Menopause Int
· 2011 Jun · PMID 21693497
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Women's health often declines in middle and old age for reasons that are avoidable. Simple measures including lifestyle change could make a significant difference. Education of women is all important. The BMS feels that...Women's health often declines in middle and old age for reasons that are avoidable. Simple measures including lifestyle change could make a significant difference. Education of women is all important. The BMS feels that the provision of a simple health check of all women at the age of 50 years would provide an excellent opportunity that would serve as a screening as well as an educational visit at which balanced information about appropriate treatments and lifestyle changes in natural and premature menopause should be given to empower women to make an informed choice.
Menopause Int
· 2011 Mar · PMID 21427422
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Insulin resistance (IR) is associated with a number of metabolic abnormalities including glucose intolerance, dyslipidemia and central obesity (the metabolic syndrome), which predispose to cardiovascular disease, diabete...Insulin resistance (IR) is associated with a number of metabolic abnormalities including glucose intolerance, dyslipidemia and central obesity (the metabolic syndrome), which predispose to cardiovascular disease, diabetes mellitus and some cancers. The incidence of many of these conditions increases after the menopause, a time when IR also increases. Medical intervention to help alleviate menopausal symptoms, frequently vasomotor in origin, usually involves hormone replacement therapy (HRT), but some women may only experience partial symptom relief. We have hypothesized that this may be due to concurrent IR. Our approach is therefore to manage menopausal symptoms in conjunction with the treatment of any concurrent IR, achieved through a combination of hormone replacement, dietary intervention and, if necessary, an insulin sensitizer. We suggest that this approach may not only improve symptom relief but may also reduce the risk of developing more serious health complaints in the future.
Menopause Int
· 2011 Mar · PMID 21427421
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The function of vitamin K is to serve as a co-factor during the post-translational carboxylation of glutamate (Glu) residues into γ-carboxyglutamate (Gla) residues. The vital importance of the Gla-proteins essential for...The function of vitamin K is to serve as a co-factor during the post-translational carboxylation of glutamate (Glu) residues into γ-carboxyglutamate (Gla) residues. The vital importance of the Gla-proteins essential for normal haemostasis is well recognized. During recent years, new Gla-containing proteins have been discovered and the vitamin K-dependent carboxylation is also essential for their function. It seems, however, that our dietary vitamin K intake is too low to support the carboxylation of at least some of these Gla-proteins. According to the triage theory, long-term vitamin K inadequacy is an independent, but modifiable risk factor for the development of degenerative diseases of ageing including osteoporosis and atherosclerosis.
Menopause Int
· 2011 Mar · PMID 21427420
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The aim of this article is to focus on compounded bioidentical hormone (BH) formulations for menopausal symptoms and to discuss the impact of these on women's choice of treatment. The practice of compounding BHs for indi...The aim of this article is to focus on compounded bioidentical hormone (BH) formulations for menopausal symptoms and to discuss the impact of these on women's choice of treatment. The practice of compounding BHs for individualized treatment of women with menopausal symptoms has developed in the USA. In spite of claims of superiority, there is no evidence to suggest that these formulations are any more efficacious or safe than conventional hormone replacement therapy (HRT). In fact, there are some concerns about dosing inconsistencies and usefulness of saliva testing that is carried out as part of this type of treatment. While there should be no serious safety issues for women, there is a mismatch between the reality of compounded BH formulations and women's perception of them.
Menopause Int
· 2011 Mar · PMID 21427419
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Previous surveys on www.menopausematters.co.uk and published in this journal show that women are reluctant to seek help for reduced libido, vaginal atrophy and dyspareunia despite adverse effects on health and wellbeing....Previous surveys on www.menopausematters.co.uk and published in this journal show that women are reluctant to seek help for reduced libido, vaginal atrophy and dyspareunia despite adverse effects on health and wellbeing. Additionally, health professionals frequently fail to explore these areas during consultations despite proven treatments being available. Women suffering urinary incontinence (UI) show similar trends in their reticence to seek help and in their health professionals addressing their issues. These issues must be addressed through patient empowerment and direct questioning from health professionals. Well maintained, publically accessible toilets are also an important provision to achieving a holistic approach to UI.
