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  1. Fulltext Practice patterns of some gynaecologists in Malaysia with regards to prophylactic oophorectomy and hormone replacement therapy
    Ravindran J, Leow CH
    Med J Malaysia, 1996 Dec;51(4):409-14.
    PMID: 10968026
    This study aimed to look at the prevailing practice patterns of gynaecologists with regards to prophylactic oophorectomy and usage of hormone replacement therapy. Questionnaires were sent to the first 200 gynaecologists listed in the membership list of the Obstetrical and Gynaecological Society of Malaysia. The response rate was 30%. The results showed that most gynaecologists would perform prophylactic oophorectomy after the age of 49 years. The result was equivocal for the ages between 45 to 49 years. Of those who retained the ovaries at the age of 45 to the menopause, 55% did so because the ovaries were still functional. Almost all gynaecologists would prescribe hormone replacement therapy (HRT) after oophorectomy and the most commonly prescribed form was the oral type. Thirty-five per cent of gynaecologists claimed that more than 80% of their patients were compliant to HRT. The reasons perceived for the poor compliance were mainly poor knowledge and misconception.
    Matched MeSH terms: Hormone Replacement Therapy*
  2. Fulltext Menopause and hormone replacement therapy. Facts and misconceptions
    Raman S, Damodaran P
    Med J Malaysia, 1996 Dec;51(4):407-8.
    PMID: 10968025
    Matched MeSH terms: Hormone Replacement Therapy*
  3. Growth hormone deficiency and cardiovascular risk
    Hew FL, O'Neal D, Kamarudin N, Alford FP, Best JD
    Baillieres Clin. Endocrinol. Metab., 1998 Jul;12(2):199-216.
    PMID: 10083892
    It is now recognized that growth hormone (GH) deficiency in adults represents a distinct clinical syndrome that encompasses reduced psychological well-being as well as specific metabolic abnormalities. The latter features, which include hypertension, central obesity, insulin resistance, dyslipidaemia and coagulopathy, closely resemble those of metabolic insulin resistance syndrome. The increased cardiovascular morbidity and mortality demonstrated in these GH-deficient (GHD) adults reinforce the close association between the two syndromes. Replacement of GH in GHD adults has resulted in a marked reduction of central obesity and significant reduction in total cholesterol but little change in other risk factors, in particular insulin resistance and dyslipidaemia. The persistent insulin resistance and dyslipidaemia, together with the elevation of plasma insulin levels and lipoprotein (a) with GH replacement in these subjects are of concern. Long-term follow-up data are required to assess the impact of GH replacement on the cardiovascular morbidity and mortality of GHD adults. Further exploration of the appropriateness of the GH dosage regimens currently being employed is also indicated.
    Matched MeSH terms: Hormone Replacement Therapy*
  4. Fulltext Profile of a menopause clinic in an urban population in Malaysia
    Damodaran P, Subramaniam R, Omar SZ, Nadkarni P, Paramsothy M
    Singapore Med J, 2000 Sep;41(9):431-5.
    PMID: 11193115
    The object of this study is to determine the status of an urban Malaysian woman in her menopause age group with reference to her menopausal symptoms, lipid profile, breast, pelvis and bone. One hundred and sixty four women attending the Menopause Clinic of University Hospital, Kuala Lumpur who had not previously been on hormone replacement therapy were studied. Forty nine women were perimenopausal, 74 women were in early menopause (within 5 years of menopause) and 41 women were in late menopause (after 5 years of menopause). The most common symptoms were hot flushes (56%) and generalised tiredness (49%). Eighty four percent (84%) of women had high cholesterol levels. Serum triglycerides were highest in the late menopause group. There were 2 cases of intraductal carcinoma diagnosed on routine mammography, with 8 cases of fibrocystic breast disease and 7 cases of suspicious breast lumps. Routine ultrasound (pelvic and abdominal) revealed two women with ovarian cysts, 6 women with an endometrial thickness of more than 5 mm and 8 women with uterine fibroids. Eighty five women (51.8%) had mild osteoporosis while four women had moderate osteoporosis on dual photon measurements for bone mineral density. Menopause clinics should aim at investigating a woman in her menopause as a whole. Vasomotor symptoms were common in the urban Malaysian menopausal woman. There was a high incidence of lipid abnormalities. Routine mammography, pelvic ultrasound examinations and bone mineral density tests detected significant pathology and abnormalities.
