Menopause international最新文献

{"title":"Fifteen medical societies agree on hormone therapy statement.","authors":"Simon Brown","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31202476","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":"Advanced nursing practice in menopause nursing.","authors":"Debby Holloway","doi":"10.1258/mi.2012.012035","DOIUrl":"https://doi.org/10.1258/mi.2012.012035","url":null,"abstract":"<p><p>Advanced nursing practice is a complex term that has been explored over the last 10 years within nursing as nurses have changed the boundaries of their clinical care to try and meet the needs of their patients in a rapidly changing health-care setting. These roles are attractive to nurses as they can remain primarily clinically based as they progress within their careers. However there is currently no standardization in relation to job titles, educational provisions or regulations. The Department of Health issued guidance in 2010, but there is nothing mandatory to date. This short article will look at the issues involved in advanced practice in menopause nursing.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31009913","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":"Early menopause linked to increased risk of cerebral aneurysm.","authors":"Simon Brown","doi":"10.1258/mi.2012.012029","DOIUrl":"https://doi.org/10.1258/mi.2012.012029","url":null,"abstract":"The appearance of occasional masculine features seen in some women after the menopause may be the result of a genetic malfunction complicated by the loss of endogenous estrogen. However, the implications of this suggestion – made in a study reported in the journal Cell in December – stretch before and beyond the menopause and into the whole lifespan of sex determination and gender maintenance. The study found, contrary to what are most people’s expectations, that gender does not depend solely on the arrangement of chromosomes. Its collaborating investigators from the European Molecular Biology Laboratory (EMBL) in Heidelberg, Germany, and the Medical Research Council’s National Institute for Medical Research (NIMR) in London, found that, if a certain gene located on a non-sex chromosome is turned off, cells in the ovaries of adult female mice turn into cells typically found in testes. The study thus challenges the long-held assumption that the development of female traits is the default pathway of nature – that is, an embryo’s default route to gender determination would be female unless a transcription factor gene known as SRY was located on the Y chromosome. The gene which appears to be instrumental in this process is known as FOXL2, and this study showed – in the mouse model – that deletion of FOXL2 in adult ovarian follicles leads to the immediate upregulation of testis-specific genes, including the critical SRY gene. Significantly, FOXL2 is located not on the sex chromosomes but on an autosome, and is therefore present in both sexes. When the FOXL2 gene was ablated (switched off) in the mouse ovaries, the investigators were surprised by the results. ‘We expected the mice to stop producing oocytes, but what happened was much more dramatic,’ said EMBL investigator Mathias Trier. ‘Somatic cells which support the developing egg took on the characteristics of the cells which usually support developing sperm, and the gender-specific hormone-producing cells also switched from a female to a male cell type’. However, it was when the EMBL scientists teamed up with the NIMR group of Robin Lovell-Badge in London that an explanation for this battle of the sexes emerged and how FOXL2 plays such a crucial role in keeping female mice female. They showed that FOXL2 and the estrogen receptors actually interact to regulate expression of the testes-promoting gene known as Sox9. Sox9 has for a while been known to function in the embryo to make the early gonads become testes rather than ovaries, but this new study now suggests that Sox9 performs its same duties in the adult as well. Thus, FOXL2 – in its interaction with estrogen – is critical to keep Sox9 turned off in ovaries throughout life, and therefore to prevent any male effects and keep females feminine. Maintenance of the ovarian phenotype is thus an active process throughout life; FOXL2 and Sox9 oppose each other’s action to ensure not just the formation but also the maintenance of the different female an","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30982664","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":"Web-based survey 'Contraception and attitudes to sexual behaviour' completed by women accessing a UK menopause website.","authors":"Grant P Cumming,&nbsp;Rosemary Cochrane,&nbsp;Heather D Currie,&nbsp;Rik Moncur,&nbsp;Amanda J Lee","doi":"10.1258/mi.2012.012020","DOIUrl":"https://doi.org/10.1258/mi.2012.012020","url":null,"abstract":"<p><strong>Background and methodology: </strong>Sociodemographic trends mean increasing numbers of new relationships in later life. These trends may not only have health consequences for women and health services but also impact on the targeting of sexual health messages. This study aimed to examine attitudes and knowledge surrounding contraception, sexual health and unwanted pregnancy among those accessing the website www.menopausematters.co.uk. A voluntary online survey was completed.