Menopause Int
· 2011 Mar · PMID 21427418
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Although women frequently associate skin issues with menopause and hormone replacement therapy (HRT), little work has been done to investigate a possible relationship. A questionnaire was given to women attending a speci...Although women frequently associate skin issues with menopause and hormone replacement therapy (HRT), little work has been done to investigate a possible relationship. A questionnaire was given to women attending a specialist menopause clinic; 87 women responded. Skin problems generally were common, with over 64% of respondents reporting past problems. Around half felt that the menopause had resulted in skin changes; dry skin was the predominant complaint at this stage. However, use of HRT in the short term did not result in any conclusive trends in skin condition in the majority of users.
Sheikh SA, Roshan TM, Khattak MN
… +4 more, Baig AA, Noor SJ, Hassan R, Zaki NM
Menopause Int
· 2011 Mar · PMID 21427417
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OBJECTIVES: In healthy postmenopausal women (PMW) increased platelet activation has been associated with adverse cardiovascular events. There is much debate about the relationship between platelet function and serum estr...OBJECTIVES: In healthy postmenopausal women (PMW) increased platelet activation has been associated with adverse cardiovascular events. There is much debate about the relationship between platelet function and serum estradiol level in PMW. This study assessed the effect of short-term oral estrogen replacement therapy (ERT) on platelet activation markers (CD62P and PAC-1) and its correlation with age and body mass index (BMI) among healthy PMW. METHODS: A prospective intervention study was conducted at Hospital University Sains Malaysia, involving 48 healthy PMW who were evaluated for platelet activation marker levels as determined by flow cytometry, before and after two weeks of oral ERT with 0.625 mg of conjugated equine estrogen once daily. The pre- and post-ERT platelets activation markers difference was analysed by paired t-test. RESULTS: The pre-ERT, mean ± SD percentage levels of CD62P and PAC-1 were significantly reduced from 7.00 ± 5.91 and 41.75 ± 26.85 to 3.05 ± 2.47 and 20.86 ± 19.02, respectively, after two weeks of ERT (P value < 0.001). The correlation of platelet activation markers was significant with estradiol but not with age and BMI. CONCLUSION: Short-term ERT leads to reduction in platelet activity, which might contribute to protection against cardiovascular diseases in healthy PMW.
Nappi RE, Albani F, Santamaria V
… +5 more, Tonani S, Martini E, Terreno E, Brambilla E, Polatti F
Menopause Int
· 2010 Dec · PMID 21156854
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The present short review underlines the role of testosterone (T) in the motivational and satisfaction components of women's sexuality and critically discusses the strategies to treat hypoactive sexual desire disorder (HS...The present short review underlines the role of testosterone (T) in the motivational and satisfaction components of women's sexuality and critically discusses the strategies to treat hypoactive sexual desire disorder (HSDD), a condition of low desire associated with personal and/or interpersonal difficulties, which is more common in surgical menopausal women. There are multiple ways androgens target the brain regions (hypothalamic, limbic and cortical) involved in sexual function and behaviour. Even though circulating available androgens have been implicated in several domains of sexual response, they seem to be related weakly to symptoms, such as low sexual desire, poor sexual arousal, orgasm and diminished well-being in postmenopausal women. The possibilities of treating low sexual desire/HSDD are multifaceted and should include the combination of pharmacological treatments able to maximize biological signals driving the sexual response, and individualized psychosocial therapies in order to overcome personal and relational difficulties. Transdermal T has been shown to be effective at a dose of 300 µg/day both in surgically and naturally menopausal women replaced with estrogen or not, without any relevant side-effects. However, the decision to treat postmenopausal women with HSDD with T is mainly based on clinical judgement, after informed consent regarding the unknown long-term risks.
Menopause Int
· 2010 Dec · PMID 21156853
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Culture is a rather amorphous concept yet has a huge impact on our attitudes to diet, lifestyle, religion, sexuality and, via its influence on society, attitudes to education and health care. The midlife is a time of emo...Culture is a rather amorphous concept yet has a huge impact on our attitudes to diet, lifestyle, religion, sexuality and, via its influence on society, attitudes to education and health care. The midlife is a time of emotional and hormonal upheaval for any woman so defining the effects on culture on her response is challenging. Much depends on the value she places on her fertility and sexuality together with her own goals and aspirations, yet these are also influenced by culture. Very few traditional cultures survive in isolation for comparison. Shifting populations mean counter influences and transitional societies can be ambivalent. Emigrants and refugees transplanted into a different environment may struggle with the concept of acculturation. In time, all cultures evolve regardless. Finally, there may be biological and hormonal differences between races. This article seeks to place these different forces into context.
