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Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society Menopause: The Journal of The North American Menopause Society Vol. 20, No. 9, pp. 888/902 DOI: 10.1097/gme.0b013e3182a122c2 * 2013 by The North American Menopause Society POSITION STATEMENT Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society Abstract Objective: To update and expand the previous position statement (...) of The North American Menopause Society (NAMS) on the management of symptomatic vulvovaginal atrophy (VVA) in postmenopausal women. Methods:NAMSsearchedPubMedformedicalliteratureonVVApublishedsincetheir2007positionstatement on the role of local vaginal estrogen for treatment of vaginal atrophy in postmenopausal women. A panel of ac- knowledged experts in the field of genitourinary health reviewed the literature to evaluate new evidence on local estrogen as well as on other management options available
Efficacy of Cognitive Behavioral Therapy and Physical Exercise in Alleviating Treatment-Induced Menopausal Symptoms in Patients With Breast Cancer: Results of a Randomized, Controlled, Multicenter Trial The purpose of our study was to evaluate the effect of cognitive behavioral therapy (CBT), physical exercise (PE), and of these two interventions combined (CBT/PE) on menopausal symptoms (primary outcome), body image, sexual functioning, psychological well-being, and health-related quality (...) of life (secondary outcomes) in patients with breast cancer experiencing treatment-induced menopause.Patients with breast cancer reporting treatment-induced menopausal symptoms (N=422) were randomly assigned to CBT (n=109), PE (n=104), CBT/PE (n=106), or to a waiting list control group (n=103). Self-report questionnaires were completed at baseline, 12 weeks, and 6 months. Multilevel procedures were used to compare the intervention groups with the control group over time.Compared with the control group
Menopausal Hormone Therapy for the Primary Prevention of Chronic Conditions: U.S. Preventive Services Task Force Recommendation Statement. Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation statement on hormone therapy for the prevention of chronic conditions in postmenopausal women.The USPSTF commissioned a review of the literature to update evidence about the benefits and harms of using menopausal hormone therapy to prevent chronic conditions, as well as whether (...) the benefits and harms of hormone therapy differ by population subgroups defined by age; the presence of comorbid medical conditions; and the type, dose, and method of hormonal delivery.This recommendation applies to postmenopausal women who are considering hormone therapy for the primary prevention of chronic medical conditions. It does not apply to women who are considering hormone therapy for the management of menopausal symptoms, such as hot flashes or vaginal dryness. It also does not apply to women
Paced Respiration for Vasomotor and Other Menopausal Symptoms: A Randomized, Controlled Trial Paced respiration has been internationally recommended for vasomotor symptom management, despite limited empirical evidence.To evaluate efficacy of a paced respiration intervention against breathing control and usual care control for vasomotor and other menopausal symptoms.A 16-week, 3-group, partially blinded, controlled trial with 2:2:1 randomization and stratification by group (breast cancer (...) , no cancer), in a Midwestern city and surrounding area.Two hundred and eighteen randomized women (96 breast cancer survivors, 122 menopausal women without cancer), recruited through community mailings and registries (29 % minority).Training, home practice support, and instructions to use the breathing at the time of each hot flash were delivered via compact disc with printed booklet (paced respiration intervention) or digital videodisc with printed booklet (fast shallow breathing control). Usual care
Menopausal hormone therapy for the primary prevention of chronic conditions: a systematic review to update the U.S. preventive services taskforce recommendations Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial Hot flushes and night sweats (HFNS) affect 65-85% of women after breast cancer treatment; they are distressing, causing sleep problems and decreased quality of life. Hormone replacement therapy is often either undesirable or contraindicated. Safe, effective non-hormonal treatments are needed. We investigated whether cognitive behavioural therapy (CBT) can
