human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The hypothalamo-pituitary-adrenal ( HPA ) axis is modulated by sex hormones . Few data exist on the relation between acute estrogen deficit and HPA axis response to corticotropin-releasing hormone ( CRH ) . The effects of a sudden drop in estradiol levels on basal and CRH-stimulated levels of ACTH , cortisol , testosterone , and rostenedione and 17-hydroxyprogesterone ( 17-OHP ) were assessed in nine premenopausal women ( 44 - 48 years of age ) , before and after ovariectomy .  The CRH test was performed before and 8 days after ovariectomy . A significant reduction in ACTH and adrenal steroids but not in cortisol response to CRH was observed after ovariectomy . The ratio of deltamax and rostenedione/17-OHP after CRH stimulation was substantially the same before and after ovariectomy , whereas deltamax 17-OHP/cortisol was significantly lower in ovariectomized women showing increased 21- and 11beta-hydroxylase activity . The results show that the acute estrogen deficit induces changes in the HPA axis characterized by reduced stimulated secretion of ACTH and steroids but normal stimulated cortisol production CONTEXT Changes in and rogen levels across the adult female life span and the effects of natural menopause and oophorectomy have not been clearly established . OBJECTIVE The objective of this study was to document the effects of age on and rogen levels in healthy women and to explore the effects of natural and surgical menopause . DESIGN , SETTING , AND PARTICIPANTS A cross-sectional study was conducted of 1423 non-healthcare-seeking women , aged 18 - 75 yr , r and omly recruited from the community over 15 months . MAIN OUTCOME MEASURES Serum levels by age of total testosterone ( T ) , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione in a reference group of women free of confounding factors . Women in the reference group had no usage of exogenous steroid therapy ; no history of tubal ligation , hysterectomy , or bilateral oophorectomy ; and no hyperprolactinemia or polycystic ovarian syndrome . The effects of natural and surgical menopause on sex steroid levels were also examined . RESULTS In the reference population ( n = 595 ) , total T , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione declined steeply with age ( P < 0.001 ) , with the decline of each being greater in the earlier than the later decades . Examination of serum and rogen levels by year in women aged 45 - 54 yr showed no independent effect of menopausal status on and rogen levels . In women aged 55 yr or older , those who reported bilateral oophorectomy and were not on exogenous steroids had significantly lower total T and free T levels than women 55 yr or older in the reference group . CONCLUSIONS We report that serum and rogen levels decline steeply in the early reproductive years and do not vary because a consequence of natural menopause and that the postmenopausal ovary appears to be an ongoing site of testosterone production . These significant variations in and rogens with age must be taken into account when normal ranges are reported and in studies of the role of and rogens in women OBJECTIVE To investigate the cross-sectional associations of  hysterectomy and oophorectomy  status , chronological age , and body mass index with early postoperative plasma levels of total and free T , DHEAS , and sex hormone-binding globulin ( SHBG ) . DESIGN A cross-sectional study . SETTING University hospital . PATIENT(S ) Ninety-two women age 35 - 47 years who were scheduled for hysterectomy and /or oophorectomy , advocated for benign gynecological pathologies . INTERVENTION(S ) Ninety-two eligible premenopausal women underwent hysterectomy and /or oophorectomy  , with plasma T , DHEAS , and SHBG levels assayed before surgery and during the postoperative period . MAIN OUTCOME MEASURE(S ) Effects of time x operation and age x operation interactions between oophorectomized and nonoophorectomized groups and within-subject main effect of time on plasma and rogen levels . RESULT ( S ) Of 92 women , hysterectomy alone was performed in only 49 ( 53.3 % ) cases . Oophorectomy , either unilateral or bilateral , was performed in 35.8 % of cases . Age x within-group interactions exhibited an important difference ( P=.03 ) in total T levels . The time x between- and within-group interaction effects on plasma DHEAS levels of postoperative day 7 , compared with day 1 , were statistically significant ( P<.001 ) . The effect of time x group interaction was remarkable , in terms of SHBG levels during the postoperative period . Age x oophorectomy interaction exhibited a statistically significant change of decline in DHEAS levels on postoperative day 7 ( P=.05 ) . CONCLUSION ( S ) The present study demonstrated a time and operation effect decline in plasma DHEAS levels . In contrast , the time x operation interaction on SHBG levels exhibited an increase toward postoperative day 7 CONTEXT In postmenopausal women , endogenous bioavailable testosterone ( T ) and estradiol ( E2 ) have been positively associated , and SHBG has been negatively associated , with incident