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Menopause guidelines

Andrew Rabley, Tina O'Shea, Russell Terry, Sharon Byun, M Louis Moy
PURPOSE OF REVIEW: The purpose of this article is to review the available data regarding the application and therapeutic outcomes of laser therapy for the treatment of genitourinary syndrome of menopause (GSM). RECENT FINDINGS: There have been several studies regarding the use of laser therapy for the treatment of GSM. Most of these studies show a trend toward safe and effective treatment in the short term (less than or equal to 12 weeks). However, these studies are lacking in randomization, blinding, placebo, and comparison groups...
August 17, 2018: Current Urology Reports
Emanuela Mello Ribeiro Cavalari, Marcela Pessoa de Paula, Mariana Arruda, Nathália Carraro, Arthur Martins, Kamila de Souza, Maria Caroline Coelho, Nathalie Anne de Oliveira E Silva de Morais, Aline Barbosa Moraes, Leonardo Vieira Neto
CONTEXT: Although metabolic syndrome has been studied in patients with autonomous cortisol secretion (ACS), there are limited data for those with nonfunctioning adrenal incidentaloma (NFAI). OBJECTIVE: To assess metabolic syndrome frequency in NFAI patients and controls without adrenal adenoma according to World Health Organization (WHO), National Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATP III), American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) and International Diabetes Federation (IDF) criteria...
July 25, 2018: Clinical Endocrinology
Fadi G Mirza, Rezan Abdul-Kadir, Christian Breymann, Ian S Fraser, Ali Taher
Iron deficiency and iron deficiency anemia are highly prevalent among women throughout their lives. Some females are particularly vulnerable to iron deficiency/iron deficiency anemia, including those with heavy menstrual bleeding (HMB) and pregnant/postpartum women. Despite the high prevalence of iron deficiency/iron deficiency anemia in women, the condition is still underdiagnosed and therefore undertreated, with serious clinical consequences. Areas covered: The following review examines the impact of iron deficiency and iron deficiency anemia on clinical outcomes and quality of life in women from adolescence to post-menopause, paying particular attention to guidelines and current recommendations for diagnostic tests and management...
August 1, 2018: Expert Review of Hematology
James M Weinberger, Justin Houman, Ashley T Caron, Devin N Patel, Avi S Baskin, A Lenore Ackerman, Karyn S Eilber, Jennifer T Anger
OBJECTIVE: To quantify the placebo effect of various pharmacologic modalities including neuromodulators, hormonal agents, and onabotulinum toxin A for female sexual dysfunction. DATA SOURCES: Using Meta-analyses Of Observational Studies in Epidemiology guidelines, we conducted a systematic review of PubMed, EMBASE,, and the Cochrane Review databases. METHODS OF STUDY SELECTION: Eleven search terms, "female sexual dysfunction" "treatment" in combination with "hypoactive sexual desire," "arousal disorder," "sexual pain disorder," "genitourinary syndrome of menopause," "orgasmic disorder," "vulvovaginal atrophy," "vaginismus," "vaginal atrophy," "vulvodynia," and "vestibulitis," were used...
August 2018: Obstetrics and Gynecology
Patti E Gravitt, Rebecca Landy, Mark Schiffman
Current US guidelines recommend against cervical screening beyond age 65 in women who have had adequate negative screening. In anticipation of the next round of evidence review and guideline updates, we provide a critical review of the evidence supporting the exiting recommendation in the US, highlighting both practice changes and new insights into the epidemiology and natural history of HPV and cervical cancer. Current recommendations are based, by necessity, on cytology alone, and will be limited in generalizability to evolving screening strategies with co-testing and primary HPV testing...
July 5, 2018: Preventive Medicine
Hiroya Okano, Tsuyoshi Higuchi, Takumi Kurabayashi, Kazuya Makita, Hideki Mizunuma, Yoshiko Mochizuki, Satoshi Obayashi, Toshiyuki Yasui, Kiyoshi Takamatsu
Hormone replacement therapy (HRT) plays a large part in maintaining and improving the quality of life (QOL) of postmenopausal women. Despite this obvious role, the use of HRT has stagnated in Japan as well as the United States, since the interim report of the HRT trial of Women's Health Initiative study was published in 2002. The Japan Society of Obstetrics and Gynecology and Japan Society for Menopause and Women's Health formulated the Guidelines for Hormone Replacement Therapy in 2009, which was subsequently revised in 2012, with the aim of organizing perceptions about HRT and allowing people to provide or receive HRT with a sense of security...
