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Spetz, Anna-Clara
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Publications (10 of 35) Show all publications
Berin, E., Hammar, M., Lindblom, H., Lindh Åstrand, L. & Spetz, A.-C. (2016). Resistance training for hot flushes in postmenopausal women: Randomized controlled trial protocol. Maturitas, 85, 96-103
Open this publication in new window or tab >>Resistance training for hot flushes in postmenopausal women: Randomized controlled trial protocol
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2016 (English)In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 85, p. 96-103Article in journal (Refereed) Published
Abstract [en]

Objectives: Hot flushes and night sweats affect 75% of all women after menopause and is a common reason for decreased quality of life in mid-aged women. Hormone therapy is effective in ameliorating symptoms but cannot be used by all women due to contraindications and side effects. Engagement in regular exercise is associated with fewer hot flushes in observational studies, but aerobic exercise has not proven effective in randomized controlled trials. It remains to be determined whether resistance training is effective in reducing hot flushes and improves quality of life in symptomatic postmenopausal women. The aim of this study is to investigate the effect of standardized resistance training on hot flushes and other health parameters in postmenopausal women. Study design: This is an open, parallel-group, randomized controlled intervention study conducted in Linkoping, Sweden. Sixty symptomatic and sedentary postmenopausal women with a mean of at least four moderate to severe hot flushes per day or 28 per week will be randomized to an exercise intervention or unchanged physical activity (control group). The intervention consists of 15 weeks of standardized resistance training performed three times a week under supervision of a physiotherapist. Main outcome measures: The primary outcome is hot flush frequency assessed by self-reported hot flush diaries, and the difference in change from baseline to week 15 will be compared between the intervention group and the control group. Conclusion: The intention is that this trial will contribute to the evidence base regarding effective treatment for hot flushes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2016
Keywords
Menopause; Hot flashes; Resistance training; Vasomotor symptoms; Exercise; Study protocol
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-126250 (URN)10.1016/j.maturitas.2015.12.015 (DOI)000370897300016 ()26857887 (PubMedID)
Note

Funding Agencies|Swedish Research Council [2014-2781]; Region Ostergotland, Sweden

Available from: 2016-03-21 Created: 2016-03-21 Last updated: 2019-02-11
Romu, T., West, J., Spetz, A.-C., Lindblom, H., Lindh Åstrand, L., Hammar, M., . . . Dahlqvist Leinhard, O. (2016). The effect of flip-angle on body composition using calibrated water-fat MRI.. In: : . Paper presented at International Society for Magnetic Resonance in Medicine Annual Meeting & Exhibition, Singapore, May 7-13, 2016.
Open this publication in new window or tab >>The effect of flip-angle on body composition using calibrated water-fat MRI.
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2016 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

This study tested how the flip angle affects body composition analysis by MRI, if adipose tissue is used as an internal intensity reference. Whole-body water-fat images with flip angle 5° and 10° were collected from 29 women in an ongoing study. The images were calibrated based on the adipose tissue signal and whole-body total adipose, lean and soft tissue volumes were measured. A mean difference of 0.29 L, or 0.90 % of the average volume, and a coefficient of variation of 0.40 % was observed for adipose tissue.