type 2 diabetes ( T2DM ) . Previous studies have not explored possible factors explaining these relationships . OBJECTIVE Our objective was to examine the association of endogenous sex hormones with incident T2DM  in postmenopausal women and possible explanatory factors . DESIGN , SETTING , AND PARTICIPANTS The Multi-Ethnic Study of Atherosclerosis ( MESA ) is a prospect i ve study that included 1612 postmenopausal women aged 45 - 84 yr , followed between the years 2000 - 2006 , who were not taking hormone replacement therapy , had no prevalent cardiovascular disease or diabetes , and had complete ascertainment of sex hormones . MAIN OUTCOME MEASURES T2DM was defined based on fasting glucose and /or treatment for diabetes . RESULTS There were 116 incident cases of diabetes during follow-up . Across higher quartiles of bioavailable T and E2 and lower quartiles of SHBG , we found significantly greater hazards of developing incident T2DM ( all P for trend < or=0.001 ) . After adjustment for body mass index and insulin resistance estimated by homeostasis model assessment of insulin resistance , bioavailable T was no longer associated with incident T2DM . The associations of E2 and SHBG with incident T2DM were partially explained by body mass index and insulin resistance but persisted in fully adjusted models ( both P for trend < 0.02 ) . Dehydroepi and rosterone had no relationship with incident T2DM . CONCLUSIONS Adiposity and insulin resistance explained most of the association of bioavailable T but only partially explained the associations of E2 and SHBG with incident T2DM among postmenopausal women In postmenopausal women , levels of estrogens , and rogens , and perhaps prolactin have been related to risk of breast and other hormonal cancers in women . However , the determinants of these hormone concentrations have not been firmly established . Associations among various demographic , menstrual , and reproductive factors , medication use and endogenous sex hormone concentrations ( estradiol , free estradiol , estrone , estrone sulfate , testosterone , free testosterone , sex hormone binding globulin , and rostenedione , dehydroepi and rosterone ( DHEA ) , DHEA sulfate ( DHEAS ) , dihydrotestosterone , and prolactin )  were evaluated in a cross-sectional analysis from a simple r and om sample of 274 postmenopausal women selected from the Women ’s Health Initiative Dietary Modification Trial . In multiple regression analyses on log-transformed hormones , the concentrations of DHEA , and DHEAS were negatively and statistically significantly associated with age ( both β = −0.03 , P < 0.001 , respectively ) . Estradiol , estrone , DHEA , and free testosterone concentrations were higher in African-American than in non-Hispanic White women , but after multivariate adjustment the associations were statistically significant only for free testosterone ( β = 0.38 , P = 0.01 ) . Women who had a history of bilateral oophorectomy had a mean 35 % lower testosterone concentration compared with women with at least one ovary remaining ( β = −0.43 , P = 0.002 ) , and lower free testosterone ( β = −0.42 , P = 0.04 ) after multivariate adjustment . Women who reported regular use of NSAIDs had higher DHEA concentrations ( β = 0.20 , P = 0.04 ) and lower prolactin concentrations ( β = −0.18 , P = 0.02 ) compared with non-users . These results suggest that while age , oophorectomy status , and NSAID use may be associated with selected sex hormone concentrations , few menstrual or reproductive factors affect endogenous sex hormones in the postmenopausal period BACKGROUND The ovaries provide approximately half the circulating testosterone in premenopausal women . After bilateral oophorectomy , many women report impaired sexual functioning despite estrogen replacement . We evaluated the effects of transdermal testosterone in women who had impaired sexual function after surgically induced menopause . METHODS Seventy-five women , 31 to 56 years old , who had undergone oophorectomy and hysterectomy received conjugated equine estrogens ( at least 0.625 mg per day orally ) and , in r and om order , placebo , 150 microg of testosterone , and 300 microg of testosterone per day transdermally for 12 weeks each . Outcome measures included scores on the Brief Index of Sexual Functioning for Women , the Psychological General Well-Being Index , and a sexual-function diary completed over the telephone . RESULTS The mean ( + /-SD ) serum free testosterone concentration increased from 1.2+/-0.8 pg per milliliter ( 4.2+/-2.8 pmol per liter ) during placebo treatment to 3.9+/-2.4 pg per milliliter ( 13.5+/-8.3 pmol per liter ) and 5.9+/-4.8 pg per milliliter ( 20.5+/-16.6 pmol per liter ) during treatment with 150 and 300 microg of testosterone per day , respectively ( normal range , 1.3 to 6.8 pg per milliliter [ 4.5 to 23.6 pmol per liter ] ) . Despite an appreciable placebo response , the higher testosterone dose result ed in further increases in scores for frequency of sexual activity and pleasure-orgasm in the Brief index of Sexual Functioning for Women ( P=0.03 for both comparisons with placebo ) . At the higher dose