Additional Information
Book Details
Abstract
Menopause is defined by the World Health Organization (WHO) and the Stages of Reproductive Ageing and Workshop (STRAW) working group as the permanent cessation of menstrual periods that occurs naturally or is induced by surgery, chemotherapy, or radiation. Natural menopause is recognized after 12 consecutive months without menstrual periods that are not associated with other causes. Although surprising, it is interesting to note the plethora of complaints that menopausal women present with all over the world. In the US, UK, and the United Arab Emirates, hot flushes are the most common symptom reported, while women from Japan, India, and Singapore suffer mostly from joint pain.
A postmenopausal woman should take into her stride the fact that menopause is a change in life, and not the end of life. Support groups should be functional in counseling these women who often face menopause in the midst of many other crises in life, like elderly parents and grown-up children leaving their nests empty to move ahead in life. Menopause is best tolerated when it is already anticipated, and social workers, doctors, and other paramedical personnel should all join hands in providing the necessary information, education, and communicating with these women at their hour of need.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Front Cover | ||
| Front Matter | ia | ||
| Elsevier Clinical Advisory Board:Obstetrics & Gynecology | ic | ||
| Copyright | ie | ||
| About Authors | if | ||
| Contents | ih | ||
| ECAB Clinical Update InformationMenopause | i | ||
| Introduction | 1 | ||
| Estrogen Therapy/Hormone Therapy: Post Womens Health Initiative Study Dilemma, Debate, and Emerging Consensus | 11a | ||
| ABSTRACT | 11a | ||
| KEYWORDS | 11b | ||
| Menopausal Health Management In Pre-Whi Era: A Global Update | 13 | ||
| Women's Health Initiative Studies: Objectives, Design, and Outcome | 18 | ||
| Pre-Whi Pointers For Safety Issues of Ert/Hrt | 19 | ||
| Women's Health Initiative: Premature Termination and its Impact | 22 | ||
| Post-Whi: Dilemma, Debate, and Emerging Consensus | 25 | ||
| Recommendations and Future Directions for Practical Prescribing Ert/Hrt in Clinical Practice | 34 | ||
| CASE STUDY I | 48 | ||
| Physical Examination | 48 | ||
| Laboratory Tests | 49 | ||
| Discussion | 49 | ||
| CASE STUDY II | 50 | ||
| Laboratory Investigations | 51 | ||
| Discussion | 51 | ||
| Nonhormonal Therapy in Managing Menopause | 53a | ||
| ABSTRACT | 53a | ||
| KEYWORDS | 53a | ||
| Why Not Hormone Replacement Therapy? | 54 | ||
| What are the Alternatives? | 55 | ||
| Nonhormonal Prescription Therapy | 57 | ||
| Neurotransmitter Modulators | 57 | ||
| Antidepressants: Selective Serotonin Reuptake Inhibitors or SSRIs | 57 | ||
| Antihypertensives: Clonidine | 59 | ||
| Neuroendocrine Agents or Antiseizure Drugs: Gabapentin | 60 | ||
| Nonprescription Therapies: Herbalism | 60 | ||
| Phytoestrogens | 61 | ||
| Black Cohosh | 65 | ||
| Other Herbal Medications | 67 | ||
| Complementary Therapies | 68 | ||
| Vitamins and Minerals | 68 | ||
| Functional Foods | 70 | ||
| Lifestyle Changes | 70 | ||
| Obesity | 71 | ||
| Addictive Substances | 71 | ||
| Exercise | 71 | ||
| Other Therapeutic Modalities | 73 | ||
| Homeopathy | 73 | ||
| Acupuncture | 74 | ||
| Stress Reduction | 75 | ||
| Conclusion | 76 | ||