National Category
Radiology, Nuclear Medicine and Medical Imaging Medical Image Processing
Identifiers
urn:nbn:se:liu:diva-128989 (URN)
Conference
International Society for Magnetic Resonance in Medicine Annual Meeting & Exhibition, Singapore, May 7-13, 2016
Available from: 2016-06-07 Created: 2016-06-07 Last updated: 2019-06-14Bibliographically approved
West, J., Romu, T., Spetz, A.-C., Lindblom, H., Lindh Åstrand, L., Borga, M., . . . Dahlqvist Leinhard, O. (2015). Automatic combined whole-body muscle and fat volume quantification using water-fat separated MRI in postmenopausal women. In: International Society for Magnetic Resonance in Medicine Annual Meeting: Proceedings. Paper presented at 23rd International Society for Magnetic Resonance in Medicine Annual Meeting & Exhibition, Toronto, Ontario, Canada, May 30 - June 5, 2015.
Open this publication in new window or tab >>Automatic combined whole-body muscle and fat volume quantification using water-fat separated MRI in postmenopausal women
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2015 (English)In: International Society for Magnetic Resonance in Medicine Annual Meeting: Proceedings, 2015Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Quantitative and exact measurements of fat and muscle in the body are important when addressing some of the greatest health-challenges today. In this study whole-body combined regional muscle and fat volume quantification was validated in a group of postmenopausal women, where the body composition is changing. Twelve subjects were scanned with a 4-echo 3D gradient-echo sequence. Water and fat image volumes were calculated using IDEAL, and image intensity correction was performed. Subsequently, automatic tissue segmentation was established using non-rigid morphon based registration. Whole-body regional fat and muscle segmentation could be performed with excellent test-retest reliability, in a single 7-minutes MR-scan.

National Category
Radiology, Nuclear Medicine and Medical Imaging Medical Image Processing
Identifiers
urn:nbn:se:liu:diva-128992 (URN)
Conference
23rd International Society for Magnetic Resonance in Medicine Annual Meeting & Exhibition, Toronto, Ontario, Canada, May 30 - June 5, 2015
Available from: 2016-06-07 Created: 2016-06-07 Last updated: 2019-06-14Bibliographically approved
Lindh-Åstrand, L., Hoffmann, M., Järvstråt, L., Fredrikson, M., Hammar, M. & Spetz, A.-C. (2015). Hormone therapy might be underutilized in women with early menopause.. Human Reproduction, 30(4), 848-852
Open this publication in new window or tab >>Hormone therapy might be underutilized in women with early menopause.
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2015 (English)In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 30, no 4, p. 848-852Article in journal (Refereed) Published
Abstract [en]

STUDY QUESTION Are Swedish women age 40–44 years with assumed early menopause ‘undertreated’ by hormone therapy (HT)?

SUMMARY ANSWER Many women with probable early menopause discontinue their HT after a short period of time. Thus, they fail to complete the recommended replacement up to age 51–52 years, the average age of menopause.

WHAT IS KNOWN ALREADY Spontaneous early menopause occurs in ∼5% of women age 40–45 years. Regardless of the cause, women who experience hormonal menopause due to bilateral oophorectomy before the median age of spontaneous menopause are at increased risk of cardiovascular disease, neurological disease, osteoporosis, psychiatric illness and even death.

STUDY DESIGN, SIZE, DURATION The study is descriptive, and epidemiological and was based on the use of national registers of dispensed drug prescriptions (HT) linking registers from the National Board of Health and Welfare and Statistics Sweden from 1 July 2005 until 31 December 2011.

PARTICIPANTS/MATERIALS, SETTING, METHODS The study population consisted of 310 404 women, 40–44 years old on 31 December 2005 who were followed from 1 July 2005 until 31 December 2011.

MAIN RESULTS AND THE ROLE OF CHANCE Only 0.9% of women 40–44 years old started HT during the study period. A majority of these women used HT <1 year.

LIMITATIONS, REASONS FOR CAUTION We do not know the indications that led to the prescription of HT but assume that early onset of menopause was the main reason. Because of the study design—making a retrospective study of registers—we can only speculate on the reasons for most of the women in this group discontinuing HT. Another limitation of this study is that we have a rather short observation time. However, we have up to now only been able to collect and combine the data since July 2005.

WIDER IMPLICATIONS OF THE FINDINGS As the occurrence of spontaneous early menopause in women age 40–45 is reported to be ∼5%, the fact that <1% of Swedish women age 40–44 are prescribed HT, and can be shown also to have had the medication dispensed at a pharmacy suggests an unexpectedly low treatment rate. Some women with early menopause may have used combined contraceptives as supplementation therapy, but in Sweden HT is the recommended treatment for early menopause so any such women are not following this recommendation. Women who experience early menopause are at increased risk for overall morbidity and mortality, and can expect to benefit from HT until they have reached at least the median age of spontaneous menopause. It is therefore important to individualize the information given these women and to convey new knowledge in this area to gynaecologists and physicians in general as well as the recommendation that women in this group continue HT at least until the average age for spontaneous menopause is reached.