the percentages of women who had sexual fantasies , masturbated , or engaged in sexual intercourse at least once a week increased two to three times from base line . The positive-well-being , depressed-mood , and composite scores of the Psychological General Well-Being Index also improved at the higher dose ( P=0.04 , P=0.03 , and P=0.04 , respectively , for the comparison with placebo ) , but the scores on the telephone-based diary did not increase significantly . CONCLUSIONS In women who have undergone oophorectomy and hysterectomy , transdermal testosterone improves sexual function and psychological well-being Summary To define the principal characteristics of X-autosome  translocations  , the authors present a study of 105 cases , five of which are personal observations . The autosomal pairs 15 , 21 , and 22 are affected by t(X-Aut ) more often than would be expected . The distribution of breakpoints on the X chromosome does not differ significantly from the expected distribution . The analysis of different patterns of inactivation seems to confirm that the inactivation could occur at r and om , but would be followed by a cellular selection favoring the better genetic balance . An estimate of the incidence of t(X-Aut ) is proposed , based upon the conclusions that only one chromosome is susceptible to translocation in meiosis in both males and females and that all affected men will be sterile , as will be 50 % of women Hormone profiles ( estradiol , testosterone , FSH , LH ) and typical estradiol deficiency phenomena were investigated prospect ively in the first 6 weeks after hysterectomy ( n = 50 ) and after additional bilateral adnexectomy ( n = 17 ) . In the second group estradiol was replaced transdermally from the 2nd postoperative day ( estradiol patch , 0.05 mg daily ) . In the 1st group 34 % of patients showed a significant decrease in estradiol , 28 % of patients a significant decrease in testosterone on the 3rd postoperative day which was no longer demonstrable after 6 weeks . In the second group no decrease in hormone levels was found . So the estradiol patch can replace estradiol to a sufficient degree and in particular physiologically even after bilateral oophorectomy Subjective complaints improved in both groups . Psychosomatic influence also seems to be of importance UNLABELLED We studied whether oophorectomy 
    Output:
    
agent
Subgroup analysis for assay type was statistically significant for spontaneous POI only .
Sensitivity analyses of high- quality studies did not change the results , and result ed in a substantial decrease in heterogeneity in spontaneous POI studies .
The current meta- analysis demonstrates that total testosterone concentrations are decreased in women with spontaneous POI or iatrogenic menopause .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The hypothalamo-pituitary-adrenal ( HPA ) axis is modulated by sex hormones . Few data exist on the relation between acute estrogen deficit and HPA axis response to corticotropin-releasing hormone ( CRH ) . The effects of a sudden drop in estradiol levels on basal and CRH-stimulated levels of ACTH , cortisol , testosterone , and rostenedione and 17-hydroxyprogesterone ( 17-OHP ) were assessed in nine premenopausal women ( 44 - 48 years of age ) , before and after ovariectomy .  The CRH test was performed before and 8 days after ovariectomy . A significant reduction in ACTH and adrenal steroids but not in cortisol response to CRH was observed after ovariectomy . The ratio of deltamax and rostenedione/17-OHP after CRH stimulation was substantially the same before and after ovariectomy , whereas deltamax 17-OHP/cortisol was significantly lower in ovariectomized women showing increased 21- and 11beta-hydroxylase activity . The results show that the acute estrogen deficit induces changes in the HPA axis characterized by reduced stimulated secretion of ACTH and steroids but normal stimulated cortisol production CONTEXT Changes in and rogen levels across the adult female life span and the effects of natural menopause and oophorectomy have not been clearly established . OBJECTIVE The objective of this study was to document the effects of age on and rogen levels in healthy women and to explore the effects of natural and surgical menopause . DESIGN , SETTING , AND PARTICIPANTS A cross-sectional study was conducted of 1423 non-healthcare-seeking women , aged 18 - 75 yr , r and omly recruited from the community over 15 months . MAIN OUTCOME MEASURES Serum levels by age of total testosterone ( T ) , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione in a reference group of women free of confounding factors . Women in the reference group had no usage of exogenous steroid therapy ; no history of tubal ligation , hysterectomy , or bilateral oophorectomy ; and no hyperprolactinemia or polycystic ovarian syndrome . The effects of natural and surgical menopause on sex steroid levels were also examined . RESULTS In the reference population ( n = 595 ) , total T , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione declined steeply with age ( P < 0.001 ) , with the decline of each being greater in