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Menopausal changes, quality of life, and hormone therapy

Nachtigall, Lila E; Nachtigall, Margaret J
PMID: 15166873
ISSN: 0009-9201
CID: 45982

A clinical study to assess the effectiveness of a nonhormonal vaginal moisturizer in menopausal women [Meeting Abstract]

Nachtigall LE; Nachtigall MJ; Jacob E
Objective: To assess the effectiveness of a vaginal moisturizer in menopausal women with external vaginal dryness. We studied a nonhormonal topically applied external vaginal moisturizer in women with external vaginal (vulvar) dryness to see if we could approach the results of a topically applied hormonal product.Methods: The 4-week clinical study included 30 subjects who were randomly divided into two groups to use either one of two topically-applied products for treating vaginal dryness: Vagisil Intimate Moisturizer (VIM) a nonprescription, nonhormonal, water based lotion and Premarin Creme (PC), a prescription hormone cream. VIM was applied twice a day to the external vaginal area. PC was applied once every other day to the internal vaginal area in healthy menopausal patients with vaginal dryness not requiring systemic therapy. The parameters studied were external dryness (0-5), pH, and subject discomfort (0-5). Patients accepted into the study were evaluated for vaginal dryness at baseline determined on a scale of 0-5. An external pH was taken and the patient rated her own discomfort on a scale of 0-5. Patients were seen at 2 and 4 weeks at which time they repeated the discomfort scale and were rated by the investigator for external vaginal dryness and pH. Subjects reported any adverse events.Results: 100% of PC treated patients and 75% of VIM patients decreased their pH to below 5. However, significant improvement was reported by patient and physician evaluation in both treatment groups.Conclusion: The nonhormonal, topical lotion Vagisil Intimate Moisturizer is a viable alternative to hormone cream for treatment of external vaginal dryness
ISSN: 0029-7844
CID: 11791

Nonprescription alternatives to hormone replacement therapy

Nachtigall, Lisa B; Nachtigall, Margaret J; Nachtigall, Lila E
ISSN: 1559-3177
CID: 90919

Application of imaging for ovulation induction and in vitro fertilization-embryo transfer

Chapter by: Schwartz LB; Nachtigall MJ; Laufer N
in: Diagnostic imaging for reproductive failure by Schwartz LB; Olive DL; McCarthy S [Eds]
New York : Parthenon, 1998
pp. ?-?
ISBN: 1850705615
CID: 4927

The application of transvaginal ultrasound for ovulation induction and in vitro fertilization

Nachtigall MJ; Schwartz LB
PMID: 8635303
ISSN: 0009-9201
CID: 57361

Hormone replacement therapy

Nachtigall LE; Nachtigall MJ
Although hormone replacement therapy (HRT) has been available for almost 100 years, conflicting opinions still exist about its efficacy and safety. There is uniform agreement that vasomotor instability and vaginal atrophy are totally reversible with HRT. Effective treatment of bone loss with HRT depends on the number of years of estrogen deprivation, peak bone mass, and rapidity of bone loss. Oral, transdermal, and pellet estrogens are equality effective. Mortality from coronary heart disease decreased 20% to 40% in women on HRT, yet the mechanism has not yet been ascertained. The increased risk of endometrial cancer has been confirmed, but better diagnostic techniques for detection in the precancerous state have been developed. The relationship of breast cancer to estrogen use has not been conclusive. Meta-analysis of 13 studies results in a relative risk of 1.06, whereas a large case-control study reveals a relative risk of 0.9. However, it is clear that in the average, healthy woman, low-dose estrogen replacement for less than 10 years does not increase the risk of breast cancer. Physicians are encouraged to help patients weigh the risks and benefits of HRT
PMID: 1450357
ISSN: 1040-872x
CID: 13352

Incidence of breast cancer in a 22-year study of women receiving estrogen-progestin replacement therapy

Nachtigall MJ; Smilen SW; Nachtigall RD; Nachtigall RH; Nachtigall LE
OBJECTIVE: To review the incidence of breast cancer in a continuous 22-year study of conjugated estrogen-medroxyprogesterone acetate hormone replacement therapy. METHODS: Eighty-four pairs of continuously hospitalized postmenopausal women who were matched for age, smoking history, and medical diagnosis were treated with estrogen-progestin hormone replacement therapy or placebo in a prospective and double-blind manner for 10 years. In the subsequent 12 years, the women were offered the choice of starting, stopping, or continuing hormone replacement therapy. RESULTS: After the initial 10 years, the incidence of breast cancer in the placebo group was 4.8%, whereas no cancers were found in the hormone replacement therapy group (P = .12). After an additional 12 years of follow-up, the overall incidence of breast cancer in the women who had never taken hormone replacement therapy was 11.5%, whereas no breast cancers had developed in the women who had ever taken hormone replacement therapy (P < .01). CONCLUSIONS: These data suggest that the 22-year administration of estrogen-progestin hormone replacement therapy did not increase the incidence of breast cancer in a small group of continuously hospitalized postmenopausal women
PMID: 1328978
ISSN: 0029-7844
CID: 57462

Endometrial assessment by vaginal ultrasonography before endometrial sampling in patients with postmenopausal bleeding

Goldstein, S R; Nachtigall, M; Snyder, J R; Nachtigall, L
Endometrial sampling is the mainstay of management of the postmenopausal patient with uterine bleeding. Thirty women with postmenopausal bleeding were studied prospectively. Before endometrial sampling, a vaginal probe ultrasonographic examination was performed. Eleven patients demonstrated a thin 'pencil line' endometrial echo in which the maximum anteroposterior thickness on the long axis view was less than or equal to 5 mm. All eleven patients had minimal tissue obtained on biopsy and a pathology report of 'tissue insufficient for diagnosis.' Seventeen patients had an echogenic endometrium greater than or equal to 6 mm. Pathology reports of their samples revealed tissue insufficient for diagnosis (two cases), proliferative endometrium (six), secretory endometrium (three), hyperplastic endometrium (three), polyp (two), and endometrial cancer (one case). Two additional patients had no endometrial echo visualized because of associated myomas. These findings suggest (1) that the absence of significant endometrial tissue (echo less than or equal to 5 mm) on vaginal ultrasonography in cases with postmenopausal bleeding is uniformly associated with tissue insufficient for diagnosis, and (2) when endometrial thickness is greater than or equal to 6 mm the histologic diagnosis should be determined in the pathology laboratory
PMID: 2197861
ISSN: 0002-9378
CID: 90915


ISSN: 0006-3185
CID: 50756