    Study site: Menopause Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hormone Replacement Therapy
  5. Fulltext Profile of breast cancer among women in Kelantan
    Norsa’adah, B.B., Rusli, B.N., lmran, B.A.K., Naing, L.
    Malaysian Journal of Public Health Medicine, 2004;4(2):24-29.
    MyJurnal
    Breast cancer is the commonest female cancer in Malaysia with a prevalence of 86.2 cases per 100,000 women in 1996. Pronling breast cancer patients is important for better planning of preventive and screening strategies for Malaysian women. The aims of this cross-sectional study were to identify histological presentation, socio-demographic and reproductive characteristics and prevalence of risk or protective factors of breast cancer among women with breast cancer in Kelantan. A total of 175 female breast cancer patients who were diagnosed in 1991 to 2000, were interviewed using standardized questionnaires. The mean (sd) age was 47.0 (9.6) years with 77.7% Malay, 20.6% Chinese and 1.7% others. About half (52.6%) had 9 years or less of formal education, while 59.4% were housewives/unemployed and 60.6% had a monthly family income of less than RM1 ,000. The commonest histological type was innltrative ductal carcinoma (73 .7%) . Presentation of breast cancer with the stage lll or Vl was 59.4%. The prevalence of nulliparity · 13.1%, breastfeeding longer than two years - 58.9%, premenstrual period - 72.0%, menarche at 11 years old or less - 5 .7%, positive family history - 14.4%, overweight/obesity - 48.0%, oral contraceptives use 30.3%, hormone replacement therapy » 1.1%, cigarette smoking - 4.6%, consuming akohol - 3.4%, previous benign breast disease - 6.3%, previous breast biopsy - 2.9% and previous oophorectomy - 4.6%. The patients were younger compared to other studies. The ethnic distribution did not represent the population distribution of Kelantan. The prevalence of overweight/obesity and smoking were higher than the national prevalence among women, thus they should be included in the prevention strategies for breast cancer. Further studies are recommended to investigate why many of breast cancer patients in Kelantan presented at a younger age and at advanced stages of cancer.
    Matched MeSH terms: Hormone Replacement Therapy
  6. Bone health in urban midlife Malaysian women: risk factors and prevention
    Lim PS, Ong FB, Adeeb N, Seri SS, Noor-Aini MY, Shamsuddin K, et al.
    Osteoporos Int, 2005 Dec;16(12):2069-79.
    PMID: 16234999 DOI: 10.1007/s00198-005-2003-4
    The aim of this study was to identify risk factors associated with osteoporosis in urban midlife Malaysian women and to assess the effectiveness of lifestyle intervention in bone loss prevention with hormone replacement therapy (HRT) as a positive control. A total of 514 disease-free, uterus-intact, non-HRT-using women aged 45 years and older were recruited into the study. After initial bone mineral density (BMD) assessments, they were randomized into three groups: GI (control), G2 (lifestyle intervention), and G3 (lifestyle intervention with HRT). The study group was composed of 67.5% Chinese, 27.8% Malay, and 4.2% Indians with a mean age of 51.07+/-5.28 years. Two-fifths were postmenopausal, and the prevalence of osteoporosis was 24.1%, seen predominantly at the hip. Postmenopausal women had significantly lower mean BMD and a higher incidence of osteoporosis compared with the premenopausal women, 42.1% vs. 11.1% (p<0.0005). A lower incidence of osteoporosis was found in women who took calcium supplementation regularly as opposed to those who do not, 18.7% vs. 29.3% (p=0.036). Age and a greater postmenopausal duration showed a significant negative association with BMD, whereas higher family income, weight, body mass index, and waist and hip circumference were positively correlated. After 18-20 months, the effect of intervention was assessed based on BMD values of 279 women at baseline and after intervention. Lifestyle intervention alone was effective in premenopausal women, preventing over 90% of spinal bone loss compared with the controls, who lost 11.6% (0.046 g/cm2) bone mass with similar losses of hip bone, 2.0% (0.026 g/cm2) vs. 1.5% (0.020 g/cm2). Premenopausal women on HRT also showed a substantial decrease in spine and hip BMD, 18.6% (0.081 g/cm2) and 9.0% (0.122 g/cm2), respectively. The lifestyle intervention program retarded postmenopausal bone loss by 21% and 37% compared with controls, who lost 9.6% (0.141 g/cm2) and 6.0% (0.138 g/cm2) bone mass at the spine and hip. In comparison, lifestyle intervention with HRT increased postmenopausal BMD by 12.7% (0.216 g/cm2) at the spine and 1.9% (0.042 g/cm2) at the hip. The changes in hip BMD were influenced by current age, ethnicity, and income, while intervention had the strongest effect on spine BMD changes. In conclusion, lifestyle intervention prevented spinal bone loss in premenopausal women and retarded postmenopausal spine and hip bone loss compared with controls. The benefits of physical activity on spine and hip BMD highlight its potential as a safe and cost-effective alternative to HRT, which is not advocated because of its potential adverse effects.
