Menopause international最新文献

Currently, 25% of women seek the advice of a medical professional for symptoms related to the menopause. However, with an increasingly ageing and medically aware population, it is likely this proportion will grow. The main symptoms related to the menopause are systemic vasomotor and localized urogenital symptoms. Numerous forms of estrogen have been used to alleviate these symptoms. Further problems that increase during the menopause include incontinence, pelvic organ prolapse and recurrent urinary tract infections. This article reviews the process by which estrogen affects the tissues of the urogenital tract, what symptoms occur during this period and what modalities of treatments are available.

The increasing prevalence of diabetes in combination with an aging population and increasing female longevity means that it is important to understand the effects of diabetes on women's health. Both type 1 and type 2 diabetes influence health outcomes throughout the life-course. This review article provides a summary of sex differences in diabetes epidemiology and covers specific aspects of the life-course in women including: the menarche, pregnancy and the menopause. It also discusses the associations with other conditions: cardiovascular disease, osteoporosis and cancer.

Androgens are known to play a pivotal role in cardiovascular function. However, a definitive explanation as to how their impact differs between genders is yet to be provided. In this review, the existing studies on the link between androgens and cardiovascular disease have been analysed, with a particular focus on the gender-specific differences. Several studies agree that both direct and indirect effects of testosterone on cardiovascular function show a gender-related dimorphism. Consistently, men and women display different responses to androgen supplementation treatment. Post-menopausal women may particularly benefit from testosterone supplementation therapy. Future studies should further clarify the optimal dose and route of administration of testosterone, and more women should be included in clinical trials, in order to identify novel gender-specific targets, and finally to develop therapeutic strategies.

Genital lichen sclerosus (LS) is usually managed with potent topical corticosteroids. There is a small (<5%) increased risk of skin cancer and long-term follow-up is recommended. We audited patients discharged to the care of their general practitioner (GP) from our regional vulval clinic. Only 29% had seen their GP in the last 12 months; 53% self-examined; 48% were unaware of the need to report abnormalities immediately; 24.4% were unaware of the recommended duration of use of their 30 g tube of steroid and only 66.7% were aware of the risk of skin cancer. Further education of both LS patients and their family practitioners is required.

Objective: Treating the effects of menopause in women with history of oestrogen-dependent cancers presents a clinical dilemma. Endocrine adjuvant agents like tamoxifen and other cancer treatments, often induce premature menopause. Vasomotor, psychological and somatic symptoms may be more severe in these women. The risk of hormone therapy (HT) and its efficacy must be balanced. Currently, there are no consensus guidelines for the management of these patients.

Study design: This is a retrospective study carried out between 10/01/2011 and 27/01/2012 in a tertiary referral menopausal clinic.

Main outcome measures: Data was collected about cancer type and treatment, symptoms, prior use of T, bone density analyses and menopause treatments.

Results: 590 patient records were scanned and 146 patients (24.7%) had a history of cancer. Of these, 45.9% were younger than 50 years old. 67.1% comprised breast cancer patients, of which 69.4% were on adjuvant endocrine agents. 24.7% consisted of gynaecological cancer patients who were predominantly treated with surgery in conjunction with adjuvant therapies. 90.4% of the women had at least one menopause-related symptom, vasomotor symptoms being most prevalent, followed by psychological and vaginal symptoms. Women used a variety of HT and non-HRT therapies for their symptoms. Of the 77 women who had a personal history of oestrogen receptor positive cancers, 19.5% chose to take HT in spite of it being contraindicated.

Conclusions: Prescribing HT to women with a history of hormone dependent cancer remains controversial. Patient 'Quality of Life' must be considered. More research is required in this area.

A qualitative study was undertaken via a questionnaire in a specialist menopause clinic in Dundee, to assess patient views of the service, their opinion of media coverage of hormone replacement therapy and whether their visit helped them reach an informed decision about using it. All women felt that they were given enough information and their concerns were addressed. Only 11% (3/28) of the women sampled viewed media coverage in a positive light.