{"title":"Notes from the journals","authors":"J. Mcgarry","doi":"10.1258/136218006779160463","DOIUrl":"https://doi.org/10.1258/136218006779160463","url":null,"abstract":"","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"60 1","pages":"175 - 176"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87370908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sexuality and the menopause.","authors":"Kevan R Wylie","doi":"10.1258/136218006779160535","DOIUrl":"https://doi.org/10.1258/136218006779160535","url":null,"abstract":"Sexual problems such as dyspareunia and decreased sexual desire are common after the menopause. Hypoactive sexual desire disorder is the diagnostic category applied to many women with loss or lack of sexual interest or desire. The principal components of assessment for sexual dysfunction in menopausal women are: a general, gynaecological, obstetric, psychiatric, psychosexual and relationship history; use of self-report questionnaires; physical examination; and hormonal evaluation. The use of low-dose vaginal estrogen tablets, rings, creams or pessaries may help to improve local genital response but does not necessarily improve sexual interest or motivation. An improvement in sexual function has been reported with tibolone and a combination of estrogen and androgen therapy, al though it remains unclear which groups of postmenopausal women with sexual problems will benefit most from such treatments. Where there is no response to estrogens or where there is premature or surgical menopause the addition of an androgen may be necessary, particularly if the free testosterone levels are low.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"12 4","pages":"149-52"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/136218006779160535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26451270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Invited papers: lifestyle","authors":"Nigel Denby, J. Tobin, D. Sturdee","doi":"10.1258/136218006779160562","DOIUrl":"https://doi.org/10.1258/136218006779160562","url":null,"abstract":"There is increasing interest in nutrition and lifestyle interventions as an alternative to hormone replacement therapy (HRT) or to complement HRT in the management of menopausal symptoms and menopause/ageing-related disease. Many women find it difficult to control their weight during menopause and this can be a key motivating factor to making dietary and lifestyle changes. From the available evidence, it would appear that isoflavones can improve some menopausal symptoms such as hot flushes and can have a positive effect on plasma lipid profiles and bone mineral density, particularly when incorporated as part of a healthy diet and lifestyle.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"3 1","pages":"197 - 197"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88304170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cognitive function testing: the case for standardization and automation.","authors":"Keith A Wesnes","doi":"10.1258/136218006779160544","DOIUrl":"https://doi.org/10.1258/136218006779160544","url":null,"abstract":"<p><p>This review considers the advantages that both standardization and automation of cognitive function testing can bring to clinical research. It reviews progress made in several fields of medicine with a standardized and automated cognitive function assessment system which has been in use in worldwide clinical trials for over 20 years. Data are presented showing the effects on cognitive function of both normal ageing and a variety of diseases. The utility of cognitive testing in the identification and classification of dementia is considered, and its ability to further our understanding of the cognitive sequelae of stroke is discussed. The correlation between assessments of cognitive function and patients' ability to undertake the activities of daily living is evaluated. Finally, the use of such techniques to identify beneficial effects of treatment in various conditions is described. The review concludes that standardization and automation of cognitive function testing have facilitated progress in a number of fields, and that the systematic application of such a technique in menopause research would greatly help advance our knowledge in this field.</p>","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"12 4","pages":"158-63"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/136218006779160544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26451272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hysterectomy and sexual function.","authors":"Tefo Mokate, Caroline Wright, Tony Mander","doi":"10.1258/136218006779160607","DOIUrl":"https://doi.org/10.1258/136218006779160607","url":null,"abstract":"<p><p>Hysterectomy is one of the most common major gynaecological operations performed in the UK and the USA. Its impact on sexual function is a major cause of preoperative anxiety. Unfortunately, this anxiety is seldom articulated by patients, nor recognized and discussed by clinicians. Reports about the impact of hysterectomy on sexual function have been conflicting, partly due