Pub Date : 2007-12-01DOI: 10.1258/175404507783004212
H. Buckler
193 who have normal ovarian function. HRT is therefore required to control vasomotor symptoms, minimize risks of cardiovascular disease, osteoporosis and possibly Alzheimer’s disease, and to maintain sexual function. There is no evidence that the results of the Women’s Health Initiative study (of much older women) apply to this younger group. HRT in POF patients is simply replacing ovarian hormones that would normally be produced at this age. It is of paramount importance that the patients understand this, in view of the recent press on HRT. The aim is to replace hormones as near to physiological levels as possible. HRT should generally continue at least until the estimated age of natural menopause (on average 51 years in the UK). Since spontaneous ovarian activity can occasionally resume, consideration should be given to appropriate contraception in women not wishing to fall pregnant. Although standard oral contraceptive pills are sometimes prescribed, they contain synthetic steroid hormones at a greater dose than is required for physiological replacement and so may not be ideal. Low-dose combined pills may be used to provide estrogen replacement and contraception, although they are less effective in the prevention of osteoporosis. The progestogen intrauterine system may also be offered in those who choose HRT and require contraception. In our experience, the choice of HRT regimen and the route of administration vary widely among patients. In the absence of better data, treatment should therefore be individualized according to choice and risk factors. Where libido is a problem, testosterone replacement should also be considered, especially in surgically menopaused women. To complement the role of HRT for the long-term prevention of osteoporosis, supplementary intake of calcium (1000–1500 mg per day) and multivitamins should be encouraged, as should weight-bearing exercises. The use of complementary therapies and non-estrogen-based treatments, such as bisphosphonates, strontium ranelate or raloxifene, for the prevention of osteoporosis in women with POF has not been studied.
{"title":"Thyroid disease and ovarian failure","authors":"H. Buckler","doi":"10.1258/175404507783004212","DOIUrl":"https://doi.org/10.1258/175404507783004212","url":null,"abstract":"193 who have normal ovarian function. HRT is therefore required to control vasomotor symptoms, minimize risks of cardiovascular disease, osteoporosis and possibly Alzheimer’s disease, and to maintain sexual function. There is no evidence that the results of the Women’s Health Initiative study (of much older women) apply to this younger group. HRT in POF patients is simply replacing ovarian hormones that would normally be produced at this age. It is of paramount importance that the patients understand this, in view of the recent press on HRT. The aim is to replace hormones as near to physiological levels as possible. HRT should generally continue at least until the estimated age of natural menopause (on average 51 years in the UK). Since spontaneous ovarian activity can occasionally resume, consideration should be given to appropriate contraception in women not wishing to fall pregnant. Although standard oral contraceptive pills are sometimes prescribed, they contain synthetic steroid hormones at a greater dose than is required for physiological replacement and so may not be ideal. Low-dose combined pills may be used to provide estrogen replacement and contraception, although they are less effective in the prevention of osteoporosis. The progestogen intrauterine system may also be offered in those who choose HRT and require contraception. In our experience, the choice of HRT regimen and the route of administration vary widely among patients. In the absence of better data, treatment should therefore be individualized according to choice and risk factors. Where libido is a problem, testosterone replacement should also be considered, especially in surgically menopaused women. To complement the role of HRT for the long-term prevention of osteoporosis, supplementary intake of calcium (1000–1500 mg per day) and multivitamins should be encouraged, as should weight-bearing exercises. The use of complementary therapies and non-estrogen-based treatments, such as bisphosphonates, strontium ranelate or raloxifene, for the prevention of osteoporosis in women with POF has not been studied.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"193 - 193"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395420","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004087
P. Clayton
