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1. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health

Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women’s Sexual Health CONSENSUS RECOMMENDATIONS Managementofgenitourinarysyndromeofmenopauseinwomenwith orathighriskforbreastcancer:consensusrecommendationsfromThe North American Menopause Society and The International Society for the Study of Women’s Sexual Health Stephanie S (...) , CCD, NCMP, IF, FACOG, 14 Shari B. Goldfarb, MD, 15 and Sheryl A. Kingsberg, PhD 16 Abstract TheobjectiveofTheNorthAmericanMenopauseSociety(NAMS)andTheInternationalSocietyfortheStudyof Women’s Sexual Health (ISSWSH) Expert Consensus Panel was to create a point of care algorithm for treating genitourinary syndrome of menopause (GSM) in women with or at high risk for breast cancer. The consensus recommendationswillassisthealthcareprovidersinmanagingGSMwithagoalofimprovingthecareandqualityof life

2019 The North American Menopause Society

2. Tibolone (Tibella) - for short-term treatment of vasomotor symptoms due to estrogen deficiency in postmenopausal women, more than one year after menopause

Tibolone (Tibella) - for short-term treatment of vasomotor symptoms due to estrogen deficiency in postmenopausal women, more than one year after menopause Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) documents provide information related to the original authorization

2020 Health Canada - Drug and Health Product Register

3. Menopause

Menopause Menopause - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Menopause Last reviewed: February 2019 Last updated: February 2019 Summary The diagnosis is clinical, based on the absence of menses for 12 months, and does not require further testing for appropriately presenting patients. Oestrogen therapy is an effective treatment for the management of menopausal symptoms including hot flushes, night sweats (...) , and is unlikely to increase the risk of stroke or venous thrombosis above that of non-users. Non-hormonal interventions may help women who have a contraindication to, or cannot tolerate, HT. However, they are less effective than HT in controlling menopausal symptoms. Definition Onset of the menopause is heralded by the cessation of menses for at least 12 consecutive months, without some other reason for amenorrhoea (such as pregnancy, hormone therapy, or other medical condition). No further testing

2019 BMJ Best Practice

4. Menopause

Menopause Evidence Maps - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4

2018 Trip Evidence Maps

5. British Menopause Society update on HRT supply shortages

British Menopause Society update on HRT supply shortages British Menopause Society further update on HRT supply shortages | British Menopause Society Search for: News 2019-08-23T12:14:14+01:00 23 August 2019 | In response to the ongoing HRT shortages, the British Menopause Society has produced this further update on the current availability of HRT products. This provides guidance to BMS members and clinical practitioners who may be experiencing difficulties with HRT supplies. There continues (...) . Available. Zumenon® 1mg oestradiol and 2mg oestradiol. Shortage of supplies. Elleste Solo™ MX patches 40mcg transdermal oestradiol. Available. Elleste Solo™ MX patches 80mcg transdermal oestradiol. Available. Mylan’s manufacturing partner continues to experience interruptions in the production of certain strengths of Elleste™, their Hormone Replacement Therapy (HRT). They have informed us that they will continue to provide updates on timing for resolution, as they receive them; to the British Menopause

2019 Royal College of Obstetricians and Gynaecologists

6. Non-hormonal-based treatments for menopausal symptoms

Non-hormonal-based treatments for menopausal symptoms Non-hormonal-based treatments for menopausal symptoms | British Menopause Society Search for: Summary consensus statement Non-hormonal-based treatments for menopausal symptoms Non-hormonal-based treatments for menopausal symptoms 2018-04-13T10:06:04+01:00 Summary practice points As clinicians we must be familiar with alternative therapies, to help inform and guide women as to which options are most likely to be beneficial to them. Few (...) complementary and alternative treatment options have proven evidence of effectiveness, but although many options do not stand up to scrutiny from a robust and evidence based perspective there will be individual women who will benefit from some of these treatments. Placebo effect is not inconsiderable and in menopausal studies will play a part in individual experience and reported benefits The full statement, scientific papers, charts, presentations etc are available in the . If you are not a member you can

