Best practice & research. Clinical endocrinology & metabolism最新文献_第4页

Menopause: Physiology, definitions, and symptoms 更年期：生理、定义和症状

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101855

Charlotte Gatenby (Community Sexual and Reproductive HealthcareTrainee) , Paul Simpson (Consultant Gynaecologist)

{"title":"Menopause: Physiology, definitions, and symptoms","authors":"Charlotte Gatenby (Community Sexual and Reproductive HealthcareTrainee) , Paul Simpson (Consultant Gynaecologist)","doi":"10.1016/j.beem.2023.101855","DOIUrl":"10.1016/j.beem.2023.101855","url":null,"abstract":"<div>The menopause transition is usually a gradual process occurring over many years, caused by the cessation of ovarian reproductive function, resulting in the end of menstrual bleeding. In the peri-menopause, ovarian function and therefore the production of the hormones oestrogen, progesterone and testosterone can fluctuate greatly, leading to a wide variety of symptoms, affecting multiple organ systems. Menopause and the management of its associated symptoms can be very challenging for patients and clinicians alike and can negatively impact quality of life. The management options include lifestyle adjustment, talking therapies, dietary supplements as well as prescribed medications, including hormone replacement therapy. The UK’s average life expectancy for women is approximately 81 years. Therefore, women will now live up to a third of their life being either peri- or postmenopausal. Thus, understanding and treating, where possible, the symptoms of menopause is essential to reduce the burden associated with this physiological state.</div>","PeriodicalId":8810,"journal":{"name":"Best practice & research. Clinical endocrinology & metabolism","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138824860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New advances in menopause symptom management 更年期症状管理的新进展

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101774

Kanyada Koysombat MBBS BSc (Specialist Registrar in Endocrinology and Diabetes / NIHR Academic Clinical Fellow) , Patrick McGown MBBS BSc (Specialist Registrar in Endocrinology and Diabetes) , Sandhi Nyunt MBBS MSc (Specialist Registrar in Endocrinology and Diabetes) , Ali Abbara MBBS BSc PhD (Clinical Senior Lecturer / Honorary Consultant in Endocrinology / NIHR Clinician Scientist) , Waljit S. Dhillo MBBS BSc PhD (Professor in Endocrinology and Metabolism / Consultant Endocrinologist / NIHR Senior Investigator, Dean of the NIHR Academy, Head of Division of Diabetes, Endocrinology and Metabolism, ICHT Divisional Director of Research for the Division of Medicine & Integrated Care)

{"title":"New advances in menopause symptom management","authors":"Kanyada Koysombat MBBS BSc (Specialist Registrar in Endocrinology and Diabetes / NIHR Academic Clinical Fellow) , Patrick McGown MBBS BSc (Specialist Registrar in Endocrinology and Diabetes) , Sandhi Nyunt MBBS MSc (Specialist Registrar in Endocrinology and Diabetes) , Ali Abbara MBBS BSc PhD (Clinical Senior Lecturer / Honorary Consultant in Endocrinology / NIHR Clinician Scientist) , Waljit S. Dhillo MBBS BSc PhD (Professor in Endocrinology and Metabolism / Consultant Endocrinologist / NIHR Senior Investigator, Dean of the NIHR Academy, Head of Division of Diabetes, Endocrinology and Metabolism, ICHT Divisional Director of Research for the Division of Medicine & Integrated Care)","doi":"10.1016/j.beem.2023.101774","DOIUrl":"10.1016/j.beem.2023.101774","url":null,"abstract":"<div>Vasomotor symptoms (VMS) are characteristic of menopause experienced by over 75% of postmenopausal women with significant health and socioeconomic implications. Although the average duration of symptoms is seven years, 10% of women experience symptoms for more than a decade. Although menopausal hormone therapy (MHT) remains an efficacious and cost-effective treatment, its use may not be suitable in all women, such as those at an increased risk of breast cancer or gynaecological malignancy. The neurokinin B (NKB) signaling pathway, together with its intricate connection to the median preoptic nucleus (MnPO), has been postulated to provide integrated reproductive and thermoregulatory responses, with a central role in mediating postmenopausal VMS. This review describes the physiological hypothalamo-pituitary-ovary (HPO) axis, and subsequently the neuroendocrine changes that occur with menopause using evidence derived from animal and human studies. Finally, data from the latest clinical trials using novel therapeutic agents that antagonise NKB signaling are reviewed.</div>","PeriodicalId":8810,"journal":{"name":"Best practice & research. Clinical endocrinology & metabolism","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9420366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-oestrogen-based and complementary therapies for menopause 以非雌激素为基础的更年期辅助疗法

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101819

Bassel H. Al Wattar (Consultant Obstetrician and Gynaecologist) , Vikram Talaulikar (Associate Specialist in Reproductive Medicine & Hon Associate Professor in Women's Health)