</p><p><strong>Results: </strong>Survey was completed by 550 respondents. Three hundred and sixty-six women, 94% of whom self-classified as pre- or perimenopausal, had been sexually active with a male partner in the previous four weeks. Commonest contraceptive methods used by perimenopausal and postmenopausal women were condoms, combined oral contraceptive pill (COCP) and male sterilization. Up to 42% of women surveyed were unhappy with their contraception. A total of 27% premenopausal, 32% perimenopausal women and 40% postmenopausal used no contraception. One-third of women were unhappy about this and 19 unplanned pregnancies had occurred. The majority of women were informed regarding COCP use over 35 years, hormone replacement therapy, emergency contraception and ceasing contraception. The majority of women were unaware that more terminations of pregnancy are performed in women over 40 than any other age group per total pregnancies.Almost a third of women were unaware that chlamydia incidence is increasing in older women. Most would use condoms in new relationship.</p><p><strong>Discussion and conclusions: </strong>Women accessing www.menopausematters.co.uk are well informed about contraception and sexual health. The majority of those accessing the site are sexually active, but many use no contraception, or are unhappy with their chosen method, leaving them vulnerable to unwanted pregnancy or sexually transmitted infection.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30738386","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":"Sally Darnborough","doi":"10.1258/mi.2012.012021","DOIUrl":"https://doi.org/10.1258/mi.2012.012021","url":null,"abstract":"A 74-year-old lady attended my general practice surgery complaining that her urine was ‘pink’ and she had noted some vaginal bleeding. She was otherwise well and had no urinary or systemic symptoms to report other than ‘quite a lot of bruising on my bottom’. I know the lady well, she attends my Primary Care Menopause clinic for regular review as she is someone who has benefited from long-term use of estrogen replacement therapy (ERT). Having had a hysterectomy and bilateral oophorectomy in the past for fibroids she has remained on ERT ever since. Several attempts had been made over the years to withdraw hormone therapy (HT) but proved unsuccessful. There were frequent documented discussions assessing her risk profile, each time she opted to remain on ERT accepting any associated increased risks. At 74 she is extremely fit and active and a passionate equestrian. She is slim, a lifelong non-smoker with no history of hypertension or cardiovascular disease. The only history of note is osteopaenia detected on previous Dual X-ray absorpitometry scan. She continues to participate in regular breast screening and is on the lowest dose of transdermal estrogen required to control her symptoms. On closer questioning I discovered that she had just completed an adventurous horse trek over rough terrain and had been in the saddle for three days. Clinical examination revealed extensive bruising in the saddle region and inner thighs. There was spontaneous bleeding from the vaginal vault and vaginal mucosa; the vaginal walls were literally oozing blood. The vaginal vault was otherwise normal with no lacerations visible. Other than her ‘pink’ urine (frank haematuria), vaginal bleeding and impressive bruising she had no complaints and felt perfectly well. I reviewed her notes looking for clues and discovered that since her last review at the menopause clinic she had undergone investigation of a ‘dizzy spell’ and had been referred to the Stroke Clinic to exclude a transient ischaemic attack. The history was unconvincing and all investigations were negative (electrocardiography, computed tomography scan, cardiac echo, carotid Doppler scans, chest X-ray, biochemistry and haematology were all normal). It was concluded she had probably experienced a vasovagal episode. Nevertheless, she was advised to stop her ERT and commence antiplatelet therapy (clopidogrel) and a statin for preventive purposes (as per SIGN 108.) She explained that since stopping her ERT she had been feeling awful and started self-medicating with Gingko biloba having heard it was a ‘natural’ remedy for menopausal symptoms. Alarm bells immediately rang – I had been lucky enough to attend the 2011 British Menopause Society conference, which included a lecture on ‘alternative therapies for the menopause’. The speaker described the commonly used alternative therapies and highlighted possible interactions and cautions. From the lecture I remembered hearing that Gingko biloba is known to interact with and po","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30781179","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":"Menopause-specific quality of life of urban women in West Bengal, India.","authors":"Nivedita Som,&nbsp;Subha Ray","doi":"10.1258/mi.2012.011107","DOIUrl":"https://doi.org/10.1258/mi.2012.011107","url":null,"abstract":"<p><strong>Objective: </strong>To find out the association of menopause-specific quality of life of women with both working status and duration of postmenopausal years.