Menopause international最新文献

{"title":"Practice observed.","authors":"Sarah Gray","doi":"10.1258/mi.2011.011024","DOIUrl":"https://doi.org/10.1258/mi.2011.011024","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30130684","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":"The British Menopause Society: next steps 2011.","authors":"Edward Morris, Heather Currie","doi":"10.1258/mi.2011.011018","DOIUrl":"https://doi.org/10.1258/mi.2011.011018","url":null,"abstract":"In this edition, we publish the recently launched statement from the British Menopause Society (BMS). The society has produced this statement in response to the health reforms proposed by the coalition government. This statement not only gives a clear outline of the expanding demographic challenge that is menopause, it also highlights the major health issues that accompany the menopausal transition. These health changes may be either directly as a result of the hormonal changes or as a consequence of the natural ageing processes. In this statement, the BMS clearly recognizes the importance of a healthy lifestyle, fitness and identification of modifiable risk factors in the overall reduction in the risk of disease. Several key recommendations have been made that encompass changes that range from simple lifestyle modifications to changes in government health policy. Inequalities of access to appropriate health care and knowledge of both well-known and lesser understood disease risk factors and of treatment options is a major concern of the BMS. There is also a concern that with the significant reduction in hormone replacement therapy (HRT) prescribing since the publication of the WHI study, there has been an evolving reduction in acknowledgement of the importance of the discussion of the menopause and its related issues in the health service in general. This is likely to be driven by:","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29952911","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":"Role of bisphosphonates in the management of postmenopausal osteoporosis: an update on recent safety anxieties.","authors":"Rosemary J Hollick,&nbsp;David M Reid","doi":"10.1258/mi.2011.011014","DOIUrl":"https://doi.org/10.1258/mi.2011.011014","url":null,"abstract":"<p><p>Following their introduction in the 1990s, bisphosphonates have become the mainstay of treatment in the management of postmenopausal osteoporosis, and their use continues to rise. Commonly noted adverse effects in clinical practice include gastrointestinal side-effects, acute phase reactions (predominately seen with intravenous preparations) cutaneous reactions and more rarely, ocular side-effects. However, recent reports of potentially serious adverse effects of bisphosphonate therapy, including atypical subtrochanteric and femoral shaft fractures, atrial fibrillation, oesophageal carcinoma and osteonecrosis of the jaw, have prompted concerns regarding the long-term safety of this class of drugs. This review summarizes the benefits and potential adverse effects of bisphosphonates used in the treatment of postmenopausal osteoporosis. Although evidence of a definitive casual relationship between bisphosphonate therapy and serious adverse effects is lacking, concern remains particularly in relation to atypical subtrochanteric and femoral shaft fractures. This has important consequences in terms of determining optimum duration of therapy and how best to target therapy at those most at risk. Recently, attention has focused on individual fracture risk assessment in order to optimize the risk-benefit ratio of treatment for individual patients. A review of the role of hormone replacement therapy in younger women with significant risk of osteoporotic fractures may be timely in these circumstances.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29953879","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":"Modernizing the NHS: observations and recommendations from the British Menopause Society.","authors":"","doi":"10.1258/mi.2011.011015","DOIUrl":"https://doi.org/10.1258/mi.2011.011015","url":null,"abstract":"<p><p>Women's health often declines in middle and old age for reasons that are avoidable. Simple measures including lifestyle change could make a significant difference. Education of women is all important. The BMS feels that the provision of a simple health check of all women at the age of 50 years would provide an excellent opportunity that would serve as a screening as well as an educational visit at which balanced information about appropriate treatments and lifestyle changes in natural and premature menopause should be given to empower women to make an informed choice.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29952912","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":"Advice given to women undergoing gynaecological surgery in relation to menopause, symptoms and hormone replacement therapy: could and should we improve the service we provide?","authors":"Jenny Lyons","doi":"10.1258/mi.2011.011019","DOIUrl":"https://doi.org/10.1258/mi.2011.011019","url":null,"abstract":"<p><p>A retrospective case-note study was undertaken to look at recorded details relating to information/advice given to women prior to or at the time of their gynaecological surgery with regard to possible effects of menopause/menopausal symptoms or advice given about hormone replacement therapy.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29953877","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":"Management of the menopause: integrated health-care pathway for the menopausal woman.","authors":"Margaret Rees","doi":"10.1258/mi.2011.011013","DOIUrl":"https://doi.org/10.1258/mi.2011.011013","url":null,"abstract":"<p><p>Management of the menopausal woman has become controversial since publication of the results of the Women's Health Initiative and the Million Women Study from 2002 onwards. This health-care pathway summarizes the role of hormone replacement therapy and non-estrogen-based treatments as well as alternative and complementary therapies. It is based on the fifth edition of Management of the Menopause and was updated on 5 April 2011.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29952914","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":"Setting and maintaining standards in menopause care: audit of current practice in a specialist clinic.","authors":"Deborah J Lee,&nbsp;Amanda J Hillard,&nbsp;Timothy C Hillard","doi":"10.1258/mi.2011.011016","DOIUrl":"https://doi.org/10.1258/mi.2011.011016","url":null,"abstract":"<p><p>Standards are an important way of demonstrating quality of care in any given setting. The British Menopause Society (BMS) has produced guidelines as to what should be recorded at the initial menopause consultation. A retrospective audit of case-notes of women attending Poole Menopause Centre was undertaken using these criteria as audit standards. Although areas of good practice were highlighted, the published criteria were met for only five of the 23 standards. An action plan to improve the documentation to achieve these standards has been formulated.