Menopause

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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.

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.

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.”

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).