Role of androgens, progestins and tibolone in the treatment of menopausal symptoms: a review of the clinical evidence

Estrogen-containing hormone therapy (HT) is the most widely prescribed and well-established treatment for menopausal symptoms. High quality evidence confirms that estrogen effectively treats hot flushes, night sweats and vaginal dryness. Progestins are combined with estrogen to prevent endometrial hyperplasia and are sometimes used alone for hot flushes, but are less effective than estrogen for this purpose. Data are conflicting regarding the role of androgens for improving libido and well-being. The synthetic steroid tibolone is widely used in Europe and Australasia and effectively treats hot flushes and vaginal dryness. Tibolone may improve libido more effectively than estrogen containing HT in some women. We summarize the data from studies addressing the efficacy, benefits, and risks of androgens, progestins and tibolone in the treatment of menopausal symptoms

The trace of an optimal normal element and low complexity normal bases

Let double-struck F signq be a finite field and consider an extension double-struck F signqn where an optimal normal element exists. Using the trace of an optimal normal element in double-struck F signqn , we provide low complexity normal elements in double-struck F signq m , with m = n/k. We give theorems for Type I and Type II optimal normal elements. When Type I normal elements are used with m = n/2, m odd and q even, our construction gives Type II optimal normal elements in double-struck F signq m ; otherwise we give low complexity normal elements. Since optimal normal elements do not exist for every extension degree m of every finite field double-struck F signq , our results could have a practical impact in expanding t

Fall in human papillomavirus prevalence following a national vaccination program

Fulltext embargoed for: 12 months post date of publicationBACKGROUND: In April 2007, Australia became the first country to introduce a national government-funded human papillomavirus (HPV) vaccination program. We evaluated the program's impact on genotype-specific HPV infection prevalence through a repeat survey of women attending clinical services. METHODS: HPV genoprevalence in women aged 18-24 years attending family planning clinics in the prevaccine period (2005-2007) was compared with prevalence among women of the same age group in the postvaccine period (2010-2011). The same recruitment and testing strategies were utilized for both sets of samples, and comparisons were adjusted for potentially confounding variables. RESULTS: The prevalence of vaccine HPV genotypes (6, 11, 16, and 18) was significantly lower in the postvaccine sample than in the prevaccine sample (6.7% vs 28.7%; P < .001), with lower prevalence observed in both vaccinated and unvaccinated women compared with the prevaccine population (5.0% [adjusted odds ratio, 0.11; 95% confidence interval, 0.06-0.21] and 15.8% [adjusted odds ratio, 0.42; 95% confidence interval, 0.19-0.93], respectively). A slightly lower prevalence of nonvaccine oncogenic HPV genotypes was also found in vaccinated women (30.8% vs 37.6%; adjusted odds ratio, 0.68; 95% confidence interval, 0.46-0.99). CONCLUSIONS: Four years after the commencement of the Australian HPV vaccination program, a substantial decrease in vaccine-targeted genotypes is evident and should, in time, translate into reductions in HPV-related lesions