Women tend to drink less alcohol than men overall, but the amount they consume still has a major influence on their health. There are both protective and detrimental effects. Drinking habits vary throughout life. More women drink around the time of the menopause than do young women; older women are more likely to drink regularly than drink excessively. But as women get older, alcohol consumption has more effect on their health. Compared with men, they are less able to metabolize alcohol and with increasing age these liver enzymes become less effective. This makes women more vulnerable to the health effects of alcohol as they get older. The acute effects of alcohol intoxication are obvious and well documented. They include all sorts of falls, accidents, violence and self-inflicted injuries. Chronic heavy drinking carries a large health risk at any age. Deaths from alcoholic liver disease in women are increasing, although still not as common as in men. Overall, modest alcohol consumption seems to be protective to women – those who consume up to 2 units of alcohol per day have a lower mortality rate than tee-total women. Once consumption exceeds 2 units per day, the age-related risk is increased. The major contributors to this mortality risk are the effects of alcohol on the risk of cardiovascular disease (protective) and on breast cancer (increased risk). Even modest levels of alcohol consumption are associated with an increased risk of breast cancer and the risk escalates with increasing levels of consumption. For many other cancers (mouth, pharynx, larynx, oesophagus and liver) there is an association between moderate alcohol consumption and an increased risk of developing that particular cancer. It is uncertain how the extra risk of breast cancer is caused by alcohol, but it is likely to be through changes in estrogen levels. Drinking alcohol leads to increased levels of circulating estrogens, and many alcoholic beverages contain significant quantities of phytoestrogens. The main benefit of alcohol consumption is the reduction in mortality from cardiovascular disease. Estrogen may again be the causative factor. It is likely that this protection is mediated through alterations in lipids and lipoproteins, as well as reductions in clot formation and platelet aggregation. Cardiovascular disease is uncommon in women before the menopause and therefore the majority of this benefit occurs in postmenopausal women.
{"title":"Slowing the ageing process","authors":"P. Clayton","doi":"10.1258/175404507783004087","DOIUrl":"https://doi.org/10.1258/175404507783004087","url":null,"abstract":"Women tend to drink less alcohol than men overall, but the amount they consume still has a major influence on their health. There are both protective and detrimental effects. Drinking habits vary throughout life. More women drink around the time of the menopause than do young women; older women are more likely to drink regularly than drink excessively. But as women get older, alcohol consumption has more effect on their health. Compared with men, they are less able to metabolize alcohol and with increasing age these liver enzymes become less effective. This makes women more vulnerable to the health effects of alcohol as they get older. The acute effects of alcohol intoxication are obvious and well documented. They include all sorts of falls, accidents, violence and self-inflicted injuries. Chronic heavy drinking carries a large health risk at any age. Deaths from alcoholic liver disease in women are increasing, although still not as common as in men. Overall, modest alcohol consumption seems to be protective to women – those who consume up to 2 units of alcohol per day have a lower mortality rate than tee-total women. Once consumption exceeds 2 units per day, the age-related risk is increased. The major contributors to this mortality risk are the effects of alcohol on the risk of cardiovascular disease (protective) and on breast cancer (increased risk). Even modest levels of alcohol consumption are associated with an increased risk of breast cancer and the risk escalates with increasing levels of consumption. For many other cancers (mouth, pharynx, larynx, oesophagus and liver) there is an association between moderate alcohol consumption and an increased risk of developing that particular cancer. It is uncertain how the extra risk of breast cancer is caused by alcohol, but it is likely to be through changes in estrogen levels. Drinking alcohol leads to increased levels of circulating estrogens, and many alcoholic beverages contain significant quantities of phytoestrogens. The main benefit of alcohol consumption is the reduction in mortality from cardiovascular disease. Estrogen may again be the causative factor. It is likely that this protection is mediated through alterations in lipids and lipoproteins, as well as reductions in clot formation and platelet aggregation. Cardiovascular disease is uncommon in women before the menopause and therefore the majority of this benefit occurs in postmenopausal women.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"199 - 200"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395528","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004249
M. Cust
Women tend to drink less alcohol than men overall, but the amount they consume still has a major influence on their health. There are both protective and detrimental effects. Drinking habits vary throughout life. More women drink around the time of the menopause than do young women; older women are more likely to drink regularly than drink excessively. But as women get older, alcohol consumption has more effect on their health. Compared with men, they are less able to metabolize alcohol and with increasing age these liver enzymes become less effective. This makes women more vulnerable to the health effects of alcohol as they get older. The acute effects of alcohol intoxication are obvious and well documented. They include all sorts of falls, accidents, violence and self-inflicted injuries. Chronic heavy drinking carries a large health risk at any age. Deaths from alcoholic liver disease in women are increasing, although