DOCSLIB.ORG

Sogc2014cpgabstract1.Pdf

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sogc2014cpgabstract1.Pdf Journal of Obstetrics and Gynaecology Canada The official voice of reproductive health care in Canada Le porte-parole officiel des soins génésiques au Canada Journal d’obstétrique et gynécologie du Canada Volume 36, Number 9 • volume 36, numéro 9 September • septembre 2014 Supplement 2 • supplément 2 Abstract . S1 Chapter 1: Assessment and Risk Management of Menopausal Women . S6 Chapter 2: Cardiovascular Disease . S16 Chapter 3: Menopausal Hormone Therapy and Breast Cancer . S23 Chapter 4: Vasomotor Symptoms . S31 Chapter 5: Urogenital Health . S35 Chapter 6: Managing Prescription Therapeutic Agents . S42 Chapter 7: Menopause Ongoing Management of Menopausal Women and Those With Special Considerations . S51 Chapter 8: Sexuality and Menopause . S59 Chapter 9: Complementary and Alternative Medicine (CAM) . S74 Publications mailing agreement #40026233. Return undeliverable Canadian copies and change of address notifications to SOGC Subscriptions Services, 780 Echo Dr. Ottawa, Ontario K1S 5R7. Editor-in-Chief / Rédacteur en chef Timothy Rowe CPL Editor / Rédactrice PPP Vyta Senikas Translator / Traducteur Martin Pothier Assistant Editor / Rédactrice adjointe Jane Fairbanks Editorial Assistant / Adjointe à la rédaction Daphne Sams Editorial Office / Bureau de la rédaction Journal of Obstetrics and Gynaecology Canada Room D 405A BC Women's Hospital 4500 Oak Street Vancouver BC V6H 3N1 [email protected] Tel: (604) 875-2424 ext. 5668 Fax: (604) 875-2590 http://www.jogc.com The Journal of Obstetrics and Gynaecology Canada (JOGC) is owned by the Society of Obstetricians and Gynaecologists of Canada (SOGC), published by the Canadian Psychiatric Association (CPA), and printed by The Lowe-Martin Group, Ottawa, ON. Le Journal d’obstétrique et gynécologie du Canada (JOGC), qui relève de la Société des obstétriciens et gynécologues du Canada (SOGC), est publié par l’Association des psychiatres du Canada (APC), et imprimé par The Lowe-Martin Group, Ottawa (Ontario). Publications Mail Agreement no. 40026233. Return undeliverable Canadian copies and change of address notices to SOGC, JOGC Subscription Service, 780 Echo Dr., Ottawa ON K1S 5R7. USPS #021-912. USPS periodical postage paid at Champlain, NY, and additional locations. Return other undeliverable copies to International Media Services, 100 Walnut St., #3, PO Box 1518, Champlain NY 12919-1518. Numéro de convention poste-publications 40026233. Retourner toutes les copies canadiennes non livrées et les avis de changement d’adresse à la SOGC, Service de l’abonnement au JOGC, 780, promenade Echo, Ottawa (Ontario), K1S 5R7. Numéro USPS 021-912. Frais postaux USPS au tarif des périodiques payés à Champlain (NY) et autres bureaux de poste. Retourner les autres copies non livrées à International Media Services, 100 Walnut St., #3, PO Box 1518, Champlain (NY) 12919-1518. The cover image was obtained through the: ISSN 1701-2163 Society of Obstetricians and Gynaecologists of Canada (SOGC) SOGC CLINICAL PRACTICE GUIDELINE No. 311, September 2014 (Replaces No. 222, January 2009) Managing Menopause This clinical practice guideline has been prepared by the The literature searches and bibliographic support for this Menopause and Osteoporosis Working Group, reviewed guideline were undertaken by Becky Skidmore, Medical by the Clinical Practice Gynaecology and Family Physician Research Analyst, Society of Obstetricians and Gynaecologists Advisory Committees, and approved by the Executive and of Canada . Council of the Society of Obstetricians and Gynaecologists Acknowledgement: Claudio N . Soares, MD, PhD, Toronto ON of Canada. Disclosure