to the use of different and often unsatisfactory parameters to assess sexual function. The aim of this review is to assess the current evidence about the effect of hysterectomy on sexual function. Female sexual function is governed by psychological, social and physiological factors. A new model of 'the sexual response cycle', comprising physical, emotional and cognitive feedback, helps explain the sexual difficulties that arise before and after hysterectomy. Evidence is lacking for sexual dysfunction caused by the disruption of local nerve and blood supply, or by changing anatomical relationships. Removal of the ovaries at hysterectomy is associated with no change or even an improvement in sexual function, particularly in women on hormone replacement therapy. Thus, overall, hysterectomy improves sexual function, regardless of surgical method or removal of the cervix. This is probably due to the amelioration of the symptoms that have previously had a negative effect on sexual function.</p>","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"12 4","pages":"153-7"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/136218006779160607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26451271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Invited papers: individualizing therapy","authors":"Tim Hillard, Paola Albertazzi, Jo Marsden","doi":"10.1258/136218006779160508","DOIUrl":"https://doi.org/10.1258/136218006779160508","url":null,"abstract":"It is now nearly four years since the publication of the original Women’s Health Initiative (WHI) trials and the huge amount of data continue to be analysed and published. The most recent publications indicate that there was actually a significant reduction in the number of breast cancers observed in estrogen-only users compared with placebo. At worst this implies that estrogen-only hormone therapy (HT) does not increase breast cancer risk and at best it suggests it may actually be protective. This is potentially excellent news for menopausal women, particularly those who have been hysterectomized. Yet, where are the media reports to get this message across to the public? Where are the reassuring statements from the regulatory authorities? At the time of going to press these latest reports have largely gone unnoticed and unreported. One of the key driving forces for the WHI trial was to identify whether or not there was a case for estrogen being ‘cardioprotective’. The initial results and accompanying headlines indicated that it was not and indeed suggested that estrogens may even be disadvantageous. Unfortunately, the media, many medical societies and the regulatory authorities all over the world subsequently took the message from the study that estrogens were not good for cardiovascular disease risk and extrapolated it to all age groups, even though the increase in adverse events was largely confined to the over70s. Reanalyses of the data now indicate an actual reduction in cardiovascular events in the younger age groups (50–59 years), the ages when most women are likely to consider HT. This is further supported by the latest Nurses’ Health Study publication showing a significant reduction in coronary heart disease in women who started HT around the time of menopause. Thus, it appears that estrogens started around the time of menopause may have a protective effect after all! Away from the WHI, the adverse publicity about HT has focused attention on non-hormonal treatments and their potential role in treating menopausal symptoms. Some alternative treatments have been the subject of appropriate scientific assessment, with varying results, but the debate about the role of alternative medicines in the management of the menopause continues.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"36 1","pages":"194 - 195"},"PeriodicalIF":0.0,"publicationDate":"2006-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85308351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-surgical treatment for detrusor overactivity.","authors":"R Alexander Slack, Simon Jackson","doi":"10.1258/136218006778234075","DOIUrl":"https://doi.org/10.1258/136218006778234075","url":null,"abstract":"<p><p>Urinary incontinence is a common but under-reported condition. Approximately 17% of women are affected by detrusor overactivity at some time in their lives. Pharmacological treatment of this condition used to be severely limited by the side-effects of the drugs and the associated poor patient compliance. Recently, however, the tolerability and effectiveness of pharmacotherapy have been improved by the introduction of new drugs and alternative methods of drug delivery. This review assesses the effectiveness and tolerability of these new treatments. Anticholinergic agents, botulinum toxin and neuromodulation are also discussed.