| Case Studies Nonhormonal Therapy in Managing Menopause | 88 | ||
| Case Study I | 88 | ||
| History | 88 | ||
| Investigations and Management | 88 | ||
| Menopause: A Metabolic Syndrome | 93a | ||
| ABSTRACT | 93a | ||
| KEYWORDS | 93a | ||
| Exploration of Mechanisms of the Metabolic Disease in Menopause6 | 95 | ||
| Insulin Resistance | 95 | ||
| Dyslipidemia | 95 | ||
| Inflammation | 95 | ||
| Vascular Function | 95 | ||
| Hormone Replacement Therapy | 95 | ||
| Soy Protein | 96 | ||
| Psychosocial Factors | 96 | ||
| Strategies for Prevention | 96 | ||
| Effect of Menopause on the Cardiovascular System | 100 | ||
| Effect of Menopause on LDL | 100 | ||
| Effect of Menopause on Body Mass | 101 | ||
| Treatment of Metabolic Syndrome in Women | 101 | ||
| Importance of Exercise in the Postmenopausal Women | 102 | ||
| Researches on the Global Front | 103 | ||
| Oral Versus Transdermal HRT and CRP Levels | 106 | ||
| Conclusion | 107 | ||
| Case Study I | 110 | ||
| History | 110 | ||
| Menstrual History | 110 | ||
| Obstetric History | 111 | ||
| On Examination | 111 | ||
| Investigation | 111 | ||
| Endometrial biopsy: Endometrial adenocarinoma Gr I | 111 | ||
| HPE: Endometrial adenocarcinoma | 111 | ||
| Discussion | 112 | ||
| Case Study II | 112 | ||
| History | 112 | ||
| Menstrual History | 112 | ||
| Obstetric History | 112 | ||
| Past History | 112 | ||
| Family History | 113 | ||
| On Examination | 113 | ||
| Advice | 113 | ||
| Discussion | 113 | ||
| Clinical Pathway for Personalizing Hormone Therapy | 115a | ||
| ABSTRACT | 115a | ||
| KEYWORDS | 115a | ||
| Clinical Presentation and Assessment | 115a | ||
| Indication of HT Identified and Specified | 117 | ||
| Investigations Performed as Appropriate | 118 | ||
| Identify Contraindications, if any, to HT | 121 | ||
| Identify Risks of the Individual Woman | 122 | ||
| Counsel Prior to Starting HT | 122 | ||
| Review with Decision and Initiate HT | 124 | ||
| Steps Followed in Pharmacotherapy when Prescribing HT | 125 | ||
| Systemic, Oral, Non-Oral, or Local Estrogens | 125 | ||
| Preferential Use of Local Estrogens | 125 | ||
| Preferential Use of Non-oral Estrogens | 126 | ||
| Use of Estrogen-only HT | 127 | ||
| Preferential Use of Tibolone | 128 | ||
| Preferential Use of SERMs | 128 | ||
| Preferential Use of Androgens | 129 | ||
| Preferential Use of Progestogens that Are 19-Nortestosterone Derivatives | 129 | ||
| Preferential Use of Progestogens that Are Derivatives of 17-Hydroxy Progesterone | 129 | ||
| Preferential Use of Antiandrogenic Progestogens | 129 | ||
| Preferential Use of Drospirenone (Fourth-generation Progestogen) | 132 | ||
| Preferential Use of Intrauterine Levonorgesterol (A Second-generation Progestogen) | 132 | ||
| Follow-up | 132 | ||
| Stopping HT | 136 | ||
| Conclusion | 137 | ||
| Risk factors of osteoporosis | 144 | ||
| Risk Factors of Colorectal Cancer | 145 | ||
| Risk Factors of Endometrial Cancer | 145 | ||
| Risk Factors of Breast Cancer5 | 146 | ||
| Assessing Patient Risk of Coronary Artery Disease | 146 | ||
| Assessing Risk of Venous Thromboembolism | 147 | ||
| Evidence-Based RCOG Guidelines-No 19 (Revised in Jan 04) | 148 | ||
| Risk Factors of Stroke | 148 | ||
| Factors | 148 | ||
| Increased risk of Dementia and Mild Cognitive Impairment with HT | 149 | ||
| Summary | 151 | ||
| ECAB ClinicalUpdate: Obstetrics &GynecologyForthcoming Books | 155 |