{"title":"Non-oestrogen-based and complementary therapies for menopause","authors":"Bassel H. Al Wattar (Consultant Obstetrician and Gynaecologist) , Vikram Talaulikar (Associate Specialist in Reproductive Medicine & Hon Associate Professor in Women's Health)","doi":"10.1016/j.beem.2023.101819","DOIUrl":"10.1016/j.beem.2023.101819","url":null,"abstract":"<div>Women are living a significant portion of their adult lives in the post-reproductive phase, and many seek help for debilitating menopausal symptoms. Every individual’s experience of menopausal transition is unique. Adopting a holistic approach to managing the menopause using a combination of lifestyle, hormonal, and non-hormonal interventions is key to maximise the quality of life of affected women. However, many opt to use non hormonal options or have contraindications to using hormonal therapy. Studies have shown that several pharmacological non-hormonal medications such as SSRIs, SSRI/SNRIs, Gabapentin, and Pregabalin are effective for managing vasomotor symptoms as well as other menopausal symptoms. Their main side effects are dry mouth, nausea, constipation, reduced libido, and loss of appetite. Clonidine is the only non-hormonal drug which is licenced for control of vasomotor symptoms in the UK, but has several side effects including dizziness and sleep disturbance. Cognitive Behavioural Therapy is recommended as a treatment for anxiety, sleep problems and vasomotor symptoms related to menopausal transition. Evidence for clinical efficacy and safety of herbal remedies and alternative therapies remains weak. Studies with neurokinin receptor 3 antagonists on women with hot flushes have shown improvement in vasomotor symptoms and results of large-scale studies are awaited.</div>","PeriodicalId":8810,"journal":{"name":"Best practice & research. Clinical endocrinology & metabolism","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Premenstrual disorders and PMDD - a review 心理问题和激素疗法

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101858

Emily Cary (Honorary Senior Lecturer) , Paul Simpson (Consultant Gynaecologist)

引用次数: 0

Oestrogen-based therapies for menopausal symptoms 治疗更年期症状的雌激素疗法

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101789

Abbie Laing, Tim Hillard

引用次数: 0

Bone health and menopause: Osteoporosis prevention and treatment 骨骼健康与更年期骨质疏松症的预防和治疗

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101782

Tobie J. de Villiers MBChB, MMED (O&), FCOG (SA), FRCOG (Consultant Gynaecologist)

引用次数: 0

Post cancer care in women with an increased risk of malignancy or previous malignancy: The use of hormone replacement therapy and alternative treatments 恶性肿瘤风险增加或曾患恶性肿瘤妇女的癌症后护理：激素替代疗法和替代疗法的使用。

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101854

Jenifer Sassarini (Consultant in Gynaecology and Obstetrics) , Mary Ann Lumsden (Hon Prof of Gynaecology and Medical Education)

引用次数: 0

Androgen-based therapies in women 妇女的雄激素疗法

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101783

Kath Whitton (Obstetrician, Gynaecologist, Fertility Specialist) , Rodney Baber (Clinical Professor of Obstetrics and Gynaecology)

{"title":"Androgen-based therapies in women","authors":"Kath Whitton (Obstetrician, Gynaecologist, Fertility Specialist) , Rodney Baber (Clinical Professor of Obstetrics and Gynaecology)","doi":"10.1016/j.beem.2023.101783","DOIUrl":"10.1016/j.beem.2023.101783","url":null,"abstract":"<div>Androgens play a key biological role in libido and sexual arousal in women, and knowledge about their complex role in other systems remains ambiguous and incomplete. This narrative review examines the role of endogenous androgens in women’s health throughout the life span before focusing on evidence surrounding the use of androgen-based therapies to treat postmenopausal women. The role of testosterone as a therapeutic agent in women continues to attract controversy as approved preparations are rare, and use of off-label and compounded formulations is widespread. Despite this androgen therapy has been used for decades in oral, injectable, and transdermal formulations. Responses to androgen therapy have been demonstrated to improve aspects of female sexual dysfunction, notably hypoactive sexual desire disorder, in a dose related manner. Substantial research has also been conducted into the role of androgens in treating aspects of the genitourinary syndrome of menopause (GSM). Evidence for benefits beyond these is mixed and more research is required regarding long-term safety. However, It remains biologically plausible that androgens will be effective in treating hypoestrogenic symptoms related to menopause, either through direct physiological effects or following aromatization to estradiol throughout the body.</div>","PeriodicalId":8810,"journal":{"name":"Best practice & research. Clinical endocrinology & metabolism","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9904516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Progestogens for endometrial protection in combined menopausal hormone therapy: A systematic review 更年期激素联合疗法中用于保护子宫内膜的孕激素：系统综述

