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Obstetrics and Gynecology Clinics of North America

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https://www.readbyqxmd.com/read/30401557/the-disruptive-changes-of-midlife-a-biopsychosocial-adventure
#1
EDITORIAL
Nanette Santoro, Howard M Kravitz
No abstract text is available yet for this article.
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401556/a-more-complete-picture-of-reproductive-aging-and-the-menopause-transition
#2
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401555/cognitive-changes-with-reproductive-aging-perimenopause-and-menopause
#3
REVIEW
Kelly N Morgan, Carol A Derby, Carey E Gleason
This article reviews the role of endogenous estrogen in neural and cognitive processing, followed by an examination of longitudinal cognitive data captured in various stages of the menopausal transition. The remaining text reviews the contradictory results from major hormone therapy trials to date, evidence for the "timing hypothesis," and closes with recommendations for future research and for practicing clinicians.
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401554/genitourinary-changes-with-aging
#4
REVIEW
Caroline M Mitchell, L Elaine Waetjen
Both chronologic aging and menopause affect the physical, physiologic, and microbiological characteristics of the genitourinary tract. The genitourinary syndrome of menopause, characterized by vulvovaginal and lower urinary tract signs and symptoms, is prevalent and has a significant negative impact on women's lives. In this article, the authors detail the genitourinary tract changes associated with menopause and/or aging. They also review the 2014 North American Menopause Society's definition of the genitourinary syndrome of menopause and present the epidemiology and impact of genitourinary aging in midlife and older women, namely, vulvovaginal, urinary, and sexual symptoms...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401553/physical-activity-and-physical-function-moving-and-aging
#5
REVIEW
Sheila A Dugan, Kelley Pettee Gabriel, Brittney S Lange-Maia, Carrie Karvonen-Gutierrez
Evidence supports that the physical disablement process starts earlier than previously thought, in midlife when women still have many years to live. Physical activity participation and interventions have been successful in preventing disability in older adults and may be promising for maintaining function at younger ages. Changing the conversation to more relevant topics in midlife, like positive changes in body composition, sleep, and improved mood, may move the dial on participation, as midlife women do not meet guidelines for physical activity...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401552/female-sexual-function-at-midlife-and-beyond
#6
REVIEW
Holly N Thomas, Genevieve S Neal-Perry, Rachel Hess
Sexual function is an important component of quality of life for women. Midlife poses several challenges to optimal sexual function and intimacy for women. In addition to anatomic factors related to estrogen deficiency, such as genitourinary syndrome of menopause, vulvovaginal atrophy, and pelvic organ prolaps, psychosocial factors, including prior sexual trauma, play an important role in sexual function in women. Several treatments have emerged for female sexual dysfunction; long-term studies and head-to-head comparisons are lacking...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401551/bone-health-during-the-menopause-transition-and-beyond
#7
REVIEW
Arun S Karlamangla, Sherri-Ann M Burnett-Bowie, Carolyn J Crandall
The menopause transition is a critical period for bone health, with rapid losses in bone mass and strength occurring in a 3-year window bracketing the date of the final menstrual period. Declines in bone mass are accompanied by deleterious changes in bone macrostructure and microarchitecture, which may be captured by changes in composite strength indices and indices of trabecular thickness and connectivity. The onset of the rapid bone loss phase is preceded by changes in sex steroid hormones and increases in markers of bone resorption, measurements of which may be clinically useful in predicting the onset of the rapid loss phase and in identifying the women who will lose the most bone strength over the menopause transition...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401550/sleep-health-and-metabolism-in-midlife-women-and-menopause-food-for-thought
#8
REVIEW
Howard M Kravitz, Rasa Kazlauskaite, Hadine Joffe
Sleep and metabolism are essential components of health. Metabolic health depends largely on individual's lifestyle. Disturbances in sleep health, such as changes in sleep patterns that are associated with menopause/reproductive aging and chronologic aging, may have metabolic health consequences. Sleep restriction and age-related changes in sleep and circadian rhythms may influence changes in appetite and reproductive hormones, energy expenditure, and body adiposity. In this article, the authors describe how menopause-related sleep disturbance may affect eating behavior patterns, immunometabolism, immunometabolic dysfunction, and associations between sleep and metabolic outcomes...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401549/depression-during-and-after-the-perimenopause-impact-of-hormones-genetics-and-environmental-determinants-of-disease
#9
REVIEW
Joyce T Bromberger, Cynthia Neill Epperson
Vulnerability to depression is increased across the menopause transition and in the early years after the final menstrual period. Clinicians should systematically screen women in this age group; if depressive symptoms or disorder are present, treatment of depression should be initiated. Potential treatments include antidepressants for moderate to severe symptoms, psychotherapy to target psychological and interpersonal factors, and hormone therapy for women with first-onset major depressive disorder or elevated depressive symptoms and at low risk for adverse effects...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401548/cardiovascular-implications-of-the-menopause-transition-endogenous-sex-hormones-and-vasomotor-symptoms
#10
REVIEW
Samar R El Khoudary, Rebecca C Thurston
The menopause transition (MT) is a critical period of women's lives marked by several physiologic changes and menopause-related symptoms that have implications for health. Risk for cardiovascular disease, the leading cause of death in women, increases after menopause, suggesting a contribution of the MT to its development. This article focuses on the relationship between 2 main features of the MT and women's cardiovascular health: (1) dynamic alterations of sex hormones, particularly endogenous estradiol and follicle-stimulating hormone, and (2) vasomotor symptoms, the cardinal symptom of the menopause...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401547/vasomotor-symptoms-across-the-menopause-transition-differences-among-women
#11
REVIEW
Nancy E Avis, Sybil L Crawford, Robin Green
Vasomotor symptoms (VMS) are the primary menopausal symptoms, occurring in up 80% of women and peaking around the final menstrual period. The average duration is 10 years, longer in women with an earlier onset. Compared with non-Hispanic white women, black and Hispanic women are more likely and Asian women are less likely to report VMS. Risk factors include greater body composition (in the early stage of menopausal transition), smoking, anxiety, depression, sensitivity to symptoms, premenstrual syndrome, lower education, and medical treatments, such as hysterectomy, oophorectomy, and breast cancer-related therapies...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401546/menstrual-cycle-hormone-changes-associated-with-reproductive-aging-and-how-they-may-relate-to-symptoms
#12
REVIEW
Amanda Allshouse, Jelena Pavlovic, Nanette Santoro
Key cycle changes occur as women transition from reproductive life to menopause, and they can be roughly linked to menopausal staging. It is important to understand the types of studies that inform the current knowledge. Patterns of symptoms within menstrual cycles (sleep, headache) generally favor worsening in association with the perimenstrual phase of the cycle, and patterns of chronic symptoms, such as hot flashes and adverse mood, appear to be worse when hormones are more variable.