Keywords
early menopause, estrogen, hormone therapy
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-116335 (URN)10.1093/humrep/dev017 (DOI)000354791000011 ()25662809 (PubMedID)
Available from: 2015-03-31 Created: 2015-03-25 Last updated: 2017-12-04
Lindh-Åstrand, L., Hoffmann, M., Hammar, M. & Spetz, A.-C. (2015). Hot flushes, hormone therapy and alternative treatments: 30 years of experience from Sweden. Climacteric, 18(1), 53-62
Open this publication in new window or tab >>Hot flushes, hormone therapy and alternative treatments: 30 years of experience from Sweden
2015 (English)In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 18, no 1, p. 53-62Article in journal (Refereed) Published
Abstract [en]

Objectives The use of hormone therapy (HT) for hot flushes has changed dramatically over the past five decades. In this cross-sectional questionnaire study, the aim was to describe the use of HT and alternative treatments and to study the frequency of hot flushes. A further aim was to compare data from the present questionnaire with data from previous studies made in the same geographic area. Method A questionnaire was sent to a random sample of 2000 women aged 47-56 years living in Ostergotland County, Sweden. The results were compared with findings from previous studies regarding use of HT, alternative treatment and hot flushes, and the number of HT prescriptions dispensed during the corresponding time using data derived from the Swedish Prescribed Drug Registry. Results The response rate was 66%. Six percent used HT, in line with prevalence data from the Swedish Prescribed Drug Registry. Alternative treatments were used by 10%. About 70% of postmenopausal women reported flushes and almost one-third of those with flushes stated that they would be positive to HT if therapy could be shown to be harmless, a view more often stated by women with severe complaints of hot flushes (67%). Conclusion The use of HT and alternative treatments is low and many women suffer from flushes that could be treated. Women considered their knowledge of the climacteric period and treatment options as insufficient. Individualized information should be given and women with significant climacteric complaints, without contraindications, should be given the opportunity to try HT.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
Keywords
HOT FLUSHES; HORMONE THERAPY; COMPLEMENTARY THERAPIES; CROSS-SECTIONAL STUDY; PHARMACOEPIDEMIOLOGY
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114411 (URN)10.3109/13697137.2014.915516 (DOI)000347983900008 ()24742038 (PubMedID)
Note

Funding Agencies|Lions Foundation; County Council of Ostergotland; Linkoping University

Available from: 2015-03-02 Created: 2015-02-20 Last updated: 2017-12-04
Lindh-Åstrand, L., Spetz, A.-C., Sydsjö, G., Andersson, G., Carlbring, P. & Nedstrand, E. (2015). Internet-delivered applied relaxation for vasomotor symptoms in postmenopausal women: Lessons from a failed trial.. Maturitas, 80(4), 432-434
Open this publication in new window or tab >>Internet-delivered applied relaxation for vasomotor symptoms in postmenopausal women: Lessons from a failed trial.
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2015 (English)In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 80, no 4, p. 432-434Article in journal (Refereed) Published
Abstract [en]

Internet-delivered therapies have a short history and promising results have been shown for several health problems, particularly for psychiatric conditions. This study was a first attempt to evaluate whether Internet-delivered applied relaxation for hot flushes in postmenopausal women may be useful. Due to a high drop-out rate the study was prematurely terminated after inclusion of approximately two thirds of calculated women. The Internet-delivered applied relaxation must probably be modified for such populations and settings before it can be used further. This article will discuss the benefits and pitfalls to learn in order to meet the challenges of future studies.

