Women s health

Writing Group for the Women s Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women principal results from the Women s Health Initiative randomized controlled trial. JAMA 288 321-333... 

When oxytocin is prescribed, the primary health care provider orders the type and amount of IV fluid, the number of units of oxytocin added to the IV solution, and the IV infusion rate An electronic infusion device is used to control the infusion rate. The primary health care provider establishes guidelines for the administration of the oxytocin solution and for increasing or decreasing the flow rate or discontinuing the administration of oxytocin based on standards established by the Association of Women s Health, Obstetric, and Neonatal Nurses (AWHONN). Usually, the flow rate is increased every 20 to 30 minutes, but this may vary according to the patient s response. The strength, frequency, and duration of contractions and the FHR are monitored closely. 

CD Since the publication of the Women s Health Initiative study, there has been an increase in the use of non-hormonal therapies for the management of menopausal symptoms. Particularly for women with CHD and breast cancer risk factors, non-hormonal therapies may offer an alternative to assist with symptom management. A wide range of therapies, both prescription and herbal, have been studied with varying degrees of success. In choosing a particular therapy, it is important to match patient symptoms with a therapy that is not only effective but also safe. 

As of 1995, almost 38% of all women 50 to 75 years of age were using HRT.1 It was in 1996 that the United States Preventive Services Task Force (USPSTF) first published its recommendations that not all postmenopausal women should be prescribed HRT, but rather, therapy should be individualized based on risk factors. This recommendation was further supported with publication of the Heart and Estrogen/Progestin Replacement Study (HERS) in 1998, which demonstrated that women who had established CHD were at an increased risk of experiencing a myocardial infarction within the first year of HRT use compared with a similar group of women without CHD risk factors. As a result, the authors concluded that HRT is not recommended for the secondary prevention of CHD.2 Then, in 2002, the Women s Health Initiative (WHI) report was published. This trial demonstrated that HRT was not protective against CHD but... 

HOPE Women s Health, Osteoporosis, Progestin/Estrogen trial... 

WHIMS Women s Health Initiative Memory Study... 

Anderson GL, Limacher M, Assaf AR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy The Women s Health Initiative randomized, controlled trial. JAMA 2004 291 1701-1712. 

Espeland MA, Rapp SR, Shumaker SA, et al. Conjugated equine estrogens and global cognitive function in postmenopausal women Women s Health Initiative memory study. JAMA 2004 291 2959-2968. 

Wassertheil-Smoller S, Hendrix SL, Limacher M, et al. Effect of estrogen plus progestin on stroke in postmenopausal women. The Women s Health Initiative A randomized trial. JAMA 2003 289 2673-2684. 

University of Tennessee Health Science Center Women s Health Nurse Practitioner/Certihed Nurse Midwife Memphis Obstetrics and Gynecological Association P.C. Bartlett, Tennessee... 

In 1990, Vatten et al.51 in Norway subsequently reviewed data on breast cancer risk from a cohort of 14,593 women with 152 cases of breast cancer during a follow up of 12 years on subjects who were between 35 and 51 years old at the beginning of the study and between 46 and 63 years at the end. They reported no overall statistically significant correlation between breast cancer and coffee consumption, but when body mass index was taken into account, lean women who consumed >5 cups per day had a lower risk than women who drank two cups or less. In obese women, however, there was a positive correlation between coffee intake and breast cancer. In a 1993 study, though, Folsom and associates52 failed to find an association between caffeine and postmenopausal breast cancer in 34,388 women in the Iowa Women s Health Study, with a median caffeine intake of 212 mg/day in women who developed breast cancer and 201 mg/day for women who did not and in Denmark, Ewertz53 studied... 

Folsom, A. R., McKenzie, D. R., Bisgard, K. M., Kushi, L. H., Sellers, T. A., No association between caffeine intake and postmenopausal breast cancer incidence in the Iowa Women s Health Study, Am J Epidemiol, 138, 380, 1993. 

In the Massachusetts Women s Health Study, a population-based cross-sectional investigation of women, Hernandiz-Avila and colleagues16 also found an inverse linear association with caffeine intake (estimated from... 

Liu S, Manson JE, Lee IM et al. (2000), Fruit and vegetable intake and risk of cardiovascular disease The Women s Health Study, Am. J. Clin. Nutr. 72 922-928. 

Mares, J. A., T. L. LaRowe et al. (2006). Predictors of optical density of lutein and zeaxanthin in retinas of older women in the carotenoids in age-related eye disease study, an ancillary study of the women s health initiative. Am. J. Clin. Nutr. 84(5) 1107-1122. 

LaRowe, TL, Mares, JA, Snodderly, DM, Klein, ML, Wooten, BR, and Chappell, R, 2008. Macular pigment density and age-related maculopathy in the Carotenoids in Age-Related Eye Disease Study. An ancillary study of the women s health initiative. Ophthalmology 115, 876-883 e871. 

Moeller, SM, Parekh, N, Tinker, L, Ritenbaugh, C, Blodi, B, Wallace, RB, and Mares, JA, 2006. Associations between intermediate age-related macular degeneration and lutein and zeaxanthin in the Carotenoids in Age-related Eye Disease Study (CAREDS) Ancillary study of the Women s Health Initiative. Arch... 

National Women s Health Information Center (NWHIC)... 

LeeLM, Cook NR, Manson JE, Buring JE, Hennekens CH. 1999. (3-Carotene supplementation and incidence of cancer and cardiovascular disease die Women s Health Study. J Natl Cancer Inst 91 2102—2106. 

Steinmetz KA, Potter JD and Folsom AR. 1993. Vegetables, fruit, and lung cancer in the Iowa Women s Health Study. Cancer Res 53 536—543. 

Arts IC, Jacobs DR Jr., Gross M, HarnackLJ and Folsom AR. 2002a. Dietary catechins and cancer incidence among postmenopausal women the Iowa Women s Health Study (United States). Cancer Causes Control 13(4) 373-382. 

The continuous combined oral estrogen-progestogen arm of the Women s Health Initiative (WHI) study was terminated prematurely after a mean of 5.2-year follow-up because of the occurrence of a prespecified level of invasive breast cancer. The study also found increased coronary disease events, stroke, and pulmonary embolism. Beneficial effects included decreases in hip fracture and colorectal cancer. 

Finally, a major question in SERM development is whether the new compounds will behave like estrogens with respect to cardiovascular events, which would be a worthless property given the results of the WHI trial (Writing Group for the Women s Health Initiative Investigators 2002 Women s Health Initiative Steering Committee 2004). This is a complex issue that will depend on the unique profile of action of the new SERM on the different components of the atherosclerosis process and the patient population and study design and conduct that is implemented. 

Shumaker SA, Legault C, Kuller L, Rapp SR, Thai L, Lane DS, et al. (2004) Conjugated equibe estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women. Women s Health Initiative Memory Study. J Am Med Assoc 291 2947-2958... 

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