2020 British Menopause Society

7. Menopause

Menopause Menopause - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Menopause Last reviewed: February 2019 Last updated: February 2019 Summary The diagnosis is clinical, based on the absence of menses for 12 months, and does not require further testing for appropriately presenting patients. Oestrogen therapy is an effective treatment for the management of menopausal symptoms including hot flushes, night sweats (...) , and is unlikely to increase the risk of stroke or venous thrombosis above that of non-users. Non-hormonal interventions may help women who have a contraindication to, or cannot tolerate, HT. However, they are less effective than HT in controlling menopausal symptoms. Definition Onset of the menopause is heralded by the cessation of menses for at least 12 consecutive months, without some other reason for amenorrhoea (such as pregnancy, hormone therapy, or other medical condition). No further testing

2018 BMJ Best Practice

8. What can employers do to support women going through the menopause?

What can employers do to support women going through the menopause? Knowledge & Library Services (KLS) Evidence Briefing What can employers do to support women going through the menopause? Dr Caroline De Brún 19 th August 2019 What can employers do to support women going through the menopause? KLS Evidence Briefing 19 th August 2019 Research question This Evidence Briefing (EB) summarises the evidence on what employers can do to support women going through the menopause, from 1 st January 2009 (...) to 17 th July 2019. Key messages • There are around 4.3 million women in employment in the UK aged 50 years and over, most of whom will experience the menopause and its symptoms. • The limited evidence on the impact of interventions by employers to support women going through the menopause, all make similar recommendations. • Most women will go through the menopause, but the severity of their symptoms will vary. • When identifying suitable interventions, employers should remember that one size does

2018 Public Health England - Evidence Briefings

9. Intravaginal Laser for Genitourinary Syndrome of Menopause and Stress Urinary Incontinence

Intravaginal Laser for Genitourinary Syndrome of Menopause and Stress Urinary Incontinence No. 358-Intravaginal Laser for Genitourinary Syndrome of Menopause and Stress Urinary Incontinence - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 40, Issue 4, Pages 503–511 No. 358-Intravaginal Laser for Genitourinary Syndrome of Menopause and Stress Urinary Incontinence x Jens-Erik Walter , MD Montréal, QC x Annick Larochelle (...) , MD Montréal, QC No. 358, April 2018 DOI: To view the full text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Figures Figure Comparative pre- and post-laser vaginal biopsies. Abstract Objective This technical bulletin reviews the evidence relating to risks and benefits of using intravaginal laser technology in the management of genitourinary syndrome of menopause and stress urinary incontinence. Intended Users Gynaecologists, urogynaecologists, urologists

2018 Society of Obstetricians and Gynaecologists of Canada

10. Abnormal Uterine Bleeding in Pre-Menopausal Women

Abnormal Uterine Bleeding in Pre-Menopausal Women No. 292-Abnormal Uterine Bleeding in Pre-Menopausal Women - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 40, Issue 5, Pages e391–e415 No. 292-Abnormal Uterine Bleeding in Pre-Menopausal Women x Sukhbir Singh , MD Ottawa, ON x Carolyn Best , MD Toronto, ON x Sheila Dunn , MD Toronto, ON x Nicholas Leyland , MD Toronto, ON x Wendy Lynn Wolfman , MD Toronto, ON No 292

2018 Society of Obstetricians and Gynaecologists of Canada

11. Menopause

Menopause Top results for menopause - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 (...) or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for menopause The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence

2018 Trip Latest and Greatest

12. Menopause

Menopause CLINICAL PROFESSIONAL RESOURCE Menopause RCN guidance for nurses, midwives and health visitors Endorsed by This publication is supported by industryMENOPAUSE 2 This publication is due for review in November 2020. To provide feedback on its contents or on your experience of using the publication, please email publications.feedback@rcn.org.uk Acknowledgements This new publication is based on, and replaces, previous RCN publications – Women’s Health and the Menopause: RCN Guidance (...) for Nurses, Midwives and Health Visitors (RCN, 2005 and 2014) and Complementary Approaches to Menopausal Symptoms: RCN Guidance for Nurses, Midwives and Health Visitors (RCN, 2006). The RCN Women’s Health Forum would like to thank the menopause project team for the development of this publication: Debra Holloway (project chair), Nurse Consultant Gynaecology, Guy’s and St Thomas’ NHS Foundation Trust and Chair of the RCN Women’s Health Forum Carmel Bagness, RCN Professional Lead Midwifery and Women’s