still not as common as in men. Overall, modest alcohol consumption seems to be protective to women – those who consume up to 2 units of alcohol per day have a lower mortality rate than tee-total women. Once consumption exceeds 2 units per day, the age-related risk is increased. The major contributors to this mortality risk are the effects of alcohol on the risk of cardiovascular disease (protective) and on breast cancer (increased risk). Even modest levels of alcohol consumption are associated with an increased risk of breast cancer and the risk escalates with increasing levels of consumption. For many other cancers (mouth, pharynx, larynx, oesophagus and liver) there is an association between moderate alcohol consumption and an increased risk of developing that particular cancer. It is uncertain how the extra risk of breast cancer is caused by alcohol, but it is likely to be through changes in estrogen levels. Drinking alcohol leads to increased levels of circulating estrogens, and many alcoholic beverages contain significant quantities of phytoestrogens. The main benefit of alcohol consumption is the reduction in mortality from cardiovascular disease. Estrogen may again be the causative factor. It is likely that this protection is mediated through alterations in lipids and lipoproteins, as well as reductions in clot formation and platelet aggregation. Cardiovascular disease is uncommon in women before the menopause and therefore the majority of this benefit occurs in postmenopausal women.
{"title":"Drinking through the menopause: the effects of alcohol","authors":"M. Cust","doi":"10.1258/175404507783004249","DOIUrl":"https://doi.org/10.1258/175404507783004249","url":null,"abstract":"Women tend to drink less alcohol than men overall, but the amount they consume still has a major influence on their health. There are both protective and detrimental effects. Drinking habits vary throughout life. More women drink around the time of the menopause than do young women; older women are more likely to drink regularly than drink excessively. But as women get older, alcohol consumption has more effect on their health. Compared with men, they are less able to metabolize alcohol and with increasing age these liver enzymes become less effective. This makes women more vulnerable to the health effects of alcohol as they get older. The acute effects of alcohol intoxication are obvious and well documented. They include all sorts of falls, accidents, violence and self-inflicted injuries. Chronic heavy drinking carries a large health risk at any age. Deaths from alcoholic liver disease in women are increasing, although still not as common as in men. Overall, modest alcohol consumption seems to be protective to women – those who consume up to 2 units of alcohol per day have a lower mortality rate than tee-total women. Once consumption exceeds 2 units per day, the age-related risk is increased. The major contributors to this mortality risk are the effects of alcohol on the risk of cardiovascular disease (protective) and on breast cancer (increased risk). Even modest levels of alcohol consumption are associated with an increased risk of breast cancer and the risk escalates with increasing levels of consumption. For many other cancers (mouth, pharynx, larynx, oesophagus and liver) there is an association between moderate alcohol consumption and an increased risk of developing that particular cancer. It is uncertain how the extra risk of breast cancer is caused by alcohol, but it is likely to be through changes in estrogen levels. Drinking alcohol leads to increased levels of circulating estrogens, and many alcoholic beverages contain significant quantities of phytoestrogens. The main benefit of alcohol consumption is the reduction in mortality from cardiovascular disease. Estrogen may again be the causative factor. It is likely that this protection is mediated through alterations in lipids and lipoproteins, as well as reductions in clot formation and platelet aggregation. Cardiovascular disease is uncommon in women before the menopause and therefore the majority of this benefit occurs in postmenopausal women.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"199 - 199"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395516","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004186
L. Cordingley, M. Towey, C. Bundy, S. Doshi, P. Gupta, M. Hunter, A. Papitsch-Clark, D. Sturdee
In this way, programmes of food derivatives can be implemented, which, in contrast to the targeted, monotherapeutic and pharmaceutical approach, act on a series of parallel processes. For example, in treating coronary artery disease, it is possible to assemble a pharmaconutritional support programme which will normalize both blood chemistry and vascular physiology. In summary, the pharmaco-nutritional approach allows the physician to combine agents which reduce excessive inflammatory, oxidative, nitrosative and glycative stress, and reduce or reverse cross-link formation. As these core processes underlie much degenerative disease, this approach holds out the prospects of achieving considerable delays in the onset of age-related morbidities. This presentation will review the causes of type B malnutrition, analyse some of its effects on disease processes and outline the pharmaco-nutritional approaches to the management and prevention of coronary artery disease and osteoporosis.
