Menopause international最新文献

{"title":"Gonadotrophin receptor hormone analogues in combination with add-back therapy: an update.","authors":"James Samuel McLaren,&nbsp;Edward Morris,&nbsp;Janice Rymer","doi":"10.1258/mi.2012.012008","DOIUrl":"https://doi.org/10.1258/mi.2012.012008","url":null,"abstract":"<p><p>Gonadotrophin receptor hormone analogues (GnRHa) have been used in a range of sex hormone-dependent disorders. In the management of premenstrual syndrome, they can completely abolish symptoms. The success of GnRHa in the treatment of endometriosis and adjuvant therapy in the management of fibroids is proven. This efficacy does not come without a cost and the side-effects of the hypo-estrogenic state have limited their application. The use of add-back therapy to counter these effects has enabled wider application, longer durations of treatment and an increase in compliance. This review article is an update on the evidence supporting gonadotrophin receptor hormone analogues in combination with add-back therapy.</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.2012.012008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631501","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":"Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder.","authors":"Andrea J Rapkin,&nbsp;Alin L Akopians","doi":"10.1258/mi.2012.012014","DOIUrl":"https://doi.org/10.1258/mi.2012.012014","url":null,"abstract":"<p><p>Premenstrual syndrome (PMS) and premenstrual dysphoric disorder are triggered by hormonal events ensuing after ovulation. The symptoms can begin in the early, mid or late luteal phase and are not associated with defined concentrations of any specific gonadal or non-gonadal hormone. Although evidence for a hormonal abnormality has not been established, the symptoms of the premenstrual disorders are related to the production of progesterone by the ovary. The two best-studied and relevant neurotransmitter systems implicated in the genesis of the symptoms are the GABArgic and the serotonergic systems. Metabolites of progesterone formed by the corpus luteum of the ovary and in the brain bind to a neurosteroid-binding site on the membrane of the gamma-aminobutyric acid (GABA) receptor, changing its configuration, rendering it resistant to further activation and finally decreasing central GABA-mediated inhibition. By a similar mechanism, the progestogens in some hormonal contraceptives are also thought to adversely affect the GABAergic system. The lowering of serotonin can give rise to PMS-like symptoms and serotonergic functioning seems to be deficient by some methods of estimating serotonergic activity in the brain; agents that augment serotonin are efficacious and are as effective even if administered only in the luteal phase. However, similar to the affective disorders, PMS is ultimately not likely to be related to the dysregulation of individual neurotransmitters. Brain imaging studies have begun to shed light on the complex brain circuitry underlying affect and behaviour and may help to explicate the intricate neurophysiological foundation of the syndrome.</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.2012.012014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30630988","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":"Treatment of premenstrual disorders by suppression of ovulation by transdermal estrogens.","authors":"John Studd","doi":"10.1258/mi.2012.012015","DOIUrl":"https://doi.org/10.1258/mi.2012.012015","url":null,"abstract":"<p><p>The understanding of the cause and treatment of premenstrual disorders is confused but it is essentially the result of cyclical ovarian activity, usually ovulation, and an effective treatment should be by suppressing ovulation. This can be done by an oral contraceptive but as these women are progestogen intolerant the symptoms may persist becoming constant rather than cyclical. Alternatively, transdermal estradiol by patch, gel or implant effectively removes the cyclical hormonal changes, which produce the cyclical symptoms. A shortened seven-day course of a progestogen is required each month for endometrial protection but it can reproduce premenstrual syndrome-type symptoms in these women. Gonadotropin-releasing hormone with 'add-back' is effective in the short term. Laparoscopic hysterectomy and bilateral oophorectomy with adequate replacement of estrogen and testosterone should be considered in the severe cases with progestogenic side-effects.