statements have been received from all contributors . PRINCIPAL AUTHORS Robert Reid, MD, Kingston ON Abstract Beth L . Abramson, MD, Toronto ON Jennifer Blake, MD, Toronto ON Objective: To provide updated guidelines for health care providers on the management of menopause in asymptomatic healthy women Sophie Desindes, MD, Sherbrooke QC as well as in women presenting with vasomotor or urogenital Sylvie Dodin, MD, Quebec QC symptoms and on considerations related to cardiovascular disease, breast cancer, urogynaecology, and sexuality . Shawna Johnston, MD, Kingston ON Outcomes: Lifestyle interventions, prescription medications, and Timothy Rowe, MB BS, Vancouver BC complementary and alternative therapies are presented according Namrita Sodhi, MD, Toronto ON to their efficacy in the treatment of menopausal symptoms. Counselling and therapeutic strategies for sexuality concerns in Penny Wilks, ND, Dundas ON the peri- and postmenopausal years are reviewed . Approaches Wendy Wolfman, MD, Toronto ON to the identification and evaluation of women at high risk of osteoporosis, along with options for prevention and treatment, are MENOPAUSE AND OSTEOPOROSIS WORKING GROUP presented in the companion osteoporosis guideline . Michel Fortier, MD (Co-Chair), Quebec QC Evidence: Published literature was retrieved through searches of PubMed and The Cochrane Library in August and September Robert Reid, MD (Co-Chair), Kingston ON 2012 with the use of appropriate controlled vocabulary (e .g ., Beth L . Abramson, MD, Toronto ON hormone therapy, menopause, cardiovascular diseases, and sexual function) and key words (e .g ., hormone therapy, Jennifer Blake, MD, Toronto ON perimenopause, heart disease, and sexuality) . Results Sophie Desindes, MD, Sherbrooke QC were restricted to clinical practice guidelines, systematic Sylvie Dodin, MD, Quebec QC reviews, randomized control trials/controlled clinical trials, and observational studies . Results were limited to publication dates Lisa Graves, MD, Toronto ON of 2009 onwards and to material in English or French . Searches Bing Guthrie, MD, Yellowknife NT were updated on a regular basis and incorporated in the guideline until January 5, 2013. Grey (unpublished) literature was identified Aliya Khan, MD, Hamilton ON through searching the websites of health technology assessment Shawna Johnston, MD, Kingston ON and health technology assessment-related agencies, national and international medical specialty societies, and clinical practice Timothy Rowe, MB BS, Vancouver BC guideline collections . Namrita Sodhi, MD, Toronto ON Penny Wilks, ND, Dundas ON Key Words: Menopause, estrogen, vasomotor symptoms, urogenital symptoms, mood, memory, cardiovascular diseases, Wendy Wolfman, MD, Toronto ON breast cancer, lifestyle, nutrition, exercise, estrogen therapy, complementary therapies, progestin, androgen, menopausal hormone therapy, hormones, estrogen, testosterone, menopause, depression, antidepressants, sexuality J Obstet Gynaecol Can 2014;36(9 eSuppl A):S1–S80 This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the SOGC. SEPTEMBER JOGC SEPTEMBRE 2014 l S1 Managing Menopause Values: The quality of the evidence in this document was rated using Recommendations for Health Care Providers the criteria described by the Report of the Canadian Task Force on 1. A waist circumference ≥ 88 cm (35 in) for women is associated Preventive Health Care (Table 1) . with an increased risk of health problems such as diabetes, heart disease, and hypertension and should be part of the initial SUMMARY STATEMENTS AND RECOMMENDATIONS assessment to identify risk . (II-2A) Chapter 1: 2 . Tobacco-use status should be updated for all patients on a regular basis, (I-A) health care providers