    Matched MeSH terms: Hormone Replacement Therapy/methods
  7. Sexual function in menopausal women in Kelantan, Malaysia
    Dhillon HK, Singh HJ, Ghaffar NA
    Maturitas, 2005 Nov-Dec;52(3-4):256-63.
    PMID: 15894440 DOI: 10.1016/j.maturitas.2005.03.014
    The aim of the study was to document sexual function in Kelantanese postmenopausal women.
    Matched MeSH terms: Hormone Replacement Therapy/utilization
  8. A study of the factors related to intima-media thickness of the common carotid artery amongst rural middle age individuals in Hospital Universiti Sains Malaysia
    Yunus R, Ariff AR, Shuaib IL, Jelani AM, Alias NA, Abdullah J, et al.
    Southeast Asian J. Trop. Med. Public Health, 2006 Jul;37(4):806-11.
    PMID: 17121310
    There is very little data regarding the factors related to intima-media thickness (IMT) of the common carotid artery in normal individuals in those with non-insulin diabetes mellitus and perimenopausal women in Southeast Asian countries. Ultrasound imaging evaluating the carotid artery IMT in those with diabetes and those on hormone replacement therapy (HRT) was performed beginning in August 2000 for a period of nearly two years at the Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. A total of 153 participants were included. Significant differences between the women on HRT and not on HRT were IMT and systolic blood pressure. When comparing those with non-insulin dependent diabetes mellitus (NIDDM) and normal individuals, the significant differences were IMT, total cholesterol level, systolic blood pressure and diastolic blood pressure. IMT was high in those with NIDDM but not in those on HRT. Both those with NIDDM and those on HRT had associated dyslipidemia and systolic hypertension.
    Matched MeSH terms: Hormone Replacement Therapy*
  9. Relationship between reproductive exposures and age-related cataract in women
    Noran NH, Salleh N, Zahari M
    Asia Pac J Public Health, 2007;19(2):23-8.
    PMID: 18050560
    The objective of this study is to evaluate the relationship between reproductive exposures and age-related cataract among women. This was a hospital based case-control study. The study population included female patients, aged 50 years and above who attended the Eye clinic at the University of Malaya Medical Centre. The outcome measurement was based on ophthalmologic examination by an ophthalmologist. The data on exposure was obtained from face to face interview using a structured questionnaire. In order to reduce the recall bias, patients' medical records were used to substantiate the exposure status. Multiple logistic regression was used to assess the association of age-related cataract with exogenous estrogen usage (HRT and OCP) and duration of menses. Important confounders such as age, history of diabetes, cigarette smoking and steroids usage were controlled for in the analysis. Females with 29 years or less of endogenous estrogen exposure of, have almost three times the risk of developing age related cataract (adjusted OR 3.42: 95% CI: 1.28, 9.16), similarly among those with exposure of 30-32 years (adjusted OR 3.64: 95% CI: 1.08, 12.26). Hormone Replacement Therapy used for more than three years was found to be a protective factor of age-related cataract. There is evidence that reproductive exposure may play a role in reducing the occurrence of age-related cataract among Malaysian women.
    Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hormone Replacement Therapy*
  10. Fulltext A New Diagnostic Approach in the Detection of Breast Carcinoma: Electrical Impedance Measurement with TransScan TS 2000
    Amran, A.R., Fatimah, M.
    International Medical Journal Malaysia, 2007;6(2):1-11.
