle, human endometrium undergoes extensive cyclic morphologic and biochemical modifications in preparation for embryo implantation. These processes are highly regulated by ovarian steroids and various locally expressed gene products and involve inflammatory reaction, apoptosis, cell proliferatio...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1096128
更新日期:2008-11-01 00:00:00
abstract::Research translation and evaluation are often underconsidered in research design and implementation thus limiting research benefit to the end user. In this article, we first describe a best practice approach to evaluation, for a center of research excellence in polycystic ovary syndrome. Within this, we outline a comp...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章
doi:10.1055/s-0038-1667308
更新日期:2018-01-01 00:00:00
abstract::In vitro fertilization (IVF) with ovarian stimulation is an effective treatment for couples needing treatment with assisted reproductive technologies (ART) where polycystic ovary syndrome (PCOS) is coexisting. However, it is also associated with an increased risk of ovarian hyperstimulation syndrome. In vitro maturati...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-992932
更新日期:2008-01-01 00:00:00
abstract::The reproductive organs in both males and females consist of gonads, internal ductal structures, and external genitalia. Normal sexual differentiation is dependent on the genetic sex determined by the presence or absence of the Y chromosome at fertilization. Testes develop under the influence of the Y chromosome and o...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2004-815593
更新日期:2003-11-01 00:00:00
abstract::Androgen receptors are present in numerous tissues throughout the female body, and knowledge of the specific actions of androgens at different sites is increasing, along with the understanding of their contribution to various pathophysiological states. This article reviews the physiology of androgens (testosterone and...
journal_title:Seminars in reproductive medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-939565
更新日期:2006-04-01 00:00:00