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101815

Petra Stute (Deputy Head Gynecological Endocrinology and Reproductive Medicine) , Linus Josef Walker (Medical Doctoral Student) , Astrid Eicher (Medical Doctoral Student) , Elena Pavicic (Medical Doctoral Student) , Argyrios Kolokythas (Gynecologic Reproductive Endocrinology and Infertility Fellow) , Susanne Theis (Senior Physician Gynecological Endocrinology and Reproductive Medicine) , Marc von Gernler (Information Specialist) , Michael von Wolff (Head Gynecological Endocrinology and Reproductive Medicine) , Sabrina Vollrath (Senior Physician Gynecological Endocrinology and Reproductive Medicine)

{"title":"Progestogens for endometrial protection in combined menopausal hormone therapy: A systematic review","authors":"Petra Stute (Deputy Head Gynecological Endocrinology and Reproductive Medicine) , Linus Josef Walker (Medical Doctoral Student) , Astrid Eicher (Medical Doctoral Student) , Elena Pavicic (Medical Doctoral Student) , Argyrios Kolokythas (Gynecologic Reproductive Endocrinology and Infertility Fellow) , Susanne Theis (Senior Physician Gynecological Endocrinology and Reproductive Medicine) , Marc von Gernler (Information Specialist) , Michael von Wolff (Head Gynecological Endocrinology and Reproductive Medicine) , Sabrina Vollrath (Senior Physician Gynecological Endocrinology and Reproductive Medicine)","doi":"10.1016/j.beem.2023.101815","DOIUrl":"10.1016/j.beem.2023.101815","url":null,"abstract":"<div>Menopausal women with an intact uterus choosing estrogens for menopausal symptom relief require a progestogen for endometrial protection. The aim of this systematic review was to evaluate the risks of endometrial hyperplasia resp. malignancy with different progestogens used in combined MHT. Overall, 84 RCTs were included. We found that 1) most studies were done with NETA, followed by MPA, MP and DYD and LNG, 2) most progestogens were only available as oral formulations, 3) the most frequently studied progestogens (oral MP, DYD, MPA, oral and transdermal NETA, transdermal LNG) were assessed in continuously as well as in sequentially combined MHT regimens, 4) FDA endometrial safety criteria were only fulfilled for some progestogen formulations, 5) most studies demonstrated endometrial protection for the progestogen dose and time period examined. However, 6) study quality varied which should be taken into account, when choosing a combined MHT, especially if off-label-use is chosen.</div>","PeriodicalId":8810,"journal":{"name":"Best practice & research. Clinical endocrinology & metabolism","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521690X23000891/pdfft?md5=a8215731fd0a000bf5ff9410767e5881&pid=1-s2.0-S1521690X23000891-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sexual health and contraception in the menopause journey 更年期之旅中的性健康和避孕。

IF 7.4 1区医学

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI: 10.1016/j.beem.2023.101822

Laura Cucinella (Gynecologist, Research Assistant in Obstetrics & Gynecology) , Lara Tiranini (Gynecologist, Research Assistant in Obstetrics & Gynecology) , Rossella E. Nappi (Gynecologist and Endocrinologist, Professor of Obstetrics & Gynecology)

{"title":"Sexual health and contraception in the menopause journey","authors":"Laura Cucinella (Gynecologist, Research Assistant in Obstetrics & Gynecology) , Lara Tiranini (Gynecologist, Research Assistant in Obstetrics & Gynecology) , Rossella E. Nappi (Gynecologist and Endocrinologist, Professor of Obstetrics & Gynecology)","doi":"10.1016/j.beem.2023.101822","DOIUrl":"10.1016/j.beem.2023.101822","url":null,"abstract":"<div>Women may experience changes in sexuality across menopause, because at this step in life hormone deficiency interacts with several determinants in a bio-psycho-social perspective. Healthcare providers should inform women about menopause impact on sexuality and be proactive during consultation in disclosing sexual concerns that would require a targeted assessment. Sexual symptoms become more frequent as women age, but they do not always translate into sexual dysfunction diagnosis, for which distress is required. It is important to recognize conditions that may increase the risk of dysfunctional response to menopause challenges in order to promote sexual longevity through counselling and specific management. In this review, we report key elements for a comprehensive assessment of sexual health around menopause, with a focus on genitourinary syndrome of menopause (GSM) and hypoactive sexual desire disorder (HSDD), representing well identified clinical conditions affecting sexuality at midlife and beyond. We also address the issue of contraception across the menopausal transition, highlighting risks and benefits, and possible implications on sexual function.</div>","PeriodicalId":8810,"journal":{"name":"Best practice & research. Clinical endocrinology & metabolism","volume":null,"pages":null},"PeriodicalIF":7.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521690X23000969/pdfft?md5=fb950300a8937046d7e3fa1c44c62137&pid=1-s2.0-S1521690X23000969-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0