</p><p><strong>Study design: </strong>We conducted a cross-sectional study on 250 postmenopausal women belonging to Bengali-speaking Hindu ethnic group, aged 47-62 years in the city of Kolkata, West Bengal, India. The participants were literate, living in wedlock with at least one surviving child, attained natural menopause at least two years ago and have never taken hormone replacement treatment. Menopause-specific quality of life was measured using a self-administered standard questionnaire (Menopause-Specific Quality of Life questionnaire, or MENQOL). MENQOL consisted of 29 menopausal symptoms (items) that are grouped under four domains. Additional information on sociodemographic aspect and reproductive history of the participants were collected using a pretested questionnaire. Main outcome measures Both bivariate and multivariate analyses showed that menopause-specific quality of life decreases with the increase in duration of postmenopausal years. Although bivariate analysis demonstrated that working women had a better menopause-specific quality of life than their non-working counterpart, multivariate linear regression model did not corroborate to this finding.</p><p><strong>Conclusion: </strong>Duration of postmenopausal years had a significant association with menopause-specific quality of life of women.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.011107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30738286","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":"Women's health concern: the patient arm of the British Menopause Society.","authors":"John Stevenson","doi":"10.1258/mi.2012.012033","DOIUrl":"https://doi.org/10.1258/mi.2012.012033","url":null,"abstract":"","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30843100","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":"Ten years on and where are we now?","authors":"Edward Morris,&nbsp;Heather Currie","doi":"10.1258/mi.2012.012031","DOIUrl":"https://doi.org/10.1258/mi.2012.012031","url":null,"abstract":"Having been involved for many years in advising, educating and always still learning about the menopause, the effects of estrogen deficiency and treatments, many changes have been seen but none so dramatic as the views on hormone replacement therapy (HRT). In the early days, HRT was seen as the answer to many problems and while it was known that it was not perfect and that all medicines carry some risk, it was strongly believed that for most women, the benefits outweighed the risks. Then, in July 2002, publication of the initial results of the Women’s Health Initiative (WHI) trial led us to be more concerned about risks and less aware of benefits with a subsequent huge fall in the use of HRT. Ten years on and a full review of the WHI trial and of other available evidence has been published. The key message appears to be that in fact, when used appropriately especially for women under the age of 60, or within 10 years of the menopause, HRT provides far more benefits than risks. It is re-assuring that the media have given this news some attention, since women and their health-care providers need to be aware of this information, so that they can make informed choices about the management of their menopause. It seems that for the last 10 years, decisions have been made based on incorrect information. Women can once again be re-assured that HRT is safe when used correctly and while not all women will need HRT, those who do need not worry unduly about risks but can enjoy the benefits. What is of great concern is that with reduced use of HRT over the last 10 years, some health-care professionals have become less familiar with the prescribing of HRT. Reports are being heard of more women being prescribed unopposed estrogen incorrectly, with four such cases being seen in 2011 in the editor’s region alone. Such cases were rare in the past. When investigated, all had endometrial hyperplasia which responded to progestogen therapy. Further discussions with primary care colleagues overwhelmingly revealed a lack of familiarity with types of HRT, e.g. with prescription of an estrogen only product which has a very similar name to a combined product, and examples of removal of Mirena and lack of appreciation that if HRT is continued, then progestogen must be added. Since it is likely that the use of HRT will increase, all those prescribing HRT should ensure that they are up to date with current thinking, principles and types. Many have stated that as a result of the WHI