{"title":"Poster presentations","authors":"L. Cordingley, M. Towey, C. Bundy, S. Doshi, P. Gupta, M. Hunter, A. Papitsch-Clark, D. Sturdee","doi":"10.1258/175404507783004186","DOIUrl":"https://doi.org/10.1258/175404507783004186","url":null,"abstract":"In this way, programmes of food derivatives can be implemented, which, in contrast to the targeted, monotherapeutic and pharmaceutical approach, act on a series of parallel processes. For example, in treating coronary artery disease, it is possible to assemble a pharmaconutritional support programme which will normalize both blood chemistry and vascular physiology. In summary, the pharmaco-nutritional approach allows the physician to combine agents which reduce excessive inflammatory, oxidative, nitrosative and glycative stress, and reduce or reverse cross-link formation. As these core processes underlie much degenerative disease, this approach holds out the prospects of achieving considerable delays in the onset of age-related morbidities. This presentation will review the causes of type B malnutrition, analyse some of its effects on disease processes and outline the pharmaco-nutritional approaches to the management and prevention of coronary artery disease and osteoporosis.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"200 - 206"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395328","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004023
N. Panay
in testosterone-treated women compared with those who received placebo. Furthermore, personal distress significantly decreased in women receiving testosterone compared with both baseline and placebo-treated women. Potential risks of androgen therapy include hirsutism, acne, irreversible deepening of the voice and adverse changes in liver function and lipids. Virilization of a female fetus would be a potential risk of androgen administration to women of reproductive age. Sideeffects would be more likely with supraphysiological dosing of androgen therapy. As most androgens are aromatized to estrogens, the risks of estrogen therapy are also possible with androgen treatment, including an increased risk of thromboembolic events and breast cancer. The safety and tolerability of transdermal testosterone has been assessed up to 36 months. Testosterone patches were well tolerated, with a favourable adverse-event profile. Limited data are available on the risks associated with long-term androgen use, and few studies have been performed in women not receiving concurrent estrogen therapy.