June 29, 2018: Journal of Obstetrics and Gynaecology Research
Danielle C Bentley, Scott G Thomas
PURPOSE: Growing evidence supports handgrip exercise training for reducing resting blood pressure (BP), with inconsistent exercise protocols reported throughout the literature. To verify safety of such protocols, real-time cardiovascular responses must be assessed. Consequently, this research sought to evaluate the acute impact of dissimilar handgrip protocols on the cardiovascular responses of BP, heart rate (HR), and forearm blood flow. METHODS: Using a randomized intraindividual crossover design, 20 post-menopausal women completed 2 distinct handgrip protocols compared with a nonexercise control: 4 × 2-min sustained grips at 30% moderate intensity with 1-min rest between sets (ZONA), and 32 × 5-sec intermittent grips at maximal intensity with 5-sec rest between sets (MINT)...
June 26, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
Marianne Holm, Anja Olsen, Cecilie Kyrø, Kim Overvad, Niels Kroman, Anne Tjønneland
The past decades have seen contradictory research results on the health benefits and risks of menopausal hormone therapy (HT). In particular, long-term associations with overall cancer incidence and the potential interplay with other lifestyle factors remain undetermined. In a population-based prospective cohort, 29,152 women aged 50-64 years at entry (1993-1997) were followed through 2013 for incidence of cancer (99% complete follow-up). Cox' proportional hazards models were used to estimate cancer incidence according to baseline HT alone and in combination with lifestyle factors including alcohol intake, BMI, physical activity, diet, and smoking...
August 2018: Hormones & Cancer
Maria Lorenza Muiesan, Anna Paini, Carlo Aggiusti, Fabio Bertacchini, Claudia Agabiti Rosei, Massimo Salvetti
An adequate cardiovascular (CV) prevention strategy in women should consider the acknowledgement of sex-specific risk factors, such as hypertension in pregnancy, the concomitant presence of autoimmune diseases and the benefit of evaluating subclinical organ damage and treating hypertension. In accordance to current guidelines, the diagnostic approach does not differ between men and women, although the cardiac response to pressure overload may suggest greater sensitivity in women, and may vary according to age, ethnic background and obesity, that potentiates the effect of hypertension on left ventricular (LV) hypertrophy...
June 26, 2018: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
Ariana L Smith, Jason Brown, Jean F Wyman, Amanda Berry, Diane K Newman, Ann E Stapleton
PURPOSE: Recurrent lower urinary tract infections (rUTI) in women are a highly prevalent and burdensome condition for which best practice guidelines for treatment and prevention that minimize harm and optimize well-being are greatly needed. To inform development of practice recommendations, a rapid literature review of original research, systematic reviews, meta-analyses and practice guidelines was conducted. MATERIALS AND METHODS: PubMed, EMBASE, Opus, Scopus, Google Scholar, The Cochrane Library, and the U...
June 22, 2018: Journal of Urology
Xing Pang, Lugang Yu, Hui Zhou, Ting Lei, Guochong Chen, Liqiang Qin
OBJECTIVE: To explore the relationship between abdominal obesity and dyslipidemia in postmenopausal women. METHODS: Based on the project of 2014 community comprehensive intervention for prevention of chronic diseases in Suzhou Industrial Park, 2 000 residents in a community were randomly selected. Among them, a total of 323 women with natural menopause for more than 12 months were observed. Height, body weight, waist circumference, blood pressure, and plasma levels of triglycerides( TG) level, total cholesterol( TC) level, high-density lipoprotein cholesterol( HDL-C) level and low-density lipoprotein cholesterol( LDL-C) were measured...
September 2017: Wei Sheng Yan Jiu, Journal of Hygiene Research
Chloe Grace Meyer, Shayef Gabasha, Ravi Gurujal, Thomas Paul Vacek
Takotsubo cardiomyopathy is characterized by transient loss of systolic function in the absence of coronary artery disease. It is significantly more common in post-menopausal women and is typically brought on by intense emotional stress. Pathophysiology is not completely elucidated, but it appears to be related, in part, to excess catecholamine; this results in coronary artery vasospasm, ischemia and eventual ventricular dysfunction. Patient presentation can vary widely, but typically presents similar to acute coronary syndrome...
May 2018: Oxford Medical Case Reports
Cynthia A Stuenkel
Vasomotor symptoms are the most common manifestation of the menopause transition and postmenopausal phases of reproductive life. They interfere not only in quality of life, but also contribute to sleep and mood disturbances that potentially compromise home and work effectiveness. Treatment options include hormone therapy (HT), nonhormonal prescription drugs, mind body and behavior therapies, and over-the-counter preparations. Evidence confirms that HT is the most effective option. The initial reticence to prescribe HT immediately following publication of the Women's Health Initiative has been replaced by clear guidelines for confidently identifying women for whom this therapy will be safe...