Cost effectiveness of denosumab compared with oral bisphosphonates in the treatment of post-menopausal osteoporotic women in Belgium Cost effectiveness of denosumab compared with oral bisphosphonates in the treatment of post-menopausal osteoporotic women in Belgium Cost effectiveness of denosumab compared with oral bisphosphonates in the treatment of post-menopausal osteoporotic women in Belgium Hiligsmann M, Reginster JY Record Status This is a critical abstract of an economic evaluation (...) . Bibliographic details Hiligsmann M, Reginster JY. Cost effectiveness of denosumab compared with oral bisphosphonates in the treatment of post-menopausal osteoporotic women in Belgium. PharmacoEconomics 2011; 29(10): 895-911 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Aged; Aged, 80 and over; Antibodies, Monoclonal /economics /therapeutic use; Antibodies, Monoclonal, Humanized; Belgium; Bone Density Conservation Agents /economics /therapeutic use; Cost-Benefit
Health symptoms during midlife in relation to menopausal transition: British prospective cohort study. To characterise symptoms experienced by women during the transition into natural menopause, to classify women into distinct symptom profiles or trajectories, and to relate these profiles to sociodemographic factors and health behaviours.Nationally representative cohort study.England, Scotland, and Wales.695 women followed-up since birth in 1946 and annually from age 47 to 54 who experienced (...) natural menopause and reported on 20 common health symptoms.Longitudinal profiles for reported bothersome symptoms.Of 20 individual symptoms, 18 formed into four stable symptom groups: psychological, somatic, vasomotor, and sexual discomfort. Using latent class analyses, all except the somatic group of symptoms showed a clear relation with the timing of menopause for some women. A small proportion of women (10%, n=63) had a severe psychological symptom profile that peaked at or in the year after
Post-menopausal Hormone Treatment Update (DOPS, KEEPS) Post Post- -menopausal Hormonal Tx menopausal Hormonal Tx Is the pendulum swinging again? Is the pendulum swinging again? ? ? Pre Pre- -2002 2002 Nurses Health Study (observational) Nurses Health Study (observational) – – Hormones widely recommended for post Hormones widely recommended for post- -menopausal (PM) menopausal (PM) women; lots of potential benefit including women; lots of potential benefit including p p heart disease heart (...) ) ) – – PM hormones aren PM hormones aren’ ’t so bad after all, if used soon after t so bad after all, if used soon after menopausal onset, in younger women, for short time. In fact menopausal onset, in younger women, for short time. In fact one underpowered study says they may even be good. one underpowered study says they may even be good. Another, underpowered study suggests safety may be related Another, underpowered study suggests safety may be related to formulation used. Some reassured; others
Compounded bioidentical menopausal hormone therapy: a committee opinion Compounded bioidentical menopausal hormone therapy American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and American Society for Reproductive Medicine Practice Committee AmericanCollegeofObstetriciansandGynecologists, Washington, DC; andAmericanSocietyforReproductiveMedicine, Birmingham, Alabama Although improvement in long-term health is no longer an indication for menopausal hormone (...) marketingandmediapromotionofcompoundedbioidenticalhormonalpreparationsassafeandeffectivealternativestoconventional menopausal hormone therapy, have led to a recent increase in the popularity of compounded bioidentical hormones as well as an in- creaseinquestionsabouttheuseofthesepreparations.Notonlyisevidencelackingtosupportsuperiorityclaimsofcompoundedbio- identical hormones over conventional menopausal hormone therapy, but these claims also pose the additional risks ofvariable purity and potency and lack ef?cacy and safety data. The Committee on Gynecologic Practice of the American College
The 2012 Hormone Therapy Position Statement of The North American Menopause Society Menopause: The Journal of The North American Menopause Society Vol. 19, No. 3, pp. 257/271 DOI: 10.1097/gme.0b013e31824b970a * 2012 by The North American Menopause Society POSITION STATEMENT The 2012 Hormone Therapy Position Statement of The North American Menopause Society Abstract Objective: This position statement aimed to update the evidence-based position statement published by The North American Menopause (...) Society (NAMS) in 2010 regarding recommendations for hormone therapy (HT) for postmenopausal women. This updated position statement further distinguishes the emerging differences in the therapeutic benefit-risk ratio between estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) at various ages and time intervals since menopause onset. Methods: An Advisory Panel of expert clinicians and researchers in the field of women’s health was enlisted to review the 2010 NAMS position statement