{"title":"Recognizing the problems of premature ovarian failure","authors":"N. Panay","doi":"10.1258/175404507783004023","DOIUrl":"https://doi.org/10.1258/175404507783004023","url":null,"abstract":"in testosterone-treated women compared with those who received placebo. Furthermore, personal distress significantly decreased in women receiving testosterone compared with both baseline and placebo-treated women. Potential risks of androgen therapy include hirsutism, acne, irreversible deepening of the voice and adverse changes in liver function and lipids. Virilization of a female fetus would be a potential risk of androgen administration to women of reproductive age. Sideeffects would be more likely with supraphysiological dosing of androgen therapy. As most androgens are aromatized to estrogens, the risks of estrogen therapy are also possible with androgen treatment, including an increased risk of thromboembolic events and breast cancer. The safety and tolerability of transdermal testosterone has been assessed up to 36 months. Testosterone patches were well tolerated, with a favourable adverse-event profile. Limited data are available on the risks associated with long-term androgen use, and few studies have been performed in women not receiving concurrent estrogen therapy.","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"192 - 193"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395263","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004221
S. Gray
{"title":"The primary care perspective","authors":"S. Gray","doi":"10.1258/175404507783004221","DOIUrl":"https://doi.org/10.1258/175404507783004221","url":null,"abstract":"","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"195 - 195"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395485","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004203
M. Dooley
{"title":"Integration of traditional and complementary therapies","authors":"M. Dooley","doi":"10.1258/175404507783004203","DOIUrl":"https://doi.org/10.1258/175404507783004203","url":null,"abstract":"","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"195 - 195"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395395","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004096
M. Slack
obvious causes for dysfunction. However, other changes may have an equal role to play, such as altered lubrication, altered body image and neuropathic pain. Without a clear understanding of the causes of sexual dysfunction it is difficult to know how to remedy the situation. In cases of introital dyspareunia and in women with a reduction in vaginal volume, there are numerous techniques described to correct the problem. It is unclear, though, how successful these procedures are in relieving symptoms. Newer techniques aimed at understanding sexual function more accurately should allow us to study the changes that occur and by so doing attempt to prevent dysfunction, or to correct it. Much anecdote and little science inform the debate on this subject. It is true that alterations in sexual function have been described following a variety of gynaecological operations. However, the true causal relationship between the surgery and the outcome remains obscure. Unfortunately, most surgical studies have paid only very superficial attention to sexual dysfunction and it is only recently that specific questionnaires have been developed to examine the issue. Without adequate documentation of the preoperative status, it is difficult to understand the changes that may have taken place as a direct consequence of the surgery. Reductions in vaginal volume or in the introital dimensions seem to be
{"title":"Maintaining sexual function after gynaecological surgery","authors":"M. Slack","doi":"10.1258/175404507783004096","DOIUrl":"https://doi.org/10.1258/175404507783004096","url":null,"abstract":"obvious causes for dysfunction. However, other changes may have an equal role to play, such as altered lubrication, altered body image and neuropathic pain. Without a clear understanding of the causes of sexual dysfunction it is difficult to know how to remedy the situation. In cases of introital dyspareunia and in women with a reduction in vaginal volume, there are numerous techniques described to correct the problem. It is unclear, though, how successful these procedures are in relieving symptoms. Newer techniques aimed at understanding sexual function more accurately should allow us to study the changes that occur and by so doing attempt to prevent dysfunction, or to correct it. Much anecdote and little science inform the debate on this subject. It is true that alterations in sexual function have been described following a variety of gynaecological operations. However, the true causal relationship between the surgery and the outcome remains obscure. Unfortunately, most surgical studies have paid only very superficial attention to sexual dysfunction and it is only recently that specific questionnaires have been developed to examine the issue. Without adequate documentation of the preoperative status, it is difficult to understand the changes that may have taken place as a direct consequence of the surgery. Reductions in vaginal volume or in the introital dimensions seem to be","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"191 - 191"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395593","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004276
J. Shifren
obvious causes for dysfunction. However, other changes may have an equal role to play, such as altered lubrication, altered body image and neuropathic pain. Without a clear understanding of the causes of sexual dysfunction it is difficult to know how to remedy the situation. In cases of introital dyspareunia and in women with a reduction in vaginal volume, there are numerous techniques described to correct the problem. It is unclear, though, how successful these procedures are in relieving symptoms. Newer techniques aimed at understanding sexual function more accurately should allow us to study the changes that occur and by so doing attempt to prevent dysfunction, or to correct it. Much anecdote and little science inform the debate on this subject. It is true that alterations in sexual function have been described following a variety of gynaecological operations. However, the true causal relationship between the surgery and the outcome remains obscure. Unfortunately, most surgical studies have paid only very superficial attention to sexual dysfunction and it is only recently that specific questionnaires have been developed to examine the issue. Without adequate documentation of the preoperative status, it is difficult to understand the changes that may have taken place as a direct consequence of the surgery. Reductions in vaginal volume or in the introital dimensions seem to be