2018 Royal College of Nursing

16. Testosterone replacement in menopause

Testosterone replacement in menopause BRITISH MENOPAUSE SOCIETY T ool for clinicians Information for GPs and other health professionals 1 of 4 1 How much and where does it come from? Testosterone is an important female hormone. Healthy young women produce approximately 100 – 400 mcg per day. This represents three to four times the amount of estrogen produced by the ovaries. Approximately half of endogenous testosterone and precursors are derived from the ovaries e.g. androstenedione and half (...) from the adrenal glands e.g. dehydroepiandrosterone. Some of the effects are direct and some due to peripheral conversion to estrogen by aromatase. Testosterone levels naturally decline throughout a woman’s lifespan. Loss of testosterone is particularly profound after iatrogenic i.e. surgical and medical menopause and premature ovarian insufficiency when testosterone production decreases by more than 50%. 2 What is its role in women? Testosterone contributes to libido, sexual arousal and orgasm

2019 British Menopause Society

17. Menopause and the Workplace Guidance: what to consider

Menopause and the Workplace Guidance: what to consider BRITISH MENOPAUSE SOCIETY T ool for clinicians Information for GPs and other health professionals 1 of 3 Menopause and the workplace guidance: what to consider This factsheet provides a ‘how-to’ guide for employers and relevant staff within organisations that are considering writing their own guidance on the menopause. Introduction • In 2019, there are over 4.3million employed women in the UK aged 45-60. 1 • Given the average age (...) of a women’s menopause is 51 years 2 , a significant number of employed women will be working through their menopausal transition. • The experiences of the menopausal transition varies enormously between women. Some women will have no symptoms but most women will experience at least one symptom. 2 Up to a third of women will experience severe menopausal symptoms that can impact on their quality of life. 3,4 • It is the work context that women report greater difficulty in managing symptoms 5,6 and can feel

2019 British Menopause Society

18. Are vaginal estradiol tablets (Vagifem) effective for genitourinary syndrome of menopause?

Are vaginal estradiol tablets (Vagifem) effective for genitourinary syndrome of menopause? Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care (...) research. www.acfp.ca June 10, 2019 Verifying the value of vaginal estradiol tablets Clinical Question: Are vaginal estradiol tablets (Vagifem®) effective for genitourinary syndrome of menopause? Bottom Line: Vaginal estradiol tablets are likely no better than placebo vaginal gel for reducing “most bothersome symptom scores” (mainly dyspareunia). However, compared to placebo vaginal tablets, they reduce symptoms (example: treatment “success” at 12 months in 86% versus 41% placebo). A non-medicated

2019 Tools for Practice

19. HIV and the menopause

HIV and the menopause BRITISH MENOPAUSE SOCIETY T ool for clinicians Information for GPs and other health professionals 1 of 2 HIV and the menopause Introduction Over the past two decades, antiretroviral therapy (ART) has transformed HIV into a long-term condition with normal life expectancy for people stable on treatment. In 2016, 10,350 women living with HIV aged 45-56 (the age when women usually go through the menopause) attended HIV clinics in the UK. This is nearly half of all women (...) attending for HIV care in the UK, and is five times the number in 2006 1 . As the number of women living with HIV reaching their midlife grows, we are beginning to understand the importance of addressing their healthcare needs during the menopause. What is the impact of the menopause on women living with HIV? • The menopause transition can have multi-dimensional impacts on the health and well-being of women living with HIV. • There is conflicting evidence on the association between HIV and earlier age

2018 British Menopause Society

20. The diagnosis of the menopause and management of oestrogen deficiency symptoms and arthralgia in women treated for breast cancer

The diagnosis of the menopause and management of oestrogen deficiency symptoms and arthralgia in women treated for breast cancer The diagnosis of the menopause and management of oestrogen deficiency symptoms and arthralgia in women treated for breast cancer | British Menopause Society Search for: Summary consensus statement The diagnosis of the menopause and management of oestrogen deficiency symptoms and arthralgia in women treated for breast cancer The diagnosis of the menopause and management (...) of oestrogen deficiency symptoms and arthralgia in women treated for breast cancer 2018-12-05T16:45:20+01:00 Key points An early menopause, estrogen deficiency symptoms and arthralgia are common side effects of systemic breast cancer therapies. Symptoms may persist for the duration of treatment and in some cases continue after treatment completion. The NICE Menopause Guidance [NG23] recommends referral of women to a healthcare professional with expertise in gynaecological endocrinology for counselling about

2018 British Menopause Society

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