Menopause

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Estrogen therapy is still the mainstay of therapy for moderate-to-severe symptoms and long-term studies on endometrial safety of local estrogen and ospemifene are lacking. Those are the key conclusions from an updated position statement on management of symptomatic vulvovaginal atrophy (VVA) in postmenopausal women issued by the North American Menopause Society (NAMS).

FDA has approved low-dose paroxetine capsules (Brisdelle, Noven Pharmaceuticals), 7.5 mg/day, for treatment of moderate to severe vasomotor symptoms (VMS) associated with menopause, also referred to as hot flashes and night sweats.

The British Menopause Society (BMS) on May 23 released updated recommendations on hormone replacement therapy (HRT), claiming that they are finally providing clarity to this murky issue. The new guidelines appear in the society’s flagship journal, Menopause International. Developed by a panel of experts, the guidelines discuss how women can optimize their menopause transition, focusing in particular on lifestyle and diet and the pros and cons of complementary therapies.

A new analysis from the SWAN study shows that anxiety before menopause does not correlate with anxiety during the menopausal transition. Researchers from the multisite Study of Women’s Health Across the Nation, report in Menopause that women who are calmer at premenopause actually are more susceptible to high anxiety during and after menopause than before menopause, and vice versa.

Hormones, particularly transdermal estradiol, may help women maintain mood, cognition and memory in middle-age and beyond. “What we have learned the past decade is that not all estrogens are the same,” said ACOG presenter Sarah Berga, MD, of Women’s Health at Wake Forrest School of Medicine, “and that the differences can be critical.”

A study appearing in the Journal of Clinical Endocrinology & Metabolism (JCEM) April 2013 issue details a model to help predict when a women will experience her final menstrual period (FMP).

Osphena (ospemifene) has been approved by the FDA to treat dyspareunia. This is the first non-steroidal estrogen available for women with dyspareunia (painful intercourse), a symptom of vulvar and vaginal atrophy (VVA) that is common during menopause.

A registry-based study by researchers at UC San Francisco (UCSF) has shown an association between BRCA1/2 mutations and early menopause. The findings, published in Cancer, suggest that women who carry the genetic defect may be at risk of earlier infertility.

New drugs, new research, new guidelines… there’s a lot for ob/gyns to look forward to in the coming year. Here, the leaders of seven ob/gyn societies share the most interesting, important, exciting things on their radar for 2013.

From ASRM’s removal of the ‘experimental’ label from the procedure of oocyte cryopreservation, to discoveries into the complex genetic processes involved in ovarian cancer, 2012 was another important year in ob/gyn research. Here, the leaders of seven major ob/gyn societies reflect on the most exciting research of the last year.