    MyJurnal
    Introduction: Mammography is commonly regarded as the single most important tool for screening and for early detection of breast cancer. However it is not generally recommended for women under 40 years of age and in those taking hormone replacement therapy as the increased density of the breast parenchyma may make mammography more difficult to read and interpret. The limitations of mammography have spurred attempts to find new techniques that can be used either separately or in conjunction with mammography. Purpose: The aim of this study was to quantify the clinical value of using electrical impedance scanning (EIS) or Trans Scan as an adjunct to mammography in order to identify cancerous tissue based upon its inherent altered local dielectric properties. Methods and Materials: The patients were examined using Trans Scan (Trans Scan Medical, Ltd., distributed by Siemens AG. The study population was derived from patients with suspicious breast lesions categorized as BIRADS 3 or 4 detected during mammography or ultrasound. Results: Fifty-three women with 53 mammographically and/or sonographically suspicious findings were examined using EIS. With respect to the histopathological findings (15 malignant and 38 benign lesions) 13 of 15 (86.6% sensitivity) malignant lesions were correctly identified using EIS whereas, 33 of 38 (81.5% specificity) benign lesions were correctly identified. Negative and positive predictive values of 93.9% and 65% were observed respectively. Two benign lesions were correctly identified in a dense breast. The smallest lesion detected in this study measured 20 x 14 mm, which was an infiltrating ductal carcinoma. Conclusion: Electrical impedance scanning as an adjunct to mammography or ultrasound in classifying suspicious lesions is promising because it increases the sensitivity for cancer detection and may reduce biopsy of equivocal lesions. The additional use of EIS with negative predictive value of 93.9% may be useful to exclude some benign lesions from further diagnostic or invasive procedures. Artifacts, such as signals from superficial skin lesions, poor contact and bubbles are currently a limitation
    Matched MeSH terms: Hormone Replacement Therapy
  11. Fulltext Prevalence and Risk Factors of Work Related Upper Limb Disorders (WRULD) Among Female Telephone Operators in a Telecommunication Centre in Kuala Lumpur
    Noor Hassim Ismail, Rafiza Shaharuddin
    Medicine & Health, 2008;3(1):38-45.
    MyJurnal
    A study was carried out on 79 female telephone operators working in a Telecommunication Centre in Kuala Lumpur to determine the prevalence of Work Related Upper Limb Disorders (WRULD) and its risk factors. Data collection for this study was done between December 2000 and May 2001. The presence of WRULD was determined based on a guided questionnaire and physical examination. The response rate for this study was 94.9% (n= 75) and results showed that the prevalence of WRULD among the female telephone operators was 48.0%: Stage 1= 38.9%, Stage 2= 19.4%, Stage 3= 38.9%, Stage 4= 0% and Stage 5= 2.8%. In the telecommunication centre, it was found that those with WRULD had a mean of 11.59±9.09 years of employment duration whereas those without WRULD had a mean of 9.89 ± 8.48 years of employment duration. None of the factors studied such as Body Mass Index, age, ethnicity, menstrual cycle, hormone replacement therapy, overtime work, duration of employment in the present unit and in the telecommunication center differ in distribution between subjects with and without WRULD. This could be contributed by factors such as small number of subjects or the common healthy worker effect found in occupational health research. The findings studied of this study show that almost 40.0% of the workers experienced pain and neurological symptoms. Since none of the factors was found to be associated with WRULD, an elaborate study with a case-control design is needed in order to match cases and enable researchers to control the effect of confounding factors. This will ensure risk factors pertinent to WRULD in the Malaysian setting to be identified.
    Matched MeSH terms: Hormone Replacement Therapy
  12. Fulltext I am hot, irritable and feeling low; what alternatives do I have besides hormone replacement therapy?
    Sharifah Sulaiha SA, Nazimah I, Zainurrashid Z
    Malays Fam Physician, 2010;5(3):126-129.
    PMID: 25606203 MyJurnal
    Women at the end of their reproductive age often complain of climacteric symptoms which can be quite debilitating at times. Physiological changes due to deficient oestrogen have received global attention in the search for an acceptable and safe measure to improve quality of life for women with these complaints. Hormone replacement therapy (HRT) used to be the main treatment for menopausal symptoms. Lately there are concerns about its possible adverse effects of increasing risks of breast malignancy, heart diseases, etc. Complementary Alternative Medicine (CAM) plays a significant role in relieving these climacteric symptoms especially in women with contraindications to hormonal therapy and in those who are worried of its adverse effects. It is important for women to be aware of these CAM to provide them with options to improve their quality of life. This paper explores other pharmacological and non-pharmacological measures as alternatives to hormone replacement therapy (HRT), to assess how useful and reliable they are according to available scientific evidence.
