Osteoporosis: Bachmann GA

Utian WH, Archer DF, Bachmann GA, Gallagher C, Grodstein F, Heiman JR, Henderson VW, Hodis HN, Karas RH, Lobo RA, Manson JE, Reid RL, Schmidt PJ, Stuenkel CA, Anonymous00380. · No affiliation provided · Menopause. · Pubmed #18580541 No free full text.

Abstract: OBJECTIVE:: To update for both clinicians and the lay public the evidence-based position statement published by The North American Menopause Society (NAMS) in March 2007 regarding its recommendations for menopausal hormone therapy (HT) for postmenopausal women, with consideration for the therapeutic benefit-risk ratio at various times through menopause and beyond. DESIGN:: An Advisory Panel of clinicians and researchers expert in the field of women's health was enlisted to review the March 2007 NAMS position statement, evaluate new evidence through an evidence-based analysis, and reach consensus on recommendations. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement. The document was provided to other interested organizations to seek their endorsement. RESULTS:: Current evidence supports a consensus regarding the role of HT in postmenopausal women, when potential therapeutic benefits and risks around the time of menopause are considered. This paper lists all these areas along with explanatory comments. Conclusions that vary from the 2007 position statement are highlighted. Addenda include a discussion of risk concepts, a new component not included in the 2007 paper, and a recommended list of areas for future HT research. A suggested reading list of key references is also provided. CONCLUSIONS:: Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal women; or both. The benefit-risk ratio for menopausal HT is favorable close to menopause but decreases with aging and with time since menopause in previously untreated women.

Heaney RP, Bachmann GA. · Creighton University, Omaha, Nebraska 68131, USA. · J Womens Health (Larchmt). · Pubmed #16372890 No free full text.

This publication has no abstract.

Avci D, Bachmann GA. · Women's Health Institute, Department of Obstetrics/Gynecology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA. · Menopause. · Pubmed #15545789 No free full text.

Abstract: Osteoarthritis and osteoporosis are two major health problems affecting more than 60% of post-menopausal women in the United States. The promotion of healthy aging and the prevention and reduction of morbidity and mortality is a main concern for healthcare providers. The similarities and differences in pathophysiology, diagnosis, and treatment for osteoarthritis and osteoporosis are often not clear for clinicians. Some osteoporosis treatments, including bisphosphonates and vitamin D, seem to have a beneficial effect on osteoarthritis as well. A review of these two conditions in terms of bone mineral density, bone turnover, hormonal effects, and treatment options will be discussed.

Burd ID, Bachmann GA. · Women's Health Institute, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA. · Curr Womens Health Rep. · Pubmed #12112971 No free full text.

Abstract: Menopause and the years leading to the menopausal transition are associated with significant decline in sex steroid levels. In contrast to the abrupt decline in estrogens at the time of menopause, a fall in the circulating testosterone and the adrenal preandrogens most closely parallel increasing age. Their accelerated decrease occurs in the years preceding menopause. It is now recognized that the decline in androgens plays a significant role in affecting perimenopausal and menopausal symptomatology and quality of life. Loss of circulating levels of androgens affects libido, vasomotor symptoms, mood and well-being, bone structure, muscle mass. Also, it influences cardiovascular profile. In the menopausal female (in whom these symptoms are clearly linked to low levels of bioavailable testosterone levels), hormone replacement therapy may be of benefit. Recently, interest is increasing in the use of androgen replacement not only for women who have undergone premature or surgical menopause but also for those who experience natural menopause and premenopausal loss of libido from diminished free testosterone.

Bachmann GA. · Department of Obstetrics, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0017, USA. · Am J Obstet Gynecol. · Pubmed #10076169 No free full text.

Abstract: The hormonal effects of estrogen and androgen were first investigated at the beginning of the twentieth century. Estrogen, which was first synthesized in the 1920s, has been shown to improve menopausal symptoms, decrease the incidence of osteoporosis, have a beneficial impact on plasma lipid profiles, probably reduce ischemic cardiovascular disease, and possibly improve cognition. In addition, retrospective studies have found a decreased incidence of Alzheimer's disease among women receiving estrogen replacement therapy compared with those not receiving this form of postmenopausal therapy. Androgen has been written about in the medical literature since 1936, when Mocquot and Moricard described its use to relieve vasomotor symptoms in postmenopausal women. During the 1940s and 1950s numerous reports appeared in the literature describing the effectiveness of estrogen-androgen combination therapy for improving the overall feeling of well-being, energy level, libido, and quality of life for postmenopausal women. Recent studies have also shown estrogen-androgen therapy to contribute to the prevention of osteoporosis and reduce serum levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Both historical data and evolving data support further evaluation of the use of estrogen-androgen replacement therapy in postmenopausal women.

Binkley N, Martens MG, Silverman SL, Derman RJ, Greenwald M, Kohles JD, Bachmann GA. · Department of Medicine, Institute on Aging, Universityof Wisconsin-Madison, 2870 University Avenue, Madison, WI 53705, USA. · South Med J. · Pubmed #19373149 No free full text.

Abstract: OBJECTIVE: This subanalysis of CURRENT, an open-label, 6-month, multicenter study, assesses changes in gastrointestinal (GI) tolerability with once-monthly oral ibandronate in women who switched from once-weekly bisphosphonates and had reported GI symptoms with their previous weekly bisphosphonate regimen. METHODS: Postmenopausal women currently taking a weekly bisphosphonate switched to 150 mg monthly ibandronate. At the start of the treatment phase and after 6 months of therapy, all participants completed the Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q), a validated instrument consisting of four domains: convenience, satisfaction, quality of life, and side effects. This subanalysis assessed GI tolerability in those women who reported GI symptoms at baseline in the side effects domain of OPSAT-Q and change in satisfaction in those who had reported stomach upset within 48 hours of taking their previous bisphosphonate at screening. RESULTS: Of women who reported GI symptoms at baseline, >60% reported an improvement in heartburn or acid reflux after switching to monthly ibandronate. Further, >70% reported improvements in stomach upset (excluding heartburn or acid reflux). Of those women who reported stomach upset within 48 hours of taking their previous weekly bisphosphonate at screening (n = 89), >80% reported improved overall satisfaction compared with baseline. Monthly ibandronate was generally well tolerated. CONCLUSION: A majority of women who experienced GI tolerability issues with weekly bisphosphonates reported improvements in GI symptoms after transitioning from a weekly bisphosphonate to monthly ibandronate for 6 months.