Keywords
Applied relaxation; Failed trial; Hot flushes; Internet-delivered therapy; Menopause; RCT
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-116334 (URN)10.1016/j.maturitas.2015.01.010 (DOI)000353085900014 ()25700856 (PubMedID)
Available from: 2015-03-31 Created: 2015-03-25 Last updated: 2018-01-11
Järvstråt, L., Spetz, A.-C., Lindh-Åstrand, L., Hoffmann, M., Fredrikson, M. & Hammar, M. (2015). Use of hormone therapy in Swedish women aged 80 years or older. Menopause: The Journal of the North American Menopause, 22(3), 275-278
Open this publication in new window or tab >>Use of hormone therapy in Swedish women aged 80 years or older
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2015 (English)In: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 22, no 3, p. 275-278Article in journal (Refereed) Published
Abstract [en]

Objective: Menopausal symptoms such as hot flashes and night sweats may persist for 10 to 20 years or even longer. Information about the extent to which older women use hormone therapy is limited. The aim of this study was to determine the use of hormone therapy in Swedish women aged 80 years or older.Methods: The study is based on national register data on dispensed drug prescriptions (ie, prescribed therapy that has been provided to individuals by pharmacies) for hormone therapy and local low-dose estrogens.Results: Of 310,923 Swedish women who were aged at least 80 years, 609 (0.2%) were new users of hormone therapy. A total of 2,361 women (0.8%) were current users of hormone therapy. The median duration of hormone therapy use in new users was 257 days (25th to 75th percentiles, 611-120 d). About one in six women aged 80 years or older had used local vaginal estrogen therapy for at least four 3-month periods. The drugs were mainly prescribed by gynecologists and general practitioners.Conclusions: Our results show that a number of women aged 80 years or older still use hormone therapy and that most women who started a new treatment period had only one or two dispensations despite the median duration of treatment being more than half a year. Because at least some of the women aged 80 years or older who used hormone therapy probably did so owing to persistent climacteric symptoms, vasomotor symptoms and hormone therapy are still relevant issues that need to be discussed when counseling women around and after age 80.

Keywords
Menopause, Hot flashes, Old age, Hormone therapy, Vaginal dryness
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-116336 (URN)10.1097/GME.0000000000000294 (DOI)000350658100007 ()25051289 (PubMedID)
Available from: 2015-03-30 Created: 2015-03-25 Last updated: 2017-12-04
Frisk, J., Hammar, M., Ingvar, M. & Spetz, A.-C. (2014). How long do the effects of acupuncture on hot flashes persist in cancer patients?. Supportive Care in Cancer, 22(5), 1409-1415
Open this publication in new window or tab >>How long do the effects of acupuncture on hot flashes persist in cancer patients?
2014 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 22, no 5, p. 1409-1415Article, review/survey (Refereed) Published
Abstract [en]

Purpose Acupuncture has been suggested as therapy for hot flashes in women with breast cancer and men with prostate cancer. In this systematic review, we sought to evaluate the long-term effects on vasomotor symptoms after the end of a defined treatment period of acupuncture in women with breast cancer and men with prostate cancer. Methods A literature search revealed 222 articles within the field. With defined exclusion criteria, we identified 17 studies. We also used the Jadad quality score and identified seven studies with a score of at least 3. Results Six of seven identified studies qualified for inclusion in an analysis that measured frequency of hot flashes weighted in relation to number of patients (n=172). The average reduction from baseline to end of acupuncture (ranging between 5 and 12 weeks of treatment) showed 43.2 % reduction of hot flashes. At the last follow-up (mean 5.8 months, range 39 months) after the end of therapy, the weighted reduction from baseline was sustained at 45.6 % in the 153 of 172 patients (89 %) who were followed up. Conclusions Data from six prospective analyzed studies indicate at least 3-month effects after the end of acupuncture treatment for flashes in women with breast cancer and men with prostate cancer. However, larger randomized trials with long-term follow-up will be needed to confirm these preliminary findings.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2014
Keywords
Acupuncture; Breastneoplasm; Prostatic cancer; Hot flashes
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-107453 (URN)10.1007/s00520-014-2126-2 (DOI)000335774600030 ()
Available from: 2014-06-12 Created: 2014-06-12 Last updated: 2017-12-05
Vikström, J., Spetz, A.-C., Sydsjö, G., Marcusson, J., Wressle, E. & Hammar, M. (2013). Hot flushes still occur in a population of 85-year-old Swedish women. Climacteric, 16(4), 453-459
Open this publication in new window or tab >>Hot flushes still occur in a population of 85-year-old Swedish women
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2013 (English)In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 16, no 4, p. 453-459Article in journal (Refereed) Published
Abstract [en]