    Matched MeSH terms: Hormone Replacement Therapy
  13. The anti-osteoporotic effect of Eurycoma Longifolia in aged orchidectomised rat model
    Shuid AN, Abu Bakar MF, Abdul Shukor TA, Muhammad N, Mohamed N, Soelaiman IN
    Aging Male, 2011 Sep;14(3):150-4.
    PMID: 20874437 DOI: 10.3109/13685538.2010.511327
    Osteoporosis in elderly men is becoming an important health issue with the aging society. Elderly men with androgen deficiency are exposed to osteoporosis and can be treated with testosterone replacement. In this study, Eurycoma longifolia (EL), a plant with androgenic effects, was supplemented to an androgen-deficient osteoporotic aged rat as alternative to testosterone. Aged 12 months old Sprague-Dawley rats were divided into groups of normal control (NC), sham-operated (SO), orchidectomised-control (OrxC), orchidectomised and supplemented with EL (Orx + El) and orchidectomised and given testosterone (Orx + T). After 6 weeks of treatment, serum osteocalcin, serum terminal C-telopeptide Type 1 collagen (CTX) and the fourth lumbar bone calcium were measured. There were no significant differences in the osteocalcin levels before and after treatment in all the groups. The CTX levels were also similar for all the groups before treatment. However, after treatment, orchidectomy had caused significant elevation of CTX compared to normal control rats. Testosterone replacements in orchidectomised rats were able to prevent the rise of CTX. Orchidectomy had also reduced the bone calcium level compared to normal control rats. Both testosterone replacement and EL supplementation to orchidectomised rats were able to maintain the bone calcium level, with the former showing better effects. As a conclusion, EL prevented bone calcium loss in orchidectomised rats and therefore has the potential to be used as an alternative treatment for androgen deficient osteoporosis.
    Matched MeSH terms: Hormone Replacement Therapy
  14. Fulltext Eurycoma longifolia: Medicinal Plant in the Prevention and Treatment of Male Osteoporosis due to Androgen Deficiency
    Mohd Effendy N, Mohamed N, Muhammad N, Naina Mohamad I, Shuid AN
    Evid Based Complement Alternat Med, 2012;2012:125761.
    PMID: 22844328 DOI: 10.1155/2012/125761
    Osteoporosis in elderly men is now becoming an alarming health issue due to its relation with a higher mortality rate compared to osteoporosis in women. Androgen deficiency (hypogonadism) is one of the major factors of male osteoporosis and it can be treated with testosterone replacement therapy (TRT). However, one medicinal plant, Eurycoma longifolia Jack (EL), can be used as an alternative treatment to prevent and treat male osteoporosis without causing the side effects associated with TRT. EL exerts proandrogenic effects that enhance testosterone level, as well as stimulate osteoblast proliferation and osteoclast apoptosis. This will maintain bone remodelling activity and reduce bone loss. Phytochemical components of EL may also prevent osteoporosis via its antioxidative property. Hence, EL has the potential as a complementary treatment for male osteoporosis.
    Matched MeSH terms: Hormone Replacement Therapy
  15. Osteoporotic fracture healing: potential use of medicinal plants from the tropics
    Abdul Jalil MA, Shuid AN, Muhammad N
    Curr Drug Targets, 2013 Dec;14(14):1651-8.
    PMID: 24354586
    With improvements in living standards and healthcare, life expectancy has been increasing dramatically in most parts of the world. These situations lead to the increase in the reported cases of geriatrics-related diseases such as hypogonadal osteoporosis with skeletal fracture being the ultimate outcome, which eventually causes significant morbidity and mortality. The deficient gonadal hormones, which are the main cause of hypogonadal osteoporosis, could be substituted with hormone replacement therapy to hinder bone loss. However, the artificial hormonal therapy has been linked to grievous conditions such as breast and prostate cancers. In view of the various adverse effects associated with conventional treatment, many researchers are now focusing on finding alternative remedies from nature. This article explores the possibilities of certain medicinal plants native to Malaysia that possess androgenic and antioxidant properties to potentially be used in the treatment of fracture due to osteoporosis in ageing people.
    Matched MeSH terms: Hormone Replacement Therapy
  16. Fulltext Influence of lifestyle factors on mammographic density in postmenopausal women
    Brand JS, Czene K, Eriksson L, Trinh T, Bhoo-Pathy N, Hall P, et al.
    PLoS One, 2013;8(12):e81876.
    PMID: 24349146 DOI: 10.1371/journal.pone.0081876
    BACKGROUND: Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT), little is known about lifestyle factors that influence breast density.
