Differences in Periodontal Severity Between Perimenopausal and Postmenopausal Women with Chronic Periodontitis

Abstract Objective: To analyze the differences in periodontal severity between perimenopausal and postmenopausal women with chronic periodontitis. Material and Methods: A cross-sectional study with 63 subjects, comprising 27 perimenopausal and 36 postmenopausal women, aged 45-59 years, was conducted in East Jakarta. The women were interviewed regarding their perimenopausal and postmenopausal status; they underwent a periodontal examination for periodontal pockets, attachment loss, gingival recession, plaque index, debris index, calculus index, oral hygiene index, papilla bleeding index, and tooth mobility. Independent T-test and Mann-Whitney U test were used for bivariate analysis Results: There were significant differences (p<0.05) in age between perimenopausal and postmenopausal women (p=0.01); however, no significant differences (p>0.05) in gingival recession (p=0.33) or tooth mobility (p=0.84) were observed. Independent t-test revealed no significant differences in pocket depth (p=0.95), attachment loss (p=0.71), plaque index (p=0.89), debris index (p=0.52), calculus index (p=0.46), oral hygiene index (p=0.48), or papilla bleeding index (p=0.63) between perimenopausal and postmenopausal women Conclusion: There was no difference in periodontal severity between perimenopausal and postmenopausal women; however, the current study obtained valuable information regarding periodontal severity in perimenopausal and postmenopausal women.

The benefits of progesterone therapy in imminent abortion.

The causes of imminent abortion are multi-factorial. The biggest causal factor is the low level of serum progesterone level. The lowest critical level of serum progesterone for survivability of pregnancy is 10 ng/ml. Eighty percent of patients experiencing abortion showed that their progesterone level was < 10 ng/ml. Patients who realized that their pregnancy would experience hemorrhage generally would suffer from depression. Stress was one of the factors responsible for the occurence of abortion. Administration of natural progesterone substitution (not progestogen) accelerates the disappearance of uterine contractions, and speeds up the stoppage of bleeding. In addition, progesterone has the effect of anti-anxiety. Adminstration of oral progesterone would result in metabolism in the intestine and liver, such that physiological level of serum progesterone could not be reached, while administration of suppositoria progesterone would result in physiological level of serum, such that it was effective to prevent imminent abortion.

Drospirinone: new generation of progestogen.

Drospirinone is a new generation of progestogen that possesses antimineralocorticoid effect. Progestogen of this type has been used as a component in combined contraceptives. The combined contraceptives of old generation contained progestogen component of testosterone derivative. Progestogen of this type does not have antimineralcorticoid effect, such that it could cause fluid retention. As a result, women who used combined pills of this type often complained of headache, breast pain, calf pain, increased body weight and blood pressure. Owing to its androgenic effect, combined contraception pills that contained testosterone-derived progestogen may cause acne and oily face. Combined contraception that contains drospirinone does not cause headache, breast pain, calf pain, increased body weight and blood pressure. Drospirinone has such a strong anti-androgenic nature that it does not result in acne and oily face. In addition, combination of ethinylestradiol and drospirinone can be used for treating pre-menstrual syndrome and menstrual pain. Drospirinone does not affect lipid and carbohydrate metabolism.

Skin abnormality and hairloss: the reproductive endocrinological viewpoint.

Excessive androgen production may cause changes in female skin, such as hirsutism and acne. The administration of antiadrogenic hormone such as cyproteron acetate, may eliminate the hyperandrogenic effect on the skin. Hairloss may also caused either by hyper-androgenemia or by low estrogen level. The administration of either antiandrogen or estrogen may reduce hairloss. Virilization, which includes excessive growth of hair and clitoris enlargement, deepened voice, muscle hypertrophy and mammary hypoplasia are also associated with hyperandrogenemia. Antiandrogen treatment could eliminate these impacts of virilization. In contrast, cellulite was supected to be due to androgen deficiency, and the use of topical testosterone could eliminate it. It is concluded that skin and/or hairloss are associated with hormonal changes in women. The treatment with antiandrogenic hormones may reduce or cure these abnormalities.

Effect of Hormone Replacement Therapy (HRT) and low-dose combined oral pill on skin thickness, lipid profile and blood chemistry of menopausal women.