</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.2012.012015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631500","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":"Severe premenstrual syndrome and bipolar disorder: a tragic confusion.","authors":"John Studd","doi":"10.1258/mi.2012.012018","DOIUrl":"https://doi.org/10.1258/mi.2012.012018","url":null,"abstract":"<p><p>Bipolar disorder and severe premenstrual syndrome (PMS) have many symptoms in common, but it is important to establish the correct diagnosis between a severe psychiatric disorder and an endocrine disorder appropriately treatable with hormones. The measurement of hormone levels is not helpful in making this distinction, as they are all premenopausal women with normal follicle-stimulating hormone and estradiol levels. The diagnosis of PMS should come from the history relating the occurrence of cyclical mood and behaviour changes with menstruation, the improvement during pregnancy, postnatal depression and the presence of runs of many good days a month and the somatic symptoms of mastalgia, bloating and headaches. Young women with severe PMS do not respond to the antidepressants and mood-stabilizing drugs typically used for bipolar disorder.</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.2012.012018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631504","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":"Menstruation and mental health: what's the chance of talking about that?","authors":"Donna Barrowman","doi":"10.1258/mi.2012.012011","DOIUrl":"https://doi.org/10.1258/mi.2012.012011","url":null,"abstract":"","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.2012.012011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631505","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":"Treatment of premenstrual syndrome: a decision-making algorithm.","authors":"Nick Panay","doi":"10.1258/mi.2012.012019","DOIUrl":"https://doi.org/10.1258/mi.2012.012019","url":null,"abstract":"<p><p>The aim of this short paper will be to guide the clinician through the plethora of possible interventions to help them to individualize treatment for their patients with PMS. The discussion will highlight management principles rather than evidence per se. It uses as its basis an updated version of the treatment algorithm published by the RCOG in its Green Top Guideline no. 48 on the management of PMS.</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.2012.012019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631506","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":"Epidemiology of premenstrual symptoms and disorders.","authors":"Lorraine Dennerstein,&nbsp;Philippe Lehert,&nbsp;Klaas Heinemann","doi":"10.1258/mi.2012.012013","DOIUrl":"https://doi.org/10.1258/mi.2012.012013","url":null,"abstract":"<p><p>The aim of this paper is to review published literature on the types and prevalences of premenstrual disorders and symptoms, and effects of these on activities of daily life and other parameters of burden of illness. The method involved review of the pertinent published literature. Premenstrual disorders vary in prevalence according to the definition or categorization. The most severe disorder being premenstrual dysphoric disorder (PMDD) affects 3-8% of women of reproductive age. This disorder focuses on psychological symptoms whereas global studies show that the most prevalent premenstrual symptoms are physical. Both psychological and physical symptoms affect women's activities of daily life. A considerable burden of illness has been shown to be associated with moderate to severe premenstrual disorders. In conclusion, premenstrual symptoms are a frequent source of concern to women during their reproductive lives and moderate to severe symptoms impact on their quality of lives.</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.2012.012013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30630987","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":"Premenstrual syndrome.","authors":"Shaughn O'Brien,&nbsp;John Studd","doi":"10.1258/mi.2012.012012","DOIUrl":"https://doi.org/10.1258/mi.2012.012012","url":null,"abstract":"It is most likely that the health professionals who regularly manage the menopause and read the journal Menopause International will be the same as those who also see patients who complain of premenstrual syndrome (PMS). Even if they do not do so by design, they will see many women who are approaching the menopause whose symptoms are indistinguishable from PMS or overlap with them. Moreover treatment options for PMS can result in the development of an induced menopause and all of the associated symptomatic and health consequences of estrogen deficiency. It must also be appreciated that administration of hormone therapy for symptoms of the natural menopause can result in the re-generation (or generation de novo) of PMS-like side-effects. This iatrogenic progestogen-induced PMS is not well recognized and often symptoms are attributed to the whole of the hormone replacement therapy (HRT) rather than just its progestogenic component. As editors of this special edition of Menopause International, we wish to emphasize to all practitioners managing the menopause that they should have a full understanding of PMS. The converse of this is equally true. We and the regular editors of Menopause International feel that this topic is sufficiently important