Menopause international最新文献

{"title":"Weight gain after stopping smoking may modify the health benefits.","authors":"Simon Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 3","pages":"106"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31836131","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 randomised controlled trial comparing the effects of micronized progesterone to medroxyprogesterone acetate on cardiovascular health, lipid metabolism and the coagulation cascade in women with premature ovarian insufficiency: study protocol and review of the literature.","authors":"Monica Mittal,&nbsp;Michael Savvas,&nbsp;Roopen Arya,&nbsp;Carmel McEniery,&nbsp;Nitish Narvekar,&nbsp;Linda Cardozo,&nbsp;Nick Panay,&nbsp;Haitham Hamoda","doi":"10.1177/1754045313503635","DOIUrl":"https://doi.org/10.1177/1754045313503635","url":null,"abstract":"<p><p>Premature ovarian insufficiency (POI) can have significant health implications for the affected patient population, but remains a largely under researched area. There is lack of evidence from randomised controlled trials to guide clinical practice, regarding the optimal hormone replacement therapy regimens, dose and route of administration. Furthermore, little research has addressed the effect of the various progestogens used on health parameters in women with POI. Here we describe an ongoing randomised clinical trial looking at the effects of micronized progesterone and medroxyprogesterone acetate, both used in combination with transdermal oestradiol on the cardiovascular system, lipid profile and coagulation cascade in women with POI as a step towards better understanding of the implications of hormone treatment in this cohort of women. </p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 3","pages":"127-32"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1754045313503635","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31763519","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":"Practice observed.","authors":"Sarah Gray","doi":"10.1177/1754045313502749","DOIUrl":"https://doi.org/10.1177/1754045313502749","url":null,"abstract":"Increasing medical specialization has undoubtedly resulted in better outcomes for patients with defined conditions. The converse to this is the lack of a generalist opinion for the presentation that is less obvious. One of the functions of the menopause clinic is to stand back and look at the bigger picture: to make an experienced analysis of a multisystem presentation. We routinely integrate risks and benefits affecting different bodily systems and in this respect differ from most other specialities. Just under a year ago, I was asked by her general practitioner (GP) to think about Tracey who was 54. I was given selected hospital correspondence and results from the previous three years and Tracey had written reams about what had happened to her. I take the view that in such situations the more information the better. From this I gleaned: Twenty years previously, age 33, Tracey had developed menopausal flushes. Her mother had been prematurely menopausal in her 30s. No other explanation was identified and she was treated successfully with cyclical HRT. Sixteen years before, age 37, Tracey had changed to continuous combined hormone replacement therapy (HRT) in the form of 2mg estradiol þ1mg norethisterone (Kliofem , NovoNordisk). This was also effective and she had no obvious flushes or other menopausal symptoms. Three years before, age 51, Tracey had begun intermittently to bleed vaginally. This was more like discoloured discharge than a period but varied from pink to brown and occasionally red. The GP notes indicated that when examined her vagina had looked atrophic. Tracey had been advised to reduce the Kliofem and with that alteration, the blood loss had increased rather than reduced. An ultrasound at the time had revealed a uniform and thin endometrium with no structural anomaly. A month later, a gynaecology out patient letter noted both the ultrasound result and that Tracey had an atrophic vagina. An endometrial biopsy had been taken and reported as scanty and atrophic. Tracey had been advised to use vaginal estradiol 25 mg tablets (Vagifem , NovoNordisk) for six weeks and to plan to reduce the Kliofem. She had continued to use the vaginal tablets twice a week ever since and also to use the 2mg combination daily as any attempt to reduce the HRT had resulted in an increase in bleeding. At about the same time, Tracey had presented with symptoms of feeling hot and unwell, almost flu-like. She had developed low abdominal pain that varied but could be severe and debilitating. At one stage, this was bad enough that she had collapsed and an ambulance was called. When reviewed by her GP her urine had been positive for blood and leucocytes and she was treated for urinary tract infection though no positive culture was obtained on that or any other occasion since. The urologists had been involved noting blood and leucocytes on dipstick testing and proposing a ‘semiresistant bug’. Flexible cystoscopy was reported as normal, renal ultrasound was unremarka","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 