Compounded Bioidentical Menopausal Hormone Therapy Compounded Bioidentical Menopausal Hormone Therapy - ACOG Menu ▼ Compounded Bioidentical Menopausal Hormone Therapy Page Navigation ▼ Number 532, August 2012 (Replaces No. 387, November 2007 and No. 322, November 2005) (Reaffirmed 2018) Committee on Gynecologic Practice and the American Society for Reproductive Medicine Practice Committee This document reflects emerging clinical and scientific advances as of the date issued and is subject (...) to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Compounded Bioidentical Menopausal Hormone Therapy ABSTRACT: Although improvement in long-term health is no longer an indication for menopausal hormone therapy, evidence supporting fewer adverse events in younger women, combined with its high overall effectiveness, has reinforced its usefulness for short-term treatment of menopausal symptoms. Menopausal therapy has been provided
Menopausal hormone therapy for the primary prevention of chronic conditions: systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force Recommendations Menopausal hormone therapy for the primary prevention of chronic conditions: systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force Recommendations. Menopausal hormone therapy for the primary prevention of chronic conditions: systematic review to update the 2002 and 2005 U.S. Preventive Services (...) Task Force Recommendations. Nelson HD, Walker M, Zakher B, Mitchell J Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Nelson HD, Walker M, Zakher B, Mitchell J. Menopausal hormone therapy for the primary prevention of chronic conditions: systematic review to update the 2002 and 2005 U.S. Preventive Services Task Force Recommendations
Cost effectiveness of secondary vs tertiary prevention for post-menopausal osteoporosis Cost effectiveness of secondary vs tertiary prevention for post-menopausal osteoporosis Cost effectiveness of secondary vs tertiary prevention for post-menopausal osteoporosis Mueller D, Gandjour A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed (...) by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the cost-effectiveness and budget impact of secondary plus tertiary prevention of osteoporosis by identifying post-menopausal women who were at increased risk of fractures, compared with tertiary prevention alone. The authors concluded that both prevention strategies were cost-effective compared with no prevention. Secondary plus tertiary prevention was more effective and more
Ageing, menopause, and ischaemic heart disease mortality in England, Wales, and the United States: modelling study of national mortality data. To use changes in heart disease mortality rates with age to investigate the plausibility of attributing women's lower heart disease mortality than men to the protective effects of premenopausal sex hormones.Modelling study of longitudinal mortality data with models assuming (i) a linear association between mortality rates and age (absolute mortality (...) data.Proportional age related changes in ischaemic heart disease mortality, suggesting a loss of reparative reserve, fit longitudinal mortality data from England, Wales, and the United States better than absolute age related changes in mortality. Acceleration in male heart disease mortality at younger ages could explain sex differences rather than any menopausal changes in women.
Abnormal vaginal bleeding in pre-, peri- and post-menopausal women. A diagnostic guide for general practitioners and gynaecologists GP refer to GynaecoloGist refer to GynaecoloGical oncoloGist History (including menstruation—any changes, irregularities), physical examination (including speculum and pelvic examination) and identify risk factors Exclude pregnancy Exclude cervical pathology: pap smear and screen for chlamydia. Colposcopy recommended for post coital bleeding Full blood count (...) includes the endometrial thickness. The GP should also indicate on the request form the menopausal status of the patient (eg. pre, peri or post). Endometrial Biopsy • Invasive procedures should be undertaken (when possible) by the relevant specialist (gynaecologist, gynaecological oncologist). • If insufficient material is obtained for a histological diagnosis, no further investigation is required in the absence of ongoing bleeding unless the woman has an endometrial thickness over 12mm for pre
Bishosphonates for Fracture Prevention in Post-Menopausal Women Without Prior Fractures Bisphosphonates for Fracture Prevention in Post-Menopausal Women Without Prior Fractures – TheNNTTheNNT Bisphosphonates for Fracture Prevention in Post-Menopausal Women Without Prior Fractures No benefit found In Summary, for those who took the bisphosphonates: Benefits in NNT 100% saw no benefit after 3 years of treatment None were helped (fracture prevented after 3 years of medicine) Harms in NNT A small