should clearly advise patients to Assessment and Risk Management quit, (I-C) the willingness of patients to begin treatment to achieve of Menopausal Women abstinence (quitting) should be assessed, (I-C) and every tobacco user who expresses the willingness to begin treatment to quit Recommendations for Patients should be offered assistance . (I-A) 1 . Women aged 51 to 70 should consume 7 servings of vegetables 3 . Blood pressure should be assessed and controlled as women and fruits, 6 of grain products, 3 of milk and alternatives, and 2 of go through menopause . (II-2B) If the systolic blood pressure is meat and alterna tives daily . (III-A) ≥ 140 mmHg and/or the diastolic blood pressure is ≥ 90 mmHg, a specific visit should be scheduled for the assessment of 2 . A diet low in sodium and simple sugars, with substitution of hypertension . (III-A) unsaturated fats for saturated and trans fats, as well as increased consumption of fruits, vegetables, and fibre, is recommended. (I-A) 4. Women ≥ 50 years of age or postmenopausal and those with addi- tional risk factors, such as current cigarette smoking, diabetes, and 3 . Routine vitamin D supplementation and calcium intake for all arterial hypertension, should have lipid-profile screening done. (II-2A) Canadian adults year round is recommended . (I-A) 5 . A cardiovascular risk assessment using the Framingham Risk 4 . Achieving and maintaining a healthy weight throughout life is Score should be completed every 3 to 5 years for women aged recommended . (I-A) 50 to 75 . (II-2A) 5 . Women aged 18 to 64 should accumulate at least 150 minutes of 6 . A history of past pregnancy complications (preeclampsia, moderate to vigorous aerobic physical activity per week in bouts of gestational hypertension, gestational diabetes, placental abruption, 10 minutes or more . (I-A) idiopathic preterm
Load more

Recommended publications
  • Dehydroepiandrosterone – Is the Fountain of Youth Drying Out?
    Physiol. Res. 52: 397-407, 2003 MINIREVIEW Dehydroepiandrosterone – Is the Fountain of Youth Drying Out? P. CELEC 1,2, L. STÁRKA3 1Faculty of Medicine, 2Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia and 3Institute of Endocrinology, Prague, Czech Republic Received September 15, 2002 Accepted October 7, 2002 Summary Dehydroepiandrosterone (DHEA) and its sulphate-bound form (DHEAS) are important steroids mainly of adrenal origin. Their physiological and pathophysiological functions are not yet fully identified, although a number of various possible features have been hypothesized. Most popular is the description of the “hormone of youth” as the long-term dynamics of DHEA levels are characterized by a sharp age-related decline in the late adulthood and later. Low levels of DHEA are, however, associated not only with the ageing process but also with diabetes mellitus, cardiovascular diseases and some neurological or immunological entities. In the past decade, a number of brief studies have concentrated on these relationships and also on the role of exogenous DHEA in health, disease and human well-being. This article tries to summarize some of the most important facts achieved recently. Key words Dehydroepiandrosterone • Intracrinology • Hormone replacement therapy • Steroids Introduction functions: 1) DHEA is an endogenous metabolite that cannot be patented so that pharmaceutical companies are In 1934 Butenandt and Dannenbaum isolated not interested in supporting research in this field. dehydroepiandrosterone (DHEA) from urine and in 1944 2) DHEA can be described as a “human molecule” Munson and colleagues identified its 3β-sulphate because other investigated species have much lower (DHEAS). Even now, nearly 70 years later, we still do concentrations.