3","pages":"135-6"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1754045313502749","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31763521","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":"Red clover causing symptoms suggestive of methotrexate toxicity in a patient on high-dose methotrexate.","authors":"Ancel Orr,&nbsp;Rachel Parker","doi":"10.1177/1754045313502473","DOIUrl":"https://doi.org/10.1177/1754045313502473","url":null,"abstract":"<p><p>The case report discusses a very serious interaction between red clover and methotrexate not previously documented. It highlights the potential pitfalls of concomitant use of herbal remedies and conventionally prescribed drugs and the importance of advising our patients about OTC drugs. A 52-year-old woman attended her general practitioner for advice on menopausal flushing. She was on methotrexate weekly injections for severe psoriasis and was not keen to consider anything that would possibly affect her skin. Alternative therapies were discussed and red clover was suggested. This was bought OTC. After the third day of taking red clover capsules (430 mg), the patient developed severe vomiting and epigastric pain. She contacted the dermatology clinic that administers the methotrexate injection and was thought to have symptoms suggestive of methotrexate toxicity even though her liver function tests remained within normal levels. She had been receiving methotrexate injections for nearly two years with no adverse effects. The only new drug that had been started was red clover and this was thought to be the probable cause of the toxicity. It was withdrawn. The patient made a full recovery and received her next injection of methotrexate with no adverse effects. The interaction was reported to the MHRA with a yellow card. </p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 3","pages":"133-4"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1754045313502473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31763520","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":"IMS updates its recommendations on the use of HRT.","authors":"Simon Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 3","pages":"105-6"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31836130","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":"No adverse--or beneficial--effect of HRT on cognitive function in younger postmenopausal women.","authors":"Simon Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 3","pages":"104-5"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31836129","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 CLOSER survey: impact of postmenopausal vaginal discomfort on women and male partners in the UK.","authors":"Claudine Domoney,&nbsp;Heather Currie,&nbsp;Nick Panay,&nbsp;Ricardo Maamari,&nbsp;Rossella E Nappi","doi":"10.1177/1754045313484139","DOIUrl":"https://doi.org/10.1177/1754045313484139","url":null,"abstract":"<p><strong>Objective: </strong>To understand the physical and emotional impact of postmenopausal vaginal discomfort on relationships between women and their male partners.</p><p><strong>Study design: </strong>In a quantitative, Internet-based survey, 8200 individuals from the UK, Denmark, Sweden, Norway, Finland, France, Italy, US and Canada (postmenopausal, married/cohabiting women, aged 55-65 years, who had experienced vaginal discomfort, and male partners of such women) completed a structured questionnaire.</p><p><strong>Main outcome measures: </strong>Results for respondents from the UK (500 men, 500 women), expressed as percentages of women/men describing particular answers, are reported.</p><p><strong>Results: </strong>Avoiding physical intimacy because of vaginal discomfort was reported by 69% of women and 76% of male partners, mainly due to concern about sex being painful (women 63%; men 61%); 18% of women considered vaginal discomfort had created emotional distance between them and their partners. Local estrogen treatment was used by 21% of women, among whom 58% subsequently reported less painful sex. Following such treatment, 33% of women and 30% of male partners reported an improved sex life, while 33% of women and 34% of male partners described becoming emotionally closer. Although 73% of women did not consider enough information about vaginal discomfort to be available, 60% would consult a physician to obtain this.</p><p><strong>Conclusions: </strong>Although vaginal discomfort has a substantial impact on postmenopausal women and their partners, improvements in sexual and emotional relationships can follow use of local estrogen therapy. Not all women may be aware of therapeutic options; healthcare providers can improve outcomes by more openly communicating and initiating discussion with patients.