Objectives Hot flushes and night sweats often cause discomfort and may negatively affect sleep and quality of life. Studies have shown that menopausal symptoms, like hot flushes, may persist for up to 20 years after the menopausal transition, but there are no published studies regarding the occurrence of hot flushes among women older than 80 years. The aim of this study is to determine the prevalence of hot flushes in 85-year-old women.

Methods All 85-year old women living in Linköping municipality in 2007 (n = 415) received a postal questionnaire. The majority, 74% (n = 307), answered the questionnaire and 47% (n = 194) agreed to visit the Department of Geriatric Medicine; during this visit questions regarding hot flushes and use of hormone therapy were asked.

Results About 16% (n = 29) of the women experienced hot flushes during the day and/or during the night and 6.5% (n = 12) of the women were currently using hormone therapy. Almost 10% (n = 17) of all responding women were very to moderately distressed by their hot flushes.

Conclusion Our results confirm and extend previous knowledge based on studies of younger postmenopausal women in showing that menopausal symptoms still occur in elderly women. We found that, while the prevalence of menopausal symptoms decreases with age, these symptoms are still experienced by some 85-year-old women.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
Keywords
menopause, hot flushes, old age, hormone therapy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96983 (URN)10.3109/13697137.2012.727199 (DOI)000321785700007 ()
Note

Funding Agencies|Health Research Council in the South-East of Sweden|FORSS-8888FORSS-11636FORSS-31811|County of Ostergotland|LIO-11877LIO-31321LIO-79951|Family Janne Elgqvist Foundation||

Available from: 2013-09-02 Created: 2013-09-02 Last updated: 2017-12-06Bibliographically approved
Spetz, A.-C., Frisk, J. & Hammar, M. (2012). Acupuncture as Treatment of Hot Flashes and the Possible Role of Calcitonin Gene-Related Peptide. Evidence-based Complementary and Alternative Medicine, 2012(579321)
Open this publication in new window or tab >>Acupuncture as Treatment of Hot Flashes and the Possible Role of Calcitonin Gene-Related Peptide
2012 (English)In: Evidence-based Complementary and Alternative Medicine, ISSN 1741-427X, E-ISSN 1741-4288, Vol. 2012, no 579321Article, review/survey (Refereed) Published
Abstract [en]

The mechanisms behind hot flashes in menopausal women are not fully understood. The flashes in women are probably preceded by and actually initiated by a sudden downward shift in the set point for the core body temperature in the thermoregulatory center that is affected by sex steroids, beta-endorphins, and other central neurotransmitters. Treatments that influence these factors may be expected to reduce hot flashes. Since therapy with sex steroids for hot flashes has appeared to cause a number of side effects and risks and women with hot flashes and breast cancer as well as men with prostate cancer and hot flashes are prevented from sex steroid therapy there is a great need for alternative therapies. Acupuncture affecting the opioid system has been suggested as an alternative treatment option for hot flashes in menopausal women and castrated men. The heat loss during hot flashes may be mediated by the potent vasodilator and sweat gland activator calcitonin gene-related peptide (CGRP) the concentration of which increases in plasma during flashes in menopausal women and, according to one study, in castrated men with flushes. There is also evidence for connections between the opioid system and the release of CGRP. In this paper we discuss acupuncture as a treatment alternative for hot flashes and the role of CGRP in this context.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation / Oxford University Press (OUP): Policy B, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-74147 (URN)10.1155/2012/579321 (DOI)000298509100001 ()
Available from: 2012-01-20 Created: 2012-01-20 Last updated: 2017-12-08
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