    [Show full text]
  • Pr-Dvd-Holdings-As-Of-September-18
    CALL # LOCATION TITLE AUTHOR BINGE BOX COMEDIES prmnd Comedies binge box (includes Airplane! --Ferris Bueller's Day Off --The First Wives Club --Happy Gilmore)[videorecording] / Princeton Public Library. BINGE BOX CONCERTS AND MUSICIANSprmnd Concerts and musicians binge box (Includes Brad Paisley: Life Amplified Live Tour, Live from WV --Close to You: Remembering the Carpenters --John Sebastian Presents Folk Rewind: My Music --Roy Orbison and Friends: Black and White Night)[videorecording] / Princeton Public Library. BINGE BOX MUSICALS prmnd Musicals binge box (includes Mamma Mia! --Moulin Rouge --Rodgers and Hammerstein's Cinderella [DVD] --West Side Story) [videorecording] / Princeton Public Library. BINGE BOX ROMANTIC COMEDIESprmnd Romantic comedies binge box (includes Hitch --P.S. I Love You --The Wedding Date --While You Were Sleeping)[videorecording] / Princeton Public Library. DVD 001.942 ALI DISC 1-3 prmdv Aliens, abductions & extraordinary sightings [videorecording]. DVD 001.942 BES prmdv Best of ancient aliens [videorecording] / A&E Television Networks History executive producer, Kevin Burns. DVD 004.09 CRE prmdv The creation of the computer [videorecording] / executive producer, Bob Jaffe written and produced by Donald Sellers created by Bruce Nash History channel executive producers, Charlie Maday, Gerald W. Abrams Jaffe Productions Hearst Entertainment Television in association with the History Channel. DVD 133.3 UNE DISC 1-2 prmdv The unexplained [videorecording] / produced by Towers Productions, Inc. for A&E Network executive producer, Michael Cascio. DVD 158.2 WEL prmdv We'll meet again [videorecording] / producers, Simon Harries [and three others] director, Ashok Prasad [and five others]. DVD 158.2 WEL prmdv We'll meet again. Season 2 [videorecording] / director, Luc Tremoulet producer, Page Shepherd.
    [Show full text]
  • DANIEL KIDNER Shoot Steadi Ltd Cameraman
    DANIEL KIDNER Shoot Steadi Ltd Cameraman CURRICULUM VITAE STEADICAM WORK Entertainment: The Mercury Music Prize BBC Productions X Factor Freemantle Media Irelands Got Talent (Studio finals) TV3 Productions EMA’S (Pre-titles) ft.Eminem Viacom Live Theatre performance of ‘Red’ Red Productions Live Theatre performance of ‘Hetty Feather’ HF Productions Portrait Artist of the Year Series 1-5 Storyvault for Sky Arts Landscape Artist of the Year Series 1-4 Storyvault for Sky Arts DMC Beyond Magic National Geographic Trend Vision fashion show Jack Morton Stand up to Cancer (Pre Titles) 2LE Fairport Convention Live BBC Productions Carabao Commercial Beast Enterprises Ltd Burberry Fashion Shoot MVP Films Cookery School Red House Productions Good Morning Britain ITV Productions The Leaders Debate BBC Productions Wales Live BBC Productions Soccer Am Sky Productions Motor GP Tonight BT Sports Sport FIFA Football World Cup 2018 HBS (Host broadcaster) The World Athletics Championships 2017 Sunset and Vine (Host Broadcaster) The Commonwealth Games 2014 Sunset and Vine (Host Broadcaster) The Rugby World Cup 2015 ITV (Host broadcaster) The Isle of Man TT 2016-’18 North One/GreenLight Premier league football BT Sport Formula One Opening Ceremony Austin Formula One Management Aviva Rugby premiership final BT Sport The Varsity Match BBC Productions BT Boxing live BT Sport Sky Boxing Sky Sports The Arsenal Kit Launch Puma The World Champion comes home Formula One Management SELECTION OF OTHER WORK Pedestal/HandHeld/ENG Camerawork T in the Park’ (2005 - 2008)