the earlier than the later decades . Examination of serum and rogen levels by year in women aged 45 - 54 yr showed no independent effect of menopausal status on and rogen levels . In women aged 55 yr or older , those who reported bilateral oophorectomy and were not on exogenous steroids had significantly lower total T and free T levels than women 55 yr or older in the reference group . CONCLUSIONS We report that serum and rogen levels decline steeply in the early reproductive years and do not vary because a consequence of natural menopause and that the postmenopausal ovary appears to be an ongoing site of testosterone production . These significant variations in and rogens with age must be taken into account when normal ranges are reported and in studies of the role of and rogens in women OBJECTIVE To investigate the cross-sectional associations of  hysterectomy and oophorectomy  status , chronological age , and body mass index with early postoperative plasma levels of total and free T , DHEAS , and sex hormone-binding globulin ( SHBG ) . DESIGN A cross-sectional study . SETTING University hospital . PATIENT(S ) Ninety-two women age 35 - 47 years who were scheduled for hysterectomy and /or oophorectomy , advocated for benign gynecological pathologies . INTERVENTION(S ) Ninety-two eligible premenopausal women underwent hysterectomy and /or oophorectomy  , with plasma T , DHEAS , and SHBG levels assayed before surgery and during the postoperative period . MAIN OUTCOME MEASURE(S ) Effects of time x operation and age x operation interactions between oophorectomized and nonoophorectomized groups and within-subject main effect of time on plasma and rogen levels . RESULT ( S ) Of 92 women , hysterectomy alone was performed in only 49 ( 53.3 % ) cases . Oophorectomy , either unilateral or bilateral , was performed in 35.8 % of cases . Age x within-group interactions exhibited an important difference ( P=.03 ) in total T levels . The time x between- and within-group interaction effects on plasma DHEAS levels of postoperative day 7 , compared with day 1 , were statistically significant ( P<.001 ) . The effect of time x group interaction was remarkable , in terms of SHBG levels during the postoperative period . Age x oophorectomy interaction exhibited a statistically significant change of decline in DHEAS levels on postoperative day 7 ( P=.05 ) . CONCLUSION ( S ) The present study demonstrated a time and operation effect decline in plasma DHEAS levels . In contrast , the time x operation interaction on SHBG levels exhibited an increase toward postoperative day 7 CONTEXT In postmenopausal women , endogenous bioavailable testosterone ( T ) and estradiol ( E2 ) have been positively associated , and SHBG has been negatively associated , with incident type 2 diabetes ( T2DM ) . Previous studies have not explored possible factors explaining these relationships . OBJECTIVE Our objective was to examine the association of endogenous sex hormones with incident T2DM  in postmenopausal women and possible explanatory factors . DESIGN , SETTING , AND PARTICIPANTS The Multi-Ethnic Study of Atherosclerosis ( MESA ) is a prospect i ve study that included 1612 postmenopausal women aged 45 - 84 yr , followed between the years 2000 - 2006 , who were not taking hormone replacement therapy , had no prevalent cardiovascular disease or diabetes , and had complete ascertainment of sex hormones . MAIN OUTCOME MEASURES T2DM was defined based on fasting glucose and /or treatment for diabetes . RESULTS There were 116 incident cases of diabetes during follow-up . Across higher quartiles of bioavailable T and E2 and lower quartiles of SHBG , we found significantly greater hazards of developing incident T2DM ( all P for trend < or=0.001 ) . After adjustment for body mass index and insulin resistance estimated by homeostasis model assessment of insulin resistance , bioavailable T was no longer associated with incident T2DM . The associations of E2 and SHBG with incident T2DM were partially explained by body mass index and insulin resistance but persisted in fully adjusted models ( both P for trend < 0.02 ) . Dehydroepi and rosterone had no relationship with incident T2DM . CONCLUSIONS Adiposity and insulin resistance explained most of the association of bioavailable T but only partially explained the associations of E2 and SHBG with incident T2DM among postmenopausal women In postmenopausal women , levels of estrogens , and rogens , and perhaps prolactin have been related to risk of breast and other hormonal cancers in women . However , the determinants of these hormone concentrations have not been firmly established . Associations among various demographic , menstrual , and reproductive factors , medication use and endogenous sex hormone concentrations ( estradiol , free estradiol , estrone , estrone sulfate , testosterone , free testosterone , sex hormone binding globulin , and rostenedione , dehydroepi and rosterone ( DHEA ) , DHEA sulfate ( DHEAS ) , dihydrotestosterone , and prolactin )  were evaluated in a cross-sectional analysis from a simple r and om sample of 274 postmenopausal women selected from the Women ’s