This study to evaluate the effect of hormone replacement therapy ( HRT ) and low-dose combinated oral pill on skin thickness , lipid profile and blood chemistry on menopausal woman.This study was carried out in one year randomized prospective study. 36 women were divided into 18 women receiving HRT and the other 18 receiving low-dose oral pill. The result of this study showed an increase in skin thickness (collagen) in both groups. But Those received low dose oral pill showed more . The increase of the skin thickness can prevent osteoporosis. The administration of HRT or low-dose oral pill could cause allteration in blood lipip profile and blood chemistry. But The changes were still within in normal limit. The administration of low-dose oral pill can be considered in postmeno-pausal women.

The use of 17 Estradiol gel and progestogen tablet for Hormone Replacement Therapy (HRT) in menopause.

The treatment and prevention of disease in menopausal women due to deficiency of estrogen hormone are done through the administration of estrogen hormone, known as hormone replacement therapy (HRT). The administration of HRT is commonly done through the administration of tablets. However, the administration of tablet will result in metabolism in the colon and liver. Tablets are usually used on a daily basis such that it may lead to boredom and results in gastrointestinal disorder. The administration of gel, on the other hand, is done by applying the gel to the body and therefore metabolism in the colon and liver can be prevented. In women with uterus, estrogen must be combined with progestogen. The type of progestogen recommended is the one with natural derivative and which possesses antimineralocorticoid properties, such that fluid retention can be avoided. One of the types of progestogen which does not result in fluid retention is nomogestrol acetate. Nomogestrol acetate will also inhibit 17β hydrosisteroiddehydrogency enzyme type 1, such that estradiol (E2) is prevented from being transformed into estron (E1). As a result, E2 level in the breast tissue is kept at minimum, thereby reducing the risk of breast cancer.

Impact of Hormone Replacement Therapy on stroke, and dementia due to Alzheimer’s disease on menopausal women.

As a result of estrogen deficiency in menopausal women various health problems occur. Disorders of central nervous system such as stroke and dementia due to Alzheimer’s disease are frequently encountered in menopausal women. Estrogen plays an important role in the maintenance of the dense network of neural fibres connecting one nerve cell to another, and in the synaptic activity facilitating cognitive thought and memory. Hormone replacement therapy (HRT) reduced the risk of stroke by 30 % and a reduction of 60 % in risk of stroke mortality. The HRT influence cognitive functioning in menopausal women and may reduce the risk of developing dementia. Women who received HRT performed better on several tests of memory and logical reasoning than women taking placebo. Vaginal bleeding episodes constitute the major cause of women’s dissatisfaction with combined HRT.

Effects of Hormone Replacement Therapy (HRT) on the body weight, blood pressure and vaginal bleeding in menopausal women.

This study was a descriptive, retrospective trial conducted in 29 menopausal women. Each patient received treatment with conjugated equine estrogen (CEE) 0.625 mg/day + medroxyprogesterone acetate (MPA) 5 mg/hari continuously for the period of 6 months. The average age of menopause was 53.7 years with duration of menopause of 5.5 years. The education level of patients was Senior High School and higher. During the period of 6 months of continuous combined HRT, a significant increase of body weight and systolic blood pressure was found, while diastolic blood pressure did not have any significant change. Vaginal bleeding in the form of spotting occurred in 69% of the patients during the use of continuous combined HRT.

Menopause and hormone replacement therapy.

The global population in the 21st century has reached 6.2 billion people, by the year 2025 it is to be around 8.3-8.5 billion, and will increase further. Elderly people are expected to grow rapidly than other groups. The fastest increase in the elderly population will take place in Asia. Life expectancy is increasing steadily throughout developed and developing countries. For many menopausal women, increased life expectancy will accompanied by many health problems. The consequences of estrogen deficiency are the menopausal symptoms. The treatment of menopause related complaints and diseases became an important socioeconomic and medical issue. Long term symptoms, such as the increase in osteoporosis fractures, cardio and cerebrovascular disesses and dementia, created a large financial burden on individuals and society. All these health problems can be lreated or prevented by hormone replacement therapy (HRT). Natural HRT is usually prefened. Synthetic estrogen in oral contraceptives (oc) are not recommended for HRT. Many contra-indications for oc, but now it is widely usedfor HRT. The main reasons for discontinuing HRT are unwanted bleeding, fear of cancer, and negative side effects. Until now there are sill debates about the rebrtonship between HRT and the incidence of breast cancer. Many data showed that there were no clear relationship between the use of HRT and breast cancer. ThereÎore, nwny experts advocate the use of HRTfrom the first sign of climacteric complaints until death.