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Menopause guidelines

Tanya J Major, Ruth K Topless, Nicola Dalbeth, Tony R Merriman
OBJECTIVE: To systematically test dietary components for association with serum urate levels and to evaluate the relative contributions of estimates of diet pattern and inherited genetic variants to population variance in serum urate levels. DESIGN: Meta-analysis of cross sectional data from the United States. DATA SOURCES: Five cohort studies. REVIEW METHODS: 16 760 individuals of European ancestry (8414 men and 8346 women) from the US were included in analyses...
October 10, 2018: BMJ: British Medical Journal
M M Uygur, T Yoldemir, D G Yavuz
The interpretation of thyroid function tests should be cautiously made during the perimenopause and postmenopause period bearing in mind that physiologic changes do exist in this group of women in terms of secretion and metabolism of thyrotropin and thyroid hormones. Moreover the incidence of thyroid disorders increases in postmenopausal and elderly women. There is no consensus for screening postmenopausal women even though there is well-known evidence about the effect of thyroid status on cognitive function, cardiovascular risk, bone turnover, and longevity...
October 8, 2018: Climacteric: the Journal of the International Menopause Society
A Doren, A Vecchiola, B Aguirre, P Villaseca
Women carriers of mutations in the genes BRCA1 and BRCA2 coding for tumor suppressor proteins are at high risk of developing breast and ovarian cancers. Hereditary breast and ovarian cancers due to BRCA pathogenic mutations occur at earlier ages: mean age 43 years at diagnosis of breast cancer for BRCA1 mutations; onset of ovarian cancer up to 10-21% by age 50 years. Preventive strategies are then defined in the reproductive years. The National Comprehensive Cancer Network (NCCN) guidelines define that BRCA1/2 genetic testing should begin with the affected cancer individual (BRCA1/2 full sequencing); then, family members should be tested for the specific gene mutation found...
October 8, 2018: Climacteric: the Journal of the International Menopause Society
Georges El Hasbani, Alaa Balaghi, Kamal Tarabine, Richard Assaker, Michel Samaha, Hadi Ghanem, Noha Bejjani, Bassel Abouzeid
Background: Gestational trophoblastic neoplasms (GTNs) encompass a wide spectrum of diseases, of which choriocarcinoma is one of the most common. Choriocarcinoma occurs mainly in relation to pregnancy and rarely after the menopause. It has the potential to metastasize to organs other than the uterus. Case Report: We describe a 62-year-old woman who presented with postmenopausal bleeding 11 years after the menopause. Pelvic ultrasound and abdominal/pelvic computerized tomography showed an intrauterine mass...
October 2018: Case Reports in Women's Health
Hyejin Hwang, Youn-Jee Chung, Sa Ra Lee, Hyun-Tae Park, Jae-Yen Song, Hoon Kim, Dong-Yun Lee, Eun-Ju Lee, Mee-Ran Kim, Sung-Tack Oh
Endometriosis is one of the most common diseases in reproductive ages, and it affects patients' quality of life and fertility. However, few Korean guidelines are available for the evaluation and management of endometriosis. Korean Society of Endometriosis reviewed various literatures and trials, and to provide seventy-one evidence-based recommendations. This review presents guidelines for the diagnosis and management of endometriosis with emphasis on: it's role in infertility, treatment of recurrence, asymptomatic women, endometriosis in adolescents and menopausal women, and possible association of endometriosis with cancer...
September 2018: Obstetrics & Gynecology Science
Michael H Chiu, Bobak Heydari, Zarah Batulan, Nadia Maarouf, Vinita Subramanya, Karin Schenck-Gustafsson, Edward R O'Brien
The recognition of sex differences in cardiovascular disease, particularly the manifestations of coronary artery disease (CAD) in post-menopausal women, has introduced new challenges in not only understanding disease mechanisms but also identifying appropriate clinical means of assessing the efficacy of management strategies. For example, the majority of treatment algorithms for CAD are derived from the study of males, focus on epicardial stenoses, and inadequately account for the small intramyocardial vessel disease in women...
September 14, 2018: Clinical Science (1979-)
Pauline M Maki, Susan G Kornstein, Hadine Joffe, Joyce T Bromberger, Ellen W Freeman, Geena Athappilly, William V Bobo, Leah H Rubin, Hristina K Koleva, Lee S Cohen, Claudio N Soares
There is a new appreciation of the perimenopause-defined as the early and late menopause transition stages as well as the early postmenopause-as a window of vulnerability for the development of both depressive symptoms and major depressive episodes. However, clinical recommendations on how to identify, characterize and treat clinical depression are lacking. To address this gap, an expert panel was convened to systematically review the published literature and develop guidelines on the evaluation and management of perimenopausal depression...
September 5, 2018: Journal of Women's Health
Pauline M Maki, Susan G Kornstein, Hadine Joffe, Joyce T Bromberger, Ellen W Freeman, Geena Athappilly, William V Bobo, Leah H Rubin, Hristina K Koleva, Lee S Cohen, Claudio N Soares
There is a new appreciation of the perimenopause - defined as the early and late menopause transition stages as well as the early postmenopause - as a window of vulnerability for the development of both depressive symptoms and major depressive episodes. However, clinical recommendations on how to identify, characterize and treat clinical depression are lacking. To address this gap, an expert panel was convened to systematically review the published literature and develop guidelines on the evaluation and management of perimenopausal depression...
October 2018: Menopause: the Journal of the North American Menopause Society
Xiangyan Ruan
In order to promote the standard application of ovarian tissue cryopreservation in China, and to provide effective scientific medical services of fertility preservation for patients, the First Chinese Guideline of Ovarian Tissue Cryopreservation and Transplantation is established according to the agreements between gynecologists, embryologists, oncologists, pediatricians, breast oncologists, hematologists, and experts on Traditional Chinese Medicine (TCM), based on already successful treated cases within Beijing Obstetrics and Gynecology Hospital, Capital Medical University, China, and based on already existing international guidelines on fertility preservation including important publications in this field...
August 21, 2018: Gynecological Endocrinology
Simona Ferraro, Cristina Robbiano, Nicoletta Tosca, Andrea Panzeri, Anna Maria Paganoni, Mauro Panteghini
BACKGROUND: The addition of human epididymis protein 4 (HE4) to carbohydrate antigen 125 (CA125) in ovarian cancer (OC) assessment has been proposed. We compared the clinical value of biomarker changes in a prospective series of patients undergoing OC monitoring. METHODS: We studied 43 patients (79% post-menopausal), followed for 3.5 ± 3.1 years. Serous OC was prevalent (53.5%), with 81.4% of patients diagnosed at late stages. Both cut-offs and reference change values (RCV) were used for assessing significant marker changes...
September 2018: Clinical Biochemistry
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 M Ribeiro Cavalari, Marcela P de Paula, Mariana Arruda, Nathália Carraro, Arthur Martins, Kamila de Souza, Maria C Coelho, Nathalie Anne de Oliveira E Silva de Morais, Aline B Moraes, Leonardo Vieira Neto
CONTEXT: Although metabolic syndrome has been studied in patients with autonomous cortisol secretion, 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...
November 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...
September 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...
September 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...
August 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...
September 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 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
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