Health Initiative Dietary Modification Trial . In multiple regression analyses on log-transformed hormones , the concentrations of DHEA , and DHEAS were negatively and statistically significantly associated with age ( both β = −0.03 , P < 0.001 , respectively ) . Estradiol , estrone , DHEA , and free testosterone concentrations were higher in African-American than in non-Hispanic White women , but after multivariate adjustment the associations were statistically significant only for free testosterone ( β = 0.38 , P = 0.01 ) . Women who had a history of bilateral oophorectomy had a mean 35 % lower testosterone concentration compared with women with at least one ovary remaining ( β = −0.43 , P = 0.002 ) , and lower free testosterone ( β = −0.42 , P = 0.04 ) after multivariate adjustment . Women who reported regular use of NSAIDs had higher DHEA concentrations ( β = 0.20 , P = 0.04 ) and lower prolactin concentrations ( β = −0.18 , P = 0.02 ) compared with non-users . These results suggest that while age , oophorectomy status , and NSAID use may be associated with selected sex hormone concentrations , few menstrual or reproductive factors affect endogenous sex hormones in the postmenopausal period BACKGROUND The ovaries provide approximately half the circulating testosterone in premenopausal women . After bilateral oophorectomy , many women report impaired sexual functioning despite estrogen replacement . We evaluated the effects of transdermal testosterone in women who had impaired sexual function after surgically induced menopause . METHODS Seventy-five women , 31 to 56 years old , who had undergone oophorectomy and hysterectomy received conjugated equine estrogens ( at least 0.625 mg per day orally ) and , in r and om order , placebo , 150 microg of testosterone , and 300 microg of testosterone per day transdermally for 12 weeks each . Outcome measures included scores on the Brief Index of Sexual Functioning for Women , the Psychological General Well-Being Index , and a sexual-function diary completed over the telephone . RESULTS The mean ( + /-SD ) serum free testosterone concentration increased from 1.2+/-0.8 pg per milliliter ( 4.2+/-2.8 pmol per liter ) during placebo treatment to 3.9+/-2.4 pg per milliliter ( 13.5+/-8.3 pmol per liter ) and 5.9+/-4.8 pg per milliliter ( 20.5+/-16.6 pmol per liter ) during treatment with 150 and 300 microg of testosterone per day , respectively ( normal range , 1.3 to 6.8 pg per milliliter [ 4.5 to 23.6 pmol per liter ] ) . Despite an appreciable placebo response , the higher testosterone dose result ed in further increases in scores for frequency of sexual activity and pleasure-orgasm in the Brief index of Sexual Functioning for Women ( P=0.03 for both comparisons with placebo ) . At the higher dose the percentages of women who had sexual fantasies , masturbated , or engaged in sexual intercourse at least once a week increased two to three times from base line . The positive-well-being , depressed-mood , and composite scores of the Psychological General Well-Being Index also improved at the higher dose ( P=0.04 , P=0.03 , and P=0.04 , respectively , for the comparison with placebo ) , but the scores on the telephone-based diary did not increase significantly . CONCLUSIONS In women who have undergone oophorectomy and hysterectomy , transdermal testosterone improves sexual function and psychological well-being Summary To define the principal characteristics of X-autosome  translocations  , the authors present a study of 105 cases , five of which are personal observations . The autosomal pairs 15 , 21 , and 22 are affected by t(X-Aut ) more often than would be expected . The distribution of breakpoints on the X chromosome does not differ significantly from the expected distribution . The analysis of different patterns of inactivation seems to confirm that the inactivation could occur at r and om , but would be followed by a cellular selection favoring the better genetic balance . An estimate of the incidence of t(X-Aut ) is proposed , based upon the conclusions that only one chromosome is susceptible to translocation in meiosis in both males and females and that all affected men will be sterile , as will be 50 % of women Hormone profiles ( estradiol , testosterone , FSH , LH ) and typical estradiol deficiency phenomena were investigated prospect ively in the first 6 weeks after hysterectomy ( n = 50 ) and after additional bilateral adnexectomy ( n = 17 ) . In the second group estradiol was replaced transdermally from the 2nd postoperative day ( estradiol patch , 0.05 mg daily ) . In the 1st group 34 % of patients showed a significant decrease in estradiol , 28 % of patients a significant decrease in testosterone on the 3rd postoperative day which was no longer demonstrable after 6 weeks . In the second group no decrease in hormone levels was found . So the estradiol patch can replace estradiol to a sufficient degree and in particular physiologically even after bilateral oophorectomy Subjective complaints improved in both groups . Psychosomatic influence also seems to be of importance UNLABELLED We studied whether oophorectomy 
    Output:
    