    METHODS: We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI) and HRT was studied.
    RESULTS: Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07). This association was modified by HRT use (P interaction  = 0.06): increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01) but not in non-current users (P trend  = 0.82). A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04). No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use.
    CONCLUSIONS: Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.
    Matched MeSH terms: Hormone Replacement Therapy/adverse effects*
  17. Phytoandrogenic properties of Eurycoma longifolia as natural alternative to testosterone replacement therapy
    George A, Henkel R
    Andrologia, 2014 Sep;46(7):708-21.
    PMID: 24386995 DOI: 10.1111/and.12214
    The testosterone deficiency syndrome (TDS) is characterised by numerous symptoms, including low libido, increased fat mass, fatigue, erectile dysfunction or osteoporosis, and up to 80% of men will experience some kind of ageing males' symptoms. This is caused by the age-depending decline in serum testosterone levels with concentrations being about 40-50% lower in men older than 60 years compared with young men. This significant decline in testosterone levels is further closely linked with medical conditions such as obesity, metabolic syndrome, diabetes or hypertension. The conventional way of treating TDS is the testosterone replacement therapy (TRT), for which preparations are on the market. Apart from the beneficial effects of TRT, significant adverse side effects have been described, and prostate cancer (PCa) as absolute contraindication is debated. Eurycoma longifolia (Tongkat Ali; TA) is natural alternative to TRT and has been shown to restore serum testosterone levels, thus significantly improving sexual health. This includes significant positive effects on bone health and physical condition of patients. In addition, a significant antihyperglycaemic effect and cytotoxicity against PCas cells has been shown. Thus far, at therapeutic concentrations, no significant side effects of the treatment were obvious. Therefore, TA might be a safe alternative to TRT.
    Matched MeSH terms: Hormone Replacement Therapy*
  18. Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia
    Ohn Mar S, Malhi F, Syed Rahim SH, Chua CT, Sidhu SS, Sandheep S
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):19S-25S.
    PMID: 25972428 DOI: 10.1177/1010539515586457
    This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P < .001), age between 50 and 54 years (P < .01), lower self-health rating (P < .05), education level of diploma or professional degree (P < .05), employment as professionals or entrepreneurs (P < .05), and the use of hormone replacement therapy (P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654).
    Matched MeSH terms: Hormone Replacement Therapy/utilization
  19. Fulltext Overweight duration in older adults and cancer risk: a study of cohorts in Europe and the United States
    Arnold M, Freisling H, Stolzenberg-Solomon R, Kee F, O'Doherty MG, Ordóñez-Mena JM, et al.
    Eur J Epidemiol, 2016 Sep;31(9):893-904.
    PMID: 27300353 DOI: 10.1007/s10654-016-0169-z
    Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing different forms of cancer. Study participants from seven European and one US cohort study with two or more weight assessments during follow-up were included (n = 329,576). Trajectories of body mass index (BMI) across ages were estimated using a quadratic growth model; overweight duration (BMI ≥ 25) and cumulative weighted overweight years were calculated. In multivariate Cox models and random effects analyses, a longer duration of overweight was significantly associated with the incidence of obesity-related cancer [overall hazard ratio (HR) per 10-year increment: 1.36; 95 % CI 1.12-1.60], but also increased the risk of postmenopausal breast and colorectal cancer. Additionally accounting for the degree of overweight further increased the risk of obesity-related cancer. Risks associated with a longer overweight duration were higher in men than in women and were attenuated by smoking. For postmenopausal breast cancer, increased risks were confined to women who never used hormone therapy. Overall, 8.4 % of all obesity-related cancers could be attributed to overweight at any age. These findings provide further insights into the role of overweight duration in the etiology of cancer and indicate that weight control is relevant at all ages. This knowledge is vital for the development of effective and targeted cancer prevention strategies.
    Matched MeSH terms: Hormone Replacement Therapy/adverse effects
  20. Fulltext The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort
    Roura E, Travier N, Waterboer T, de Sanjosé S, Bosch FX, Pawlita M, et al.
    PLoS One, 2016;11(1):e0147029.
    PMID: 26808155 DOI: 10.1371/journal.pone.0147029
    BACKGROUND: In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC).

    METHODS AND FINDINGS: We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥ 15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4-0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7).

    CONCLUSIONS: Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening guidelines should minimize the increased risk of CC associated with these hormonal risk factors.

    Matched MeSH terms: Hormone Replacement Therapy/adverse effects
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