trial and the ensuing publicity, we have had 10 wasted years and that women have suffered unnecessarily. This may be the case but we cannot turn back the years and decisions were made in good faith. Lessons have been learnt and perhaps we should realize that major shifts in practice should not be based on one study, no matter how large. Further, over the last 10 years, aspects of menopause care have broadened away from HRT, leading to a better understanding of the consequences of estrogen deficienc","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30843099","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":"Searching for pelvic floor muscle exercises on YouTube: what individuals may find and where this might fit with health service programmes to promote continence.","authors":"Kate Stephen,&nbsp;Grant P Cumming","doi":"10.1258/mi.2012.012007","DOIUrl":"https://doi.org/10.1258/mi.2012.012007","url":null,"abstract":"<p><strong>Objective: </strong>This paper describes the investigation, categorization/characterization and viewing of pelvic floor muscle exercises (PFME) on YouTube from the perspective of the 'wisdom of the crowd'. The aim of the research was to increase awareness of the type of clips that individuals are likely to come across when searching YouTube and to describe trends and popularity. This awareness will be useful for the design of continence promotion services, especially for hard-to-reach individuals.</p><p><strong>Study design: </strong>Web-based videos relating to PFE were identified by searching YouTube using the snowball technique. Main outcome measures Number of views; the approach taken (health, fitness, sexual and pregnancy); product promotion; and the use of music, visual cues and elements designed to encourage exercise. The number of views of each video was recorded at three points over a seven-month period.</p><p><strong>Results: </strong>Twenty-two videos were identified. Overall these videos had been viewed over 430,000 times during the study period. One video was viewed over 100,000 times and overall the median increase in views was 59.4%.</p><p><strong>Conclusions: </strong>YouTube is increasingly used to access information about pelvic floor exercises. Different approaches are used to communicate PFME information but there are no formal structures for quality control. Further research is required to identify which elements of the video clips are effective in communicating information and in motivating exercise and to establish appropriate protocols. Kitemarking is recommended in order that women obtain correct advice.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30738285","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":"Classification of premenstrual disorders as proposed by the International Society for Premenstrual Disorders.","authors":"Suman Kadian,&nbsp;Shaughn O'Brien","doi":"10.1258/mi.2012.012017","DOIUrl":"https://doi.org/10.1258/mi.2012.012017","url":null,"abstract":"<p><p>Premenstrual disorders have been recognized as affecting innumerable women for decades but unlike most other medical conditions universally accepted criteria for definition and diagnosis are not established. Although premenstrual syndrome (PMS) occurs throughout reproductive life, there are some women who become particularly troubled. Those approaching the menopause may also have a mixture of PMS and menopause symptoms, not to mention heavy periods. Furthermore, some of the symptoms are similar in nature and so it is a challenge to identify which set of symptoms belongs to which spectrum. This is an area that has not been explored well. Various classifications have been proposed over the last few decades. A further effort towards the classification was made by an international multidisciplinary group of experts established as the International Society for Premenstrual Disorders (ISPMD) in Montreal in September 2008. Their deliberations resulted in a unified diagnosis, classification of premenstrual disorders (PMD) along with their quantification and guidelines on clinical trial design. This classification of PMS is far more comprehensive and inclusive than previous attempts. PMD in the ISPMD Montreal consensus are divided into two categories: Core and Variant PMD. Core PMD are typical, pure or reference disorders associated with spontaneous ovulatory menstrual cycles while Variant PMD exist where more complex features are present. Further, the consensus group considered that PMD may be subdivided into three subgroups predominantly physical, predominantly psychological and mixed. Variant PMD encompass primarily four different types; premenstrual exacerbation, PMD with anovulatory ovarian activity, PMD with absent menstruation and progestogen-induced PMD.</p>","PeriodicalId":87478,"journal":{"name":"Menopause international","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/mi.2012.012017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30630985","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}