</p>","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"12 3","pages":"109-14"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/136218006778234075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26295774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A 10-year follow-up of postmenopausal women on long-term continuous combined hormone replacement therapy: Update of safety and quality-of-life findings.","authors":"Jorma Heikkinen, Raija Vaheri, Ulla Timonen","doi":"10.1258/136218006778234093","DOIUrl":"https://doi.org/10.1258/136218006778234093","url":null,"abstract":"<p><strong>Objective: </strong>To assess the safety and health-related quality of life (HRQOL) of continuous combined hormone replacement therapy (ccHRT) with estradiol valerate/medroxyprogesterone acetate (E(2)V/MPA) over nine years and at follow-up one year after discontinuation.</p><p><strong>Study design: </strong>A total of 419 women were randomized to one of four treatments: once-daily 1 mg E2V/2.5 mg MPA (1 + 2.5 group); 1 mg E2V/5 mg MPA daily (1 + 5 group); 2 mg E2V/2.5 mg MPA daily (2 + 2.5 group); 2 mg E2V/5 mg MPA daily (2 + 5 group) (Indivina, Orion Pharma). For the last six months, all received the 1 + 2.5 dosage. The 2 + 2.5 dosage was discontinued at the end of year 7. A total of 198 women continued after year 7.</p><p><strong>Results: </strong>Annualized percentage rates for cardiovascular events [corrected] and endometrial cancers [corrected] were below national rates for Finland and those reported for the Women's Health Initiative. There were no serious events with the 1 + 2.5 dosage or after ccHRT discontinuation. Climacteric symptoms remained significantly below baseline values after dosage reduction; some symptoms recurred after discontinuation of ccHRT. HRQOL ratings improved with ccHRT, irrespective of dosage, including depressed mood, anxiety, health perception and sexual interest. Scores on a scale assessing daily functioning and enjoyment (Q-LES-Q) improved from year 7 to year 9. They deteriorated during follow-up in women not continuing ccHRT.</p><p><strong>Conclusions: </strong>Lower dosages of HRT were as effective as higher doses in improving climacteric symptoms and HRQOL ratings and had fewer safety concerns. Following discontinuation of ccHRT, patient satisfaction was variable, with 15% electing to continue or restart HRT and 7% resuming at follow-up. This supports the need for an individualized approach to therapy recommendations.</p>","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"12 3","pages":"115-25"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/136218006778234093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26295694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exercise for women in the early postmenopausal years.","authors":"Janet Brockie","doi":"10.1258/136218006778234039","DOIUrl":"https://doi.org/10.1258/136218006778234039","url":null,"abstract":"<p><p>Exercise has many benefits throughout life but in later life in particular it will protect against cardiovascular disease, obesity, diabetes and cancer, and preserve musculoskeletal health and psychological wellbeing. Women as they get older are at increasing risk of osteoporosis and the aim of exercise is to slow these skeletal changes. The early postmenopausal years in particular are associated with a rapid loss of bone mass, together with a loss of aerobic fitness and muscle strength. Therefore an evidence-based exercise regime to protect against these problems is essential, so that the exercise is of the appropriate quantity, duration and intensity for the required outcome.</p>","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"12 3","pages":"126-7"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/136218006778234039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26295695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leon Flicker, Nicola T Lautenschlager, Osvaldo P Almeida
{"title":"Healthy mental ageing.","authors":"Leon Flicker, Nicola T Lautenschlager, Osvaldo P Almeida","doi":"10.1258/136218006778234011","DOIUrl":"https://doi.org/10.1258/136218006778234011","url":null,"abstract":"<p><p>Healthy mental ageing may be defined as the absence of the common disabling mental health problems of older people, especially cognitive decline and depression, accompanied by the perception of a positive quality of life. Older people are particularly prone to negative effects on mental health due to poor physical health. Modifiable aspects of lifestyle have been shown to be associated with healthy mental ageing. These include increased physical activity, intellectual stimulation (including education), avoidance of smoking and various aspects of diet. There is reasonably strong evidence that the treatment of hypertension will decrease the risk of cognitive impairment, and moderate alcohol intake may also have some benefits on cognition. These modifiable lifestyle factors may benefit from deliberate individual and population health promotion strategies to maximize mental health in old age, although to date intervention trials have not been performed to support the evidence obtained from observational studies.</p>","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"12 3","pages":"92-6"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/136218006778234011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26295771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}