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 2","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1754045313484139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31609940","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":"Estrogen deficiency: education for all!","authors":"Edward Morris,&nbsp;Heather Currie","doi":"10.1177/1754045313490906","DOIUrl":"https://doi.org/10.1177/1754045313490906","url":null,"abstract":"In July 2011, the Royal College of Obstetricians and Gynaecologists published the Expert Advisory Group Report High Quality Women’s Health Care: A Proposal for Change. This landmark publication highlighted a new concept – the continuum of important aspects of women’s health through puberty, the reproductive years, menstruation, pregnancy, contraception and fertility, through to the menopause and postreproductive health. We feel the concept of a life-course approach to healthcare should be widely adopted with an emphasis on the fluid and changing challenges in women’s health. Healthcare providers need to be reminded that many conditions and disease processes evolve during the process of aging. This means that the same condition may have different manifestations depending upon her age and consequently her endocrinological status. For example, a history of polycystic ovarian syndrome increases the risk of endometrial cancer and so would influence the threshold for investigation of increased perimenopausal bleeding or postmenopausal bleeding; pregnancy-related problems such as pre-eclampsia increase the risk of cardiovascular disease in later life; the use of hormonal contraceptives may influence a woman’s views, and those of her doctor, on the use of hormone replacement therapy (HRT); diabetes influences the use of contraception, pregnancy and management of the menopause as clearly outlined in this issue in the review paper by Morling. So has this concept been applied to the care of women experiencing the menopause, and to the management of postmenopausal health? There has certainly been a broadening of interest in postmenopausal health and focus has moved away simply from ‘the menopause’ and the pros and cons of HRT, but it appears that the concept of changing health as life progresses after the point of the menopause has not been widely adapted. When women attend gynaecology clinics with postmenopausal bleeding, is full assessment taken of the number of years since the menopause, i.e. since she became estrogen deficient, whether or not she is still experiencing vasomotor symptoms, what has been the effect of estrogen deficiency on her vagina and bladder, how healthy are her bones and what is her cardiovascular risk? The same can be applied to women attending with prolapse, continence problems, and even when asymptomatic and attending for cervical or breast screening after the age of 50. If these assessments of the effects of estrogen deficiency are not being made, then surely opportunities are being lost? While cognisance has to be made of time limitations and what is realistically achievable, surely at least gynaecologists should take on the broader, life-course view of women’s health and of the continuum of estrogen deficiency in particular and address the possible effects in any woman attending their clinics who is in an estrogen-deficient state. How can this message be adapted? It is time that primary care doctors and nurses, gynaecologists, p","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 2","pages":"55"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1754045313490906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31609938","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":"How a mother’s age at menopause predicts her daughter’s ovarian reserve.","authors":"Simon Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 2","pages":"57-8"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31653480","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 2013 British Menopause Society & Women's Health Concern recommendations on hormone replacement therapy.","authors":"Nick Panay,&nbsp;Haitham Hamoda,&nbsp;Roopen Arya,&nbsp;Michael Savvas","doi":"10.1177/1754045313489645","DOIUrl":"https://doi.org/10.1177/1754045313489645","url":null,"abstract":"The British Menopause Society (BMS) recommendations on hormone replacement therapy (HRT) are designed to complement the BMS Observations and Recommendations on menopause management, submitted to the Department of Health in the UK and published in full in Menopause International, The Journal of the British Menopause Society and in the Royal College of Obstetricians and Gynaecologists Expert Advisory Group Report, High Quality Women’s Health Care. Our key recommendation is that all women should be able to access advice on how they can optimise their menopause transition and beyond, with particular reference to lifestyle and diet and an opportunity to discuss the pros and cons of complementary therapies andHRT. The following information based on the latest available evidence can be used to provide guidance to prescribers of HRT and alternatives. An extensive reference section and links to useful websites provide an opportunity to access extensive evidence based information in each key area.","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":"19 2","pages":"59-68"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1754045313489645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31594144","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}