Menopause

Positive Association Between Mammographic Breast Density and Bone Mineral Density in thePostmenopausal Estrogen/Progestin Interventions Study

Five years ago this summer the National Institutes of Health’s stopped early a major portion of the Women’s Health Initiative (WHI), a large and ambitious study to address the most common causes of death, disability and impaired quality of life in postmenopausal women.

Recently there have been numerous references in the news about the new types of estrogens that do not cause an increased risk of breast cancer. While studies looking at an increased risk of breast cancer with traditional hormone replacement use still do not show a clear consensus, it is generally accepted that there may an increased, albeit small, risk of breast cancer with the use of traditional replacement hormones.

The HERS trial was the first study to put a damper on enthusiasm for hormone replacement therapy (HRT) as a preventive therapy for heart disease. A second trial called ERA (Estrogen Replacement and Atheriosclerosis trial), reported at the 49th Annual Meeting of the American College of Cardiology, held in Anaheim, California, March 12–15, 2000, provides additional evidence that HRT does not prevent heart disease.

Hysterectomy is one of the most common abdominal surgical procedures performed in women today with 600,000 hysterectomies in the USA annually, one in three women undergoing hysterectomy, and 6–20% in European countries.

The optimal surgical approach to treatment of stress urinary incontinence (SUI) in women continues to be a topic of controversy. This debate is fueled, in part, by the difficulty in comparing data on the different surgical procedures due to variations in patient selection, diagnostic methods, techniques, outcome criteria, and length of follow-up.

Interview with Steve Fleischman

Roberta Speyer: “This is Roberta Speyer and I’m reporting for OBGYN.net. I have the pleasure of talking to Dr. Fleischman who is an Assistant Clinical Professor at Yale University and in private practice with Gynecology & Infertility, PC. Today we are going to talk about urinary incontinence and how OBGYN physicians can fit this into their practice. As a practicing OBGYN yourself, this is something you have a great degree of specialization in. Tell us a little about your practice Dr. Fleischman.”

A study sponsored by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health found that postmenopausal women with heart disease who took hormone therapy and high dose antioxidant vitamins - either alone or in combination with hormones - did not have fewer heart attacks, deaths, or progression of coronary disease.

Perimenopause is a time of hormonal fluctuations where some perimenopausal women will experience psychological symptoms during this transition (Carter, 2001; Conboy, O’Connell, & Domar, 2000). Perimenopause may be connected with a new onset of psychiatric symptoms or exacerbation of pre-existing psychiatric problems in women (Simon, et. al., 1998).

Urinary incontinence (leakage) refers to the involuntary loss of urine from the bladder, which constitutes a social or hygienic problem for the individual. Bladder control problems affect about 17 million people in the United States.

Each year, about 180,000 women in the United States discover they have breast cancer. Those at greatest risk are women over the age of 50. Nevertheless, it is important to keep in mind that younger women account for up to 30% of cases.

Many women experience vasomotor symptoms at or around the time of menopause. Hot flushes and night sweats are considered primary menopausal symptoms that may also be associated with sleep and mood disturbances, as well as decreased cognitive function.

The average age of natural menopause in Western societies is estimated to be 51 years; women in Canada can therefore expect to live, on average, a third of their lives in post-menopausal years. During these years women are at increased risk of chronic diseases such as osteoporosis and cardiovascular disease.

Researchers from Italy have found that premenopausal breast cancer patients treated with triptorelin and chemotherapy were less likely to experience early menopause and were more likely to resume menses than patients who received chemotherapy alone.

Thanks to innovative treatments like in vitro fertilization and egg donation, we are able to help thousands of infertile patients build their families.

Results from a new study by doctors at the University of Michigan Hospitals and Health Centers indicate that long-term estrogen replacement has a beneficial effect on postmenopausal women's non-verbal memory and attention span.

The Editorial: Timing is Everything…  - A. R. Genazzani, MD., Ph.D., FRCOG, President, The International Society of Gynecological Endocrinology (ISGE)