    [Show full text]
  • Drama Drama Documentary
    1 Springvale Terrace, W14 0AE Graeme Hayes 37-38 Newman Street, W1T 1QA SENIOR COLOURIST 44-48 Bloomsbury Street WC1B 3QJ Tel: 0207 605 1700 [email protected] Drama The People Next Door 1 x 60’ Raw TV for Channel 4 Enge UKIP the First 100 Days 1 x 60’ Raw TV for Channel 4 COLOURIST Cyberbully 1 x 76’ Raw TV for Channel 4 BAFTA & RTS Nominations Playhouse Presents: Foxtrot 1 x 30’ Sprout Pictures for Sky Arts American Blackout 1 x 90’ Raw TV for NGC US Blackout 1 x 90’ Raw TV for Channel 4 Inspector Morse 6 x 120’ ITV Studios for ITV 3 Poirot’s Christmas 1 x 100’ ITV Studios for ITV 3 The Railway Children 1 x 100’ ITV Studios for ITV 3 Taking the Flak 6 x 60’ BBC Drama for BBC Two My Life as a Popat 14 x 30’ Feelgood Fiction for ITV 1 Suburban Shootout 4 x & 60’ Feelgood Fiction for Channel 5 Slap – Comedy Lab 8 x 30’ World’s End for Channel 4 The Worst Journey in the World 1 x 60’ Tiger Aspect for BBC Four In Deep – Series 3 4 x 60’ Valentine Productions for BBC1 Drama Documentary Nazi Megaweapons Series III 1 x 60’ Darlow Smithson for NGCi Metropolis 1 x 60’ Nutopia for Travel Channel Million Dollar Idea 2 x 60’ Nutopia Hostages 1 x 60’ Al Jazeera Cellblock Sisterhood 3 x 60’ Raw TV Planes That Changed the World 3 x 60’ Arrow Media Nazi Megaweapons Series II 1 x 60’ Darlow Smithson for NGCi Dangerous Persuasions Series II 6 x 60’ Raw TV Love The Way You Lie 6 x 60’ Raw TV Mafia Rules 1 x 60’ Nerd Nazi Megaweapons 5 x 60’ Darlow Smithson for NGCi Breakout Series 2 10 x 60’ Raw TV for NGC Paranormal Witness Series 2 12 x 60’ Raw TV
    [Show full text]
  • Pinoresinol Reductase 1 Impacts Lignin Distribution During Secondary Cell Wall Biosynthesis in Arabidopsis
    Phytochemistry xxx (2014) xxx–xxx Contents lists available at ScienceDirect Phytochemistry journal homepage: www.elsevier.com/locate/phytochem Pinoresinol reductase 1 impacts lignin distribution during secondary cell wall biosynthesis in Arabidopsis Qiao Zhao a, Yining Zeng b,e, Yanbin Yin c, Yunqiao Pu d,e, Lisa A. Jackson a,e, Nancy L. Engle e,f, Madhavi Z. Martin e,f, Timothy J. Tschaplinski e,f, Shi-You Ding b,e, Arthur J. Ragauskas d,e, ⇑ Richard A. Dixon a,e,g, a Plant Biology Division, Samuel Roberts Noble Foundation, 2510 Sam Noble Parkway, Ardmore, OK 73401, USA b Biosciences Center, National Renewable Energy Laboratory, Golden, CO 80401, USA c Department of Biological Sciences, Northern Illinois University, DeKalb, IL 60115, USA d Institute of Paper Science and Technology, Georgia Institute of Technology, Atlanta, GA, USA e BioEnergy Science Center (BESC), Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA f Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA g Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA article info abstract Article history: Pinoresinol reductase (PrR) catalyzes the conversion of the lignan (À)-pinoresinol to (À)-lariciresinol in Available online xxxx Arabidopsis thaliana, where it is encoded by two genes, PrR1 and PrR2, that appear to act redundantly. PrR1 is highly expressed in lignified inflorescence stem tissue, whereas PrR2 expression is barely detect- Keywords: able in stems. Co-expression analysis has indicated that PrR1 is co-expressed with many characterized Lignan genes involved in secondary cell wall biosynthesis, whereas PrR2 expression clusters with a different Lignin set of genes.