{"title":"Androgen therapy for postmenopausal women","authors":"J. Shifren","doi":"10.1258/175404507783004276","DOIUrl":"https://doi.org/10.1258/175404507783004276","url":null,"abstract":"obvious causes for dysfunction. However, other changes may have an equal role to play, such as altered lubrication, altered body image and neuropathic pain. Without a clear understanding of the causes of sexual dysfunction it is difficult to know how to remedy the situation. In cases of introital dyspareunia and in women with a reduction in vaginal volume, there are numerous techniques described to correct the problem. It is unclear, though, how successful these procedures are in relieving symptoms. Newer techniques aimed at understanding sexual function more accurately should allow us to study the changes that occur and by so doing attempt to prevent dysfunction, or to correct it. Much anecdote and little science inform the debate on this subject. It is true that alterations in sexual function have been described following a variety of gynaecological operations. However, the true causal relationship between the surgery and the outcome remains obscure. Unfortunately, most surgical studies have paid only very superficial attention to sexual dysfunction and it is only recently that specific questionnaires have been developed to examine the issue. Without adequate documentation of the preoperative status, it is difficult to understand the changes that may have taken place as a direct consequence of the surgery. Reductions in vaginal volume or in the introital dimensions seem to be","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"191 - 192"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395753","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}
Pub Date : 2007-12-01DOI: 10.1258/175404507783004078
S. Gray
number of body systems and with significant family, social and psychological influences. Menopause is one among many problems that is suited to management in this setting. Can we make it easier to do? Using hypothetical but very typical patients, the issues of presentation, provision of information, assessment and prescribing in this setting will be discussed. Patient review, simple troubleshooting, regime modification and stopping will be considered along with when to refer to a more specialist clinic. Menopause occurs to all women and for those who do suffer as a result, a balanced and reasonable response from their primary care providers should be available as an essential service. Enhanced and specialist services can then provide support and assistance. There would be no dispute that the prescription of hormone therapy to women has greatly reduced in the last five years. This was initiated by publication of the results of both the Women’s Health Initiative and the Million Women Study and has been exacerbated by the style of media reporting. Both women and their healthcare advisers have been subjected to this influence. Hormones are ‘hot topics’ that everyone now has an opinion on, often based on very flimsy information. The problems that women experience around and after menopause have, however, not gone away. Women may be more reluctant to present their problems overtly. Some clinicians have been reluctant to prescribe at all. The essence of primary care is that it deals with a great many issues that are unclear, often involving a
{"title":"The role of the Internet","authors":"S. Gray","doi":"10.1258/175404507783004078","DOIUrl":"https://doi.org/10.1258/175404507783004078","url":null,"abstract":"number of body systems and with significant family, social and psychological influences. Menopause is one among many problems that is suited to management in this setting. Can we make it easier to do? Using hypothetical but very typical patients, the issues of presentation, provision of information, assessment and prescribing in this setting will be discussed. Patient review, simple troubleshooting, regime modification and stopping will be considered along with when to refer to a more specialist clinic. Menopause occurs to all women and for those who do suffer as a result, a balanced and reasonable response from their primary care providers should be available as an essential service. Enhanced and specialist services can then provide support and assistance. There would be no dispute that the prescription of hormone therapy to women has greatly reduced in the last five years. This was initiated by publication of the results of both the Women’s Health Initiative and the Million Women Study and has been exacerbated by the style of media reporting. Both women and their healthcare advisers have been subjected to this influence. Hormones are ‘hot topics’ that everyone now has an opinion on, often based on very flimsy information. The problems that women experience around and after menopause have, however, not gone away. Women may be more reluctant to present their problems overtly. Some clinicians have been reluctant to prescribe at all. The essence of primary care is that it deals with a great many issues that are unclear, often involving a","PeriodicalId":85745,"journal":{"name":"The journal of the British Menopause Society","volume":"13 1","pages":"195 - 196"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1258/175404507783004078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66395108","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}
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