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29952915","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":"Bazedoxifene: a new selective estrogen receptor modulator for postmenopausal osteoporosis.","authors":"Harry K Genant","doi":"10.1258/mi.2011.011011","DOIUrl":"https://doi.org/10.1258/mi.2011.011011","url":null,"abstract":"<p><p>An ongoing need for safe and effective pharmacological therapies exists for postmenopausal osteoporosis, which imposes a significant burden on both women and the health-care system. Bazedoxifene is a novel selective estrogen receptor modulator with a unique tissue-selectivity profile. In phase 3 clinical trials of nearly 10,000 postmenopausal women, bazedoxifene was shown to significantly reduce the risk of new vertebral fracture versus placebo, with favourable effects on bone mineral density, bone turnover markers and the lipid profile. Moreover, in a subgroup of women at increased risk of fracture, bazedoxifene significantly decreased non-vertebral fracture risk versus both placebo and raloxifene. Bazedoxifene has been shown to be safe and well tolerated, with no evidence of endometrial or breast stimulation. These data suggest that bazedoxifene may offer significant clinical benefit for postmenopausal women with or at risk of developing osteoporosis, which may subsequently lessen the medical and economic burden of this disease.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29952913","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":"National Osteoporosis Society's Position statement on hormone replacement therapy in the prevention and treatment of osteoporosis.","authors":"C E Bowring,&nbsp;R M Francis","doi":"10.1258/mi.2011.011012","DOIUrl":"https://doi.org/10.1258/mi.2011.011012","url":null,"abstract":"<p><p>Hormone replacement therapy (HRT) has been shown to increase bone density, reduce the risk of fracture and can successfully relieve menopausal symptoms. From a time when HRT was the major therapeutic option for the management of osteoporosis, women and their clinicians now have a range of treatments available. Following the publication of the Women's Health Initiative (WHI) and the Million Women Study highlighting potential side-effects, such as breast cancer, heart disease and stroke, many doctors and women are now reluctant to use HRT. The National Osteoporosis Society felt that the role of HRT in the management of osteoporosis needed to be clarified. Using the Charity's expert clinical and scientific advisers, and through public consultation with members and key stakeholders, a Position Statement has been published. We conclude that HRT has a role to play in the management of osteoporosis in postmenopausal women below the age of 60 years. The key recommendations of the Position Statement are presented in this paper.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29953878","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":"The new NHS and what it will mean for the management of the menopause.","authors":"Edward Morris,&nbsp;Heather Currie","doi":"10.1258/mi.2011.011005","DOIUrl":"https://doi.org/10.1258/mi.2011.011005","url":null,"abstract":"As we write this editorial, the publication of the Health and Social Care Bill (2011) proposes some of the biggest changes in the National Health Service (NHS) for decades. It is clear that all of us who provide health care in the UK will – to some extent – have to change the way in which we deliver that care. Whatever form the NHS takes in the future, it is clear that the running of a service will rely firmly on a clear and sensible dialogue between primary and secondary care. Providers should not see this time purely as a time of worry about the future; they should look upon the proposals as an opportunity to improve access to safe and high quality care for their patients. How will the proposed changes affect the care of women with menopausal problems? In England, the NHS Commissioning Board will be responsible for ensuring that the commissioning process is effective and transparent and achieves better quality care with improved outcomes. This, through use of evidencebased guidance from the National Institute of Health and Clinical Excellence (NICE), will steer primary care consortia to commission local service provision. Much of the work will continue to be supplied by the current providers; however, like-minded groups of general practitioners (GPs) and other health-care providers will be able to join together to deliver higher quality care in a more economical fashion with less bureaucracy. The ideology appears sound, but how will it work in our corner of medicine? As we have mentioned before, there has been a significant shift of the care of women with menopausal problems into primary care. This has been, for the most part, appropriate and many women have benefited from better access to care from well-trained primary care doctors and nurses. In developing menopause services within the proposed framework the temptation would be to try to manage problems in primary care and refer when necessary, as usual. However, as much of the management of the menopause should be focused on preventative health care that requires extensive counselling, for many a proactive approach to the commissioning of an integrated service makes more sense. Failure to engage may result in a temptation to delay primary management or onward referral of women, which may then miss important preventative health-care opportunities, in addition to issues of immediate symptom control. For example, a group of like-minded primary care practitioners could meet with local specialist providers to plan how best to deliver comprehensive health care for women with postmenopausal problems. What might such a service look like? At the outset, evidence-based care pathways for the common issues of the menopause should be designed. These will enable GPs and nurses in primary care to manage the vast majority of menopause problems to a high standard without the need for onward referral. Further development and education of primary care physicians and nurses, with additional specialist skill in ","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2011.011005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29760395","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}