    [Show full text]
  • Nutraceuticals Brian Lockwood
    CjigVXZji^XVah HZXdcYZY^i^dc 7g^VcAdX`lddY 00 Prelim 2/3/07 18:51 Page i Nutraceuticals 00 Prelim 2/3/07 18:51 Page ii 00 Prelim 2/3/07 18:51 Page iii Nutraceuticals A guide for healthcare professionals Second edition Brian Lockwood BPharm, PhD, MRPharmS Senior Lecturer in Pharmacy, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK London • Chicago 00 Prelim 2/3/07 18:51 Page iv Published by the Pharmaceutical Press An imprint of RPS Publishing 1 Lambeth High Street, London SE1 7JN, UK 100 South Atkinson Road, Suite 200, Grayslake, IL 60030–7820, USA © Pharmaceutical Press 2007 is a trade mark of RPS Publishing RPS Publishing is the publishing organisation of the Royal Pharmaceutical Society of Great Britain First edition published 2002 Second edition published 2007 Typeset by Type Study, Scarborough, North Yorkshire Printed in Great Britain by TJ International, Padstow, Cornwall ISBN 978 0 85369 659 9 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the copyright holder. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. The right of Brian Lockwood to be identified as the author of this work has been asserted by him in accordance with sections 77 and 78 and subject to section 79(6) of the Copyright, Designs and Patents Act, 1988.
    [Show full text]
  • Study Protocol and Statistical Analysis Plan
    Confidential Clinical study protocol number: J1228 Page 1 Version Date: May 7, 2018 IRB study Number: NA_00067315 A Trial of maintenance Rituximab with mTor inhibition after High-dose Consolidative Therapy in CD20+, B-cell Lymphomas, Gray Zone Lymphoma, and Hodgkin’s Lymphoma Principal Investigator: Douglas E. Gladstone, MD The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins 1650 Orleans Street, CRBI-287 Baltimore, MD 21287 Phone: 410-955-8781 Fax: 410-614-1005 Email: [email protected] IRB Protocol Number: NA_00067315 Study Number: J1228 IND Number: EXEMPT Novartis Protocol Number: CRAD001NUS157T Version: May 7, 2018 Co-Investigators: Jonathan Powell 1650 Orleans Street, CRBI-443 Phone: 410-502-7887 Fax: 443-287-4653 Email: [email protected] Richard Jones 1650 Orleans Street, CRBI-244 Phone: 410-955-2006 Fax: 410-614-7279 Email: [email protected] Confidential Clinical study protocol number: J1228 Page 2 Version Date: May 7, 2018 IRB study Number: NA_00067315 Satish Shanbhag Johns Hopkins Bayview Medical Center 301 Building, Suite 4500 4940 Eastern Ave Phone: 410-550-4061 Fax: 410-550-5445 Email: [email protected] Statisticians: Gary Rosner Phone: 410-955-4884 Email: [email protected] Marianna Zahurak Phone: 410-955-4219 Email: [email protected] Confidential Clinical study protocol number: J1228 Page 3 Version Date: May 7, 2018 IRB study Number: NA_00067315 Table of contents Table of contents ......................................................................................................................... 3 List of abbreviations
    [Show full text]
  • Effect of Dehydroepiandrosterone and Testosterone Supplementation on Systemic Lipolysis
    ORIGINAL ARTICLE Effect of Dehydroepiandrosterone and Testosterone Supplementation on Systemic Lipolysis Ana E. Espinosa De Ycaza, Robert A. Rizza, K. Sreekumaran Nair, and Michael D. Jensen Division of Endocrinology, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota 55905 Downloaded from https://academic.oup.com/jcem/article/101/4/1719/2804555 by guest on 24 September 2021 Context: Dehydroepiandrosterone (DHEA) and T hormones are advertised as antiaging, antiobe- sity products. However, the evidence that these hormones have beneficial effects on adipose tissue metabolism is limited. Objective: The objective of the study was to determine the effect of DHEA and T supplementation on systemic lipolysis during a mixed-meal tolerance test (MMTT) and an iv glucose tolerance test (IVGTT). Design: This was a 2-year randomized, double-blind, placebo-controlled trial. Setting: The study was conducted at a general clinical research center. Participants: Sixty elderly women with low DHEA concentrations and 92 elderly men with low DHEA and bioavailable T concentrations participated in the study. Interventions: Elderly women received 50 mg DHEA (n ϭ 30) or placebo (n ϭ 30). Elderly men received 75 mg DHEA (n ϭ 30),5mgT(nϭ 30), or placebo (n ϭ 32). Main Outcome Measures: In vivo measures of systemic lipolysis (palmitate rate of appearance) during a MMTT or IVGTT. Results: At baseline there was no difference in insulin suppression of lipolysis measured during MMTT and IVGTT between the treatment groups and placebo. For both sexes, a univariate analysis showed no difference in changes in systemic lipolysis during the MMTT or IVGTT in the DHEA group and T group when compared with placebo.