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401545/menstrual-cycle-changes-as-women-approach-the-final-menses-what-matters
#13
REVIEW
Siobán D Harlow
Increased variability in menstrual cycle length marks the onset of the menopausal transition, with the likelihood of long cycles increasing as women approach menopause. This article describes the STRAW+10 bleeding criteria for recognizing onset of the early and late menopausal transition, as well as the specific bleeding changes a woman may experience during this life stage, including how women's bleeding experiences differ. The high probability of episodes of excessive and prolonged bleeding as women approach their final menstrual period is documented, as is the continuing probability of ovulation as women reach their final menstrual period...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401544/onset-of-the-menopause-transition-the-earliest-signs-and-symptoms
#14
REVIEW
Clarisa R Gracia, Ellen W Freeman
Although more than 80% of women experience some degree of psychological or physical symptoms around menopause, both women and clinicians have misconceptions about how hormonal changes relate to menopausal symptoms and psychological conditions. Recently, several large-scale, longitudinal studies have been conducted to better characterize symptoms and changes that occur around menopause. This article offers current evidence for symptoms that occur in the early menopause transition, including vasomotor symptoms, mood changes, sleep problems, and changes in sexual functioning...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30401543/declining-fertility-with-reproductive-aging-how-to-protect-your-patient-s-fertility-by-knowing-the-milestones
#15
REVIEW
Molly M Quinn, Marcelle I Cedars
Protection of fertility shares many of the same concepts as optimization of general health, such as smoking cessation, maintenance of a healthy body weight, and moderation of alcohol intake. Increasing attention has been placed on minimizing exposures to known reproductive toxicants. There are few conclusive data to support specific diet patterns or supplements for fertility. Ovarian reserve testing has been explored as potential diagnostic tests for assessment of reproductive aging with some controversy. Finally, the development of vitrification in the assisted reproduction laboratory has increased the success and, therefore, access to fertility preservation by way of oocyte or embryo cryopreservation...
December 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092931/treatment-of-peripartum-mental-health-disorders-an-essential-element-of-prenatal-care
#16
EDITORIAL
Constance Guille, Roger B Newman
No abstract text is available yet for this article.
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092930/pregnancy-an-opportune-time-to-evaluate-and-treat-mental-health-disorders
#17
EDITORIAL
William F Rayburn
No abstract text is available yet for this article.
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092929/psychosocial-aspects-of-fertility-and-assisted-reproductive-technology
#18
REVIEW
Jamie Stanhiser, Anne Z Steiner
Psychosocial aspects of fertility, infertility, and assisted reproductive technology (ART) can significantly impact patients' sense of self-identity and personal agency, mental well-being, sexual and marital relationships, reproductive efficiency, compliance with treatment, and pregnancy outcomes. Research is needed to understand how stress, anxiety, depression, mood disorders, and psychotropic medications impact fertility and infertility treatment. The psychosocial implications of ART on our society include a shift toward older maternal age at conception, the complexities of third-party reproduction, and consideration for the psychological and socioeconomic barriers to receiving care...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092928/the-unwelcome-guest-working-with-childhood-sexual-abuse-survivors-in-reproductive-health-care
#19
REVIEW
Phyllis M Florian
Health care providers (HCPs) are often poorly prepared to respond to childhood sexual abuse (CSA) survivors' needs in reproductive health care. With few protocols addressing the CSA survivor population, HCPs struggle with delivering interventions that meet professional standards of care within the systemic constraints of reproductive health care. To bridge the gap that exists when the unwelcome guest of CSA enters the reproductive health care arena, it is important to understand the psychological influences of trauma that affect CSA survivors, the symptoms or behavioral cues that are commonly revealed, and therapeutic approaches that can facilitate positive patient-provider experiences in health care...
September 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/30092927/perinatal-intimate-partner-violence
#20
REVIEW
Christine K Hahn, Amanda K Gilmore, Rosaura Orengo Aguayo, Alyssa A Rheingold
This article reviews the prevalence and outcomes of perinatal intimate partner violence (IPV). Reported rates of perinatal IPV range from 3.7% to 9.0%. Perinatal IPV is associated with a multitude of mental and obstetric health outcomes that affect the mother and child. Perinatal medical providers have an opportunity to detect victims of IPV and facilitate services for this population. Screening, safety planning, and referral procedures are essential for addressing this public health problem.
September 2018: Obstetrics and Gynecology Clinics of North America
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