Menopause Int
· 2010 Dec · PMID 21156852
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Subtotal hysterectomy (SH), which is also referred to as supracervical hysterectomy, is a common gynaecological procedure in which the uterus is removed and the cervix is retained. There is continuing debate about the ad...Subtotal hysterectomy (SH), which is also referred to as supracervical hysterectomy, is a common gynaecological procedure in which the uterus is removed and the cervix is retained. There is continuing debate about the advantages and disadvantages of SH compared with total abdominal hysterectomy. Persistent vaginal bleeding and the need for continued cervical screening appear to be the main disadvantages of SH. The procedure is often combined with removal of the ovaries. Women should be counselled appropriately prior to removal of their ovaries. Following an internal audit of practice of hormone replacement therapy (HRT) prescription within our own unit, we discovered that there were inconsistencies in the prescription of HRT following SH which led us to investigate this matter further. We concluded that evidence is lacking to guide HRT prescription following SH and bilateral oophorectomy and propose content that can help produce guidelines for the counselling of women prior to SH and prescription of HRT.
Dennerstein L, Lehert P, Keung LS
… +2 more, Pal SA, Choi D
Menopause Int
· 2010 Dec · PMID 21156851
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OBJECTIVE: The aim of this paper is to assess the effects of premenstrual symptoms on quality of life as measured by the impact symptoms have on women's activities of daily life (ADL). STUDY DESIGN: Cross-sectional surve...OBJECTIVE: The aim of this paper is to assess the effects of premenstrual symptoms on quality of life as measured by the impact symptoms have on women's activities of daily life (ADL). STUDY DESIGN: Cross-sectional survey. Population-based, face-to-face interview with 1202 women aged 15-49 years recruited by random sampling in cities of Hong Kong, Pakistan and Thailand. Main outcome measures Checklist of 23 premenstrual symptoms, sociodemographic and lifestyle variables, ADL: overall impact of premenstrual symptoms on ADL and impact on each of six ADL areas. Regression analysis measured the impact of premenstrual symptoms and sociodemographic factors on ADL. RESULTS: Premenstrual physical and mental symptom domains had similar negative effects on ADL. Seventy-four percent of women were not affected or minimally affected in ADL, 17% had a clinically significant effect on ADL and 9% were severely affected in ADL. ADL were predominantly affected by premenstrual symptom severity. Oral contraceptive pill users and women living in Pakistan reported less impact on ADL, while married women report more impact of symptoms on ADL. CONCLUSIONS: The severity of premenstrual symptoms was found to have a significant impact on ADLs with the type of activity affected, reflecting how women predominantly spend their time in the different cultures studied.
Dennerstein L, Lehert P, Keung LS
… +2 more, Pal SA, Choi D
Menopause Int
· 2010 Dec · PMID 21156850
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OBJECTIVE: This paper aims to explore women's experiences of premenstrual symptoms in three Asian countries and the factors affecting the prevalence of these symptoms. STUDY DESIGN: Cross-sectional survey. A sample of 12...OBJECTIVE: This paper aims to explore women's experiences of premenstrual symptoms in three Asian countries and the factors affecting the prevalence of these symptoms. STUDY DESIGN: Cross-sectional survey. A sample of 1202 women aged 15-49 years were recruited by random sampling in Hong Kong, Pakistan and Thailand. Main outcome measures The interviewer used a questionnaire with a checklist of 23 premenstrual symptoms, sociodemographic and lifestyle variables. RESULTS: The most prevalent symptoms were joint, muscle and back pain, cramps, abdominal pain and breast tenderness. The severity of symptoms was directly proportional to duration (months affected) (R = 0.85). Significant effects on symptom duration, severity, index of age (linear and quadratic effects), educational level and parity were found by multiple regression. There were also differences between countries for certain symptoms. CONCLUSIONS: Physical symptoms are an important component of premenstrual syndromes. These have been shown to be psychobiological in nature. Further analysis will examine the impact on the quality of life and the relationship with existing classificatory systems.