    [Show full text]
  • Reproductive DHEA-S
    Reproductive DHEA-S Analyte Information - 1 - DHEA-S Introduction DHEA-S, DHEA sulfate or dehydroepiandrosterone sulfate, it is a metabolite of dehydroepiandrosterone (DHEA) resulting from the addition of a sulfate group. It is the sulfate form of aromatic C19 steroid with 10,13-dimethyl, 3-hydroxy group and 17-ketone. Its chemical name is 3β-hydroxy-5-androsten-17-one sulfate, its summary formula is C19H28O5S and its molecular weight (Mr) is 368.5 Da. The structural formula of DHEA-S is shown in (Fig.1). Fig.1: Structural formula of DHEA-S Other names used for DHEA-S include: Dehydroisoandrosterone sulfate, (3beta)-3- (sulfooxy), androst-5-en-17-one, 3beta-hydroxy-androst-5-en-17-one hydrogen sulfate, Prasterone sulfate and so on. As DHEA-S is very closely connected with DHEA, both hormones are mentioned together in the following text. Biosynthesis DHEA-S is the major C19 steroid and is a precursor in testosterone and estrogen biosynthesis. DHEA-S originates almost exclusively in the zona reticularis of the adrenal cortex (Fig.2). Some may be produced by the testes, none is produced by the ovaries. The adrenal gland is the sole source of this steroid in women, whereas in men the testes secrete 5% of DHEA-S and 10 – 20% of DHEA. The production of DHEA-S and DHEA is regulated by adrenocorticotropin (ACTH). Corticotropin-releasing hormone (CRH) and, to a lesser extent, arginine vasopressin (AVP) stimulate the release of adrenocorticotropin (ACTH) from the anterior pituitary gland (Fig.3). In turn, ACTH stimulates the adrenal cortex to secrete DHEA and DHEA-S, in addition to cortisol.
    [Show full text]
  • Safety Data Sheet
    SAFETY DATA SHEET SECTION 1: PRODUCT IDENTIFICATION PRODUCT NAME DHEA (Prasterone) (Micronized) PRODUCT CODE 0733 SUPPLIER MEDISCA Inc. Tel.: 1.800.932.1039 | Fax.: 1.855.850.5855 661 Route 3, Unit C, Plattsburgh, NY, 12901 3955 W. Mesa Vista Ave., Unit A-10, Las Vegas, NV, 89118 6641 N. Belt Line Road, Suite 130, Irving, TX, 75063 MEDISCA Pharmaceutique Inc. Tel.: 1.800.665.6334 | Fax.: 514.338.1693 4509 Rue Dobrin, St. Laurent, QC, H4R 2L8 21300 Gordon Way, Unit 153/158, Richmond, BC V6W 1M2 MEDISCA Australia PTY LTD Tel.: 1.300.786.392 | Fax.: 61.2.9700.9047 Unit 7, Heritage Business Park 5-9 Ricketty Street, Mascot, NSW 2020 EMERGENCY PHONE CHEMTREC Day or Night Within USA and Canada: 1-800-424-9300 NSW Poisons Information Centre: 131 126 USES Adjuvant; Androgen SECTION 2: HAZARDS IDENTIFICATION GHS CLASSIFICATION Toxic to Reproduction (Category 2) PICTOGRAM SIGNAL WORD Warning HAZARD STATEMENT(S) Reproductive effector, prohormone. Suspected of damaging fertility or the unborn child. May cause harm to breast-fed children. Causes serious eye irritation. Causes skin and respiratory irritation. Very toxic to aquatic life with long lasting effects. AUSTRALIA-ONLY HAZARDS Not Applicable. PRECAUTIONARY STATEMENT(S) Prevention Wash thoroughly after handling. Obtain special instructions before use. Do not handle until all safety precautions have been read and understood. Do not breathe dusts or mists. Do not eat, drink or smoke when using this product. Avoid contact during pregnancy/while nursing. Wear protective gloves, protective clothing, eye protection, face protection. Avoid release to the environment. Response IF ON SKIN (HAIR): Wash with plenty of water.