that a whole special issue of what is predominantly a menopause journal should be dedicated to the subject of PMS. The penultimate article of this edition, a single case summary from a patient perspective, really says it all. The tortuous patient experience via general practitioners, psychiatrists and gynaecologists all with insufficient understanding of the subject of PMS, its diagnosis, consequences and treatment is eloquently described. A woman’s pathway passes through all known remedies to the eventual eradication of the problem by the necessary invasive procedure of hysterectomy and bilateral salpingo-oophorectomy – the only known permanent cure apart from the arrival of the spontaneous menopause. The story continues with the consequent iatrogenic premature surgical management and its management with complete resolution in the patient’s mind of all of her problems of the forgoing years. The issue begins by describing why the diagnosis, measurement and treatment of PMS is difficult. It bases this on a recent consensus publication of experts on classification. This should help all involved in management by giving an understanding of the many things that contribute to the concept of premenstrual disorders. The terminology in itself has been baffling. It is important to remember that virtually all women have some symptoms leading up to the period but if they do not cause impairment then they are normal and physiological. Hippocrates described this as ‘agitations’. It was then called PMT, PMS, LLPDD, premenstrual dysphoric disorder (PMDD) and PMD. What we suggest is that PMT is used as the non-medical colloquial term. Premenstrual disorders (PMD) is the generic term under which all these differing problems ex","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.2012.012012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30630983","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":"Psychotropic medications and other non-hormonal treatments for premenstrual disorders.","authors":"Teri Pearlstein","doi":"10.1258/mi.2012.012010","DOIUrl":"https://doi.org/10.1258/mi.2012.012010","url":null,"abstract":"<p><p>Selective serotonin re-uptake inhibitors have well-established efficacy for severe premenstrual syndrome and premenstrual dysphoric disorder. Efficacy has been reported with both continuous dosing (all cycle) and intermittent or luteal phase dosing (from ovulation to menses). Efficacy may be less with intermittent dosing, particularly for premenstrual physical symptoms. The efficacy of symptom-onset dosing (medication taken only on luteal days when symptoms occur) needs further systematic study. Women going through the menopausal transition may need to adjust their antidepressant dosing regimen due to the change in frequency of menstruation. Anxiolytics, calcium, chasteberry and cognitive-behaviour therapy may also have a role in the treatment of premenstrual symptoms.</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.2012.012010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631499","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":"Potential strategies to avoid progestogen-induced premenstrual disorders.","authors":"Lucy J Baker,&nbsp;P M S O'Brien","doi":"10.1258/mi.2012.012016","DOIUrl":"https://doi.org/10.1258/mi.2012.012016","url":null,"abstract":"<p><p>Non-hormonal approaches to premenstrual syndrome (PMS) treatment such as selective serotonin reuptake inhibitors are by no means effective for all women and frequently we must resort to endocrine therapy. During many of the hormonal approaches, PMS-like symptoms can be introduced or re-introduced during the necessary cyclical or continuous progestogen component of the therapy. This is seen with combined oral contraception, progestogen only contraception, progestogen therapy for heavy menstrual bleeding and endometriosis, sequential hormone replacement therapy and any therapeutic strategy for premenstrual syndrome where it is necessary to provide endometrial protection, including estrogen suppression of ovulation or add-back during gonadotrophin releasing hormone suppression. The link to progestogen is very often missed by health professionals. When the pattern of symptoms mimics the cyclicity of PMS, it is termed progestogen-induced premenstrual disorder. The need to use progestogen to protect the endometrium from the proliferative actions of estrogen can pose insurmountable difficulties in managing premenstrual disorders. In the absence of any really useful evidence, nearly all practice in this area depends on clinician experience. We cannot afford to wait for adequate research evidence to be produced - it never will - and so we must rely on empirical findings, clinical experience, theoretical strategies and common sense.</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.2012.012016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30631502","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}