September 2018: Clinical Obstetrics and Gynecology
Tauqeer Hussain Mallhi, Yusra Habib Khan, Amer Hayat Khan, Qaisar Mahmood, Syed Haroon Khalid, Mohammad Saleem
Hot flushes during menopause are distressing for women and result in poor quality of life. Purpose of the current review was to evaluate the available treatment modalities that should be utilised for the management of hot flushes. Menopause refers to last menses of women life and can be declared after amenorrhea of 12 months. Vasomotor symptoms including hot flushes and night sweats are common after menopause, affecting almost 50 - 85% women older than 45 years. The mean increment in core body and skin temperature is 0...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Jeroen K de Vries, Jan W Balder, Michelle J Pena, Petra Denig, Andries J Smit
BACKGROUND AND AIMS: Non-LDL dyslipidemia (NLD) confers cardiovascular risk, and prevalence rates appear to be high in elderly populations. Small cohorts have identified several lifestyle, anthropometric, and medical factors associated with NLD. We aimed to assess sex- and age-specific prevalence of NLD in a contemporary population cohort (n = 167 729), and to identify independent determinants of NLD, focusing on lifestyle, anthropometric, and medical factors. METHODS: The prevalence of NLD was assessed per 10-year age intervals in adults without cardiovascular disease not using lipid-modifying drugs from the Dutch LifeLines cohort...
July 2018: Atherosclerosis
Debra Holloway
Menopause is a complex time in a woman's life. It is an increasingly a midlife event, when health care professionals should be aiming to optimize a woman's health for the next 30 years or so. Nurses need to be able to give up-to-date information and evidence for all forms of treatment based on a background of complex and ever-changing research. This article covers the main presenting complaints and treatments, from lifestyle to hormone replacement therapy, by drawing on guidelines from national bodies.
June 2018: Nursing Clinics of North America
Masumeh Ghazanfarpour, Talat Khadivzadeh, Robab Latifnejad Roudsari
Objectives: The goal of this study was to explore perceptions and experiences of general practitioners and midwives during sexual dialogue with menopausal women. Methods: In a descriptive exploratory qualitative study, 13 midwives and 12 general practitioners were selected using a semi-structured interview and purposive sampling method. Data analysis was conducted using qualitative content analysis adopted by Graneheim and Lundman. Results: Through data analysis "sexual disharmony" emerged as a central theme, which included three categories of reasons, strategies, and ramifications of sexual disharmony...
April 2018: Journal of Menopausal Medicine
Chrisandra Shufelt, Joann Manson
In the United States, nearly 10 million women are currently in the menopause transition and 2.25 million women are 51 years of age, which is the average age of menopause. Approximately 75% of these women will experience vasomotor symptoms such as hot flashes and night sweats. Menopause hormone therapy (HT) remains the most effective treatment for menopausal symptoms, but the decision to use HT is complex and requires balancing the benefits and risks for the individual patient. The decision also requires clinical judgment and shared decision making with the patient...
September 2018: Clinical Obstetrics and Gynecology
S Pizzato, C Trevisan, P Lucato, G Girotti, M Mazzochin, B M Zanforlini, G Bano, F Piovesan, A Bertocco, F Zoccarato, M Dianin, E Manzato, G Sergi
PURPOSE: Vertebral fractures are associated with persistent pain, disability and mortality. However, around two thirds of women with vertebral fractures are unaware of them. We aimed to analyze which factors could mostly be associated to the presence of vertebral fractures in post-menopausal women, and evaluate the effectiveness of current screening criteria for the detection of vertebral fractures in an outpatient setting. METHODS: We evaluated 1132 post-menopausal women referred to the osteoporosis outpatient clinic of the Geriatrics Department of Padova...
August 2018: Bone
Mathis Grossmann, Sabashini K Ramchand, Frances Milat, Amanda Vincent, Elgene Lim, Mark A Kotowicz, Jill Hicks, Helena Teede
To formulate clinical consensus recommendations on bone health assessment and management of women with oestrogen receptor-positive early breast cancer receiving endocrine therapy, representatives appointed by relevant Australian Medical Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing 5 key questions. Women receiving adjuvant aromatase inhibitors and the subset of premenopausal woman treated with tamoxifen have accelerated bone loss and increased fracture risk...
May 9, 2018: Clinical Endocrinology
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