    [Show full text]
  • Daidzein and Genistein Content of Cereals
    European Journal of Clinical Nutrition (2002) 56, 961–966 ß 2002 Nature Publishing Group All rights reserved 0954–3007/02 $25.00 www.nature.com/ejcn ORIGINAL COMMUNICATION Daidzein and genistein content of cereals J Liggins1, A Mulligan1,2, S Runswick1 and SA Bingham1,2* 1Medical Research Council Dunn Human Nutrition Unit, Hills Road, Cambridge, UK; and 2European Prospective Investigation of Cancer, University of Cambridge, Cambridge, UK Objective: To analyse 75 cereals and three soy flours commonly eaten in Europe for the phytoestrogens daidzein and genistein. Design: The phytoestrogens daidzein and genistein were extracted from dried foods, and the two isoflavones quantified after hydrolytic removal of any conjugated carbohydrate. Completeness of extraction and any procedural losses of the isoflavones 0 0 were accounted for using synthetic daidzin (7-O-glucosyl-4 -hydroxyisoflavone) and genistin (7-O-glucosyl-4 5-dihydroxyiso- flavone) as internal standards. Setting: Foods from the Cambridge UK area were purchased, prepared for eating, which included cooking if necessary, and freeze dried. Three stock soy flours were also analysed. Results: Eighteen of the foods assayed contained trace or no detectable daidzein or genistein. The soy flours were rich sources, containing 1639 – 2117 mg=kg. The concentration of the two isoflavones in the remaining foods ranged from 33 to 11 873 mg=kg. Conclusion: These analyses will supply useful information to investigators determining the intake of phytoestrogens in cereal products in order to relate intakes to potential biological activities. Sponsorship: This work was supported by the United Kingdom Medical Research Council, Ministry of Agriculture Fisheries and Food (contract FS2034) and the United States of America Army (contract DAMD 17-97-1-7028).
    [Show full text]
  • St. John's Wort 2018
    ONLINE SERIES MONOGRAPHS The Scientific Foundation for Herbal Medicinal Products Hyperici herba St. John's Wort 2018 www.escop.com The Scientific Foundation for Herbal Medicinal Products HYPERICI HERBA St. John's Wort 2018 ESCOP Monographs were first published in loose-leaf form progressively from 1996 to 1999 as Fascicules 1-6, each of 10 monographs © ESCOP 1996, 1997, 1999 Second Edition, completely revised and expanded © ESCOP 2003 Second Edition, Supplement 2009 © ESCOP 2009 ONLINE SERIES ISBN 978-1-901964-61-5 Hyperici herba - St. John's Wort © ESCOP 2018 Published by the European Scientific Cooperative on Phytotherapy (ESCOP) Notaries House, Chapel Street, Exeter EX1 1EZ, United Kingdom www.escop.com All rights reserved Except for the purposes of private study, research, criticism or review no part of this text may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without the written permission of the publisher. Important Note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment may be required. In their efforts to provide information on the efficacy and safety of herbal drugs and herbal preparations, presented as a substantial overview together with summaries of relevant data, the authors of the material herein have consulted comprehensive sources believed to be reliable. However, in view of the possibility of human error by the authors or publisher of the work herein, or changes in medical knowledge, neither the authors nor the publisher, nor any other party involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for results obtained by the use of such information.
    [Show full text]