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Objective To study the impact of low-dose unopposed esterified estrogens on menopausal symptoms and quality of life.Methods In a long-term, 2-year, randomized, double-blind, placebo-controlled study, 204 postmenopausal women were treated with esterified estrogens 0.3 mg daily or placebo. Menopausal symptoms were assessed with a modified Kupperman index at baseline, 3, 6 and thereafter every 6 months. In a second 12-week, open-label, short-term pilot study, 25 postmenopausal women with moderate to severe vasomotor symptoms were treated with esterified estrogens 0.3 mg daily for 12 weeks. Vasomotor symptoms and quality of life were assessed using the Greene scale and Quality of Life Menopause Scale (QUALMS).Results In the long-term study, significant (p < 0.05) reductions in total symptom scores were observed at each time point with esterified estrogens compared with placebo. Somatic symptom scores (hot flushes, night sweats, vaginal dryness) decreased significantly (p < 0.01) in patients treated with esterified estrogens 0.3 mg compared to baseline and placebo. In the short-term, open-label pilot study, the incidence of vasomotor symptoms was significantly (p < 0.01) reduced with esterified estrogens 0.3 mg from week 4 until the study end. Significant (p < 0.05) improvements versus baseline were seen in the somatic and vasomotor/sleep domains and in the total quality-of-life score.Conclusions Esterified estrogens 0.3 mg given daily provide adequate menopausal symptom relief and improved quality of life in postmenopausal women.

1. The trachea is constructed by a series of U‐shaped cartilaginous rings supporting a membranous posterior wall. We have studied separately the pressure‐volume relationships of the two components. 2. The motion of the membranous posterior wall contributes most to the tracheal volume change caused by any given transmural pressure change; the cartilaginous rings provide a semi‐rigid support to the posterior wall and have a far greater compliance with negative than positive transmural pressure. 3. The response of tracheal stretch receptors to transmural pressure can be explained by the mechanical coupling between cartilages and posterior wall. They respond both to positive and negative transmural pressure, they are active at zero transmural pressure and have a point of least activity with small negative transmural pressures. 4. The stress‐strain relationship of the posterior wall has been studied in static and dynamic conditions in control situations and after removal of either the tunica fibrosa or the trachealis muscle. Each of these two components contributes to the stiffness of the posterior wall, with the trachealis muscle providing most of its viscosity. 5. The response of tracheal stretch receptors to transverse traction of the posterior membranous wall has been studied in both static and dynamic conditions before and after removal of the tunica fibrosa. The behaviour of these receptors reflects the visco‐elastic properties of the trachealis muscle in which they have been localized.

To establish a quantitative method for the diagnosis of premenstrual syndrome (PMS), a simple prospective inventory, the calendar of premenstrual experiences, was constructed. The validity and reliability of this instrument were assessed by administering it throughout two consecutive ovulatory cycles to 36 rigidly screened women with PMS and to 18 controls. To establish concurrent validity, scores on behavioral items were correlated with simultaneously obtained scores on lengthier, well-validated psychiatric inventories designed to measure depression rather than PMS, the Beck Depression Inventory and the Profile of Mood States. The results showed that the calendar of premenstrual experiences luteal phase score distinguished PMS women from controls correctly in 104 of 108 cycles, with a 2.8 falsenegative rate and no false positives when used for two consecutive cycles. An upper limit follicular phase score was observed beneath which all PMS and normal control subjects fell, suggesting that a higher score is not consistent with PMS. Correlation coefficients of calendar item scores with Profile of Mood States scale scores were 0.58 for tension, 0.51 for depression, 0.46 for anger, 0.61 for fatigue, and 0.57 for confusion (P<.0001 for all correlations). The correlation of the- calendar depression item with the Beck Depression Inventory score was 0.56 (P<.0001). The test-retest reliability of the calendar given in the same phase of two consecutive menstrual cycles was high (r0.78, P<.0001). We conclude that this instrument is a valid, reliable, and practical PMS inventory, applicable to clinical and some research settings.