Menopause

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Menopause

Daily Treatment Report

Cognitive Therapy-CBT-Psychotherapy

Device Therapy

Drug Side-Effects and Interactions

Androgen therapy for loss of desire in women: is the benefit worth the breast cancer risk? (Fertil Steril. 2007) "RESULT(S): Endogenous androgen levels are not correlated with sexual desire in population-based studies of aging women. Factors that are strongly associated with low desire include pain with sexual activity, emotional distress, life stress, and relationship conflict. The efficacy of testosterone therapy for women's desire problems is modest. Expectancy effects were not adequately controlled in randomized trials. Epidemiological findings agree that higher endogenous serum androgen levels confer increased breast cancer risk both before and after menopause. Androgenic hormonal replacement regimens also increase the risk of breast cancer. CONCLUSION(S): Testosterone supplementation should not be prescribed to women with low sexual desire unless long-term studies can demonstrate its efficacy and safety. Treatments for low sexual desire in women should address its common correlates: relationship distress, emotional distress, and dyspareunia."

[Postmenopausal hormone therapy and vascular risk.] (Rev Neurol (Paris). 2007)

Individualizing the risks and benefits of postmenopausal hormone therapy. (Menopause. 2007)

For a Low-Dose Hormone, Take Your Pick "The current recommendation for troubling menopausal symptoms is to take the lowest hormone dose needed for relief for the shortest possible time. But doctors acknowledge the lack of proof that lower doses are safer."

The Impact of Hormone Replacement Therapy on the Pathophysiology of Peripheral Arterial Disease. (Eur J Vasc Endovasc Surg. 2007)

Does menopausal HRT increase the risk of ovarian cancer?

HRT: a reappraisal of the risks and benefits. (Med J Aust. 2007)

Certain Painkillers May Negate Heart Benefits of HRT "Women who were taking hormone replacement therapy had a 22 percent lower chance of having a heart attack compared with women who were not using hormones. But women who were taking traditional NSAIDs such as ibuprofen (Motrin, Advil and others), naproxen (Aleve, Naprosyn and others) and diclofenac while they were taking hormones had a higher risk of heart attack. "

Safety of testosterone treatment in postmenopausal women. (Fertil Steril. 2007)

Incidences of breast cancer throughout long-term hormone replacement therapy. (J Steroid Biochem Mol Biol. 2007)

Hormone Replacement Therapy Linked to Ovarian Cancer "The Million Women Study, a trial in the United Kingdom of postmenopausal women, has found that those receiving hormone replacement therapy (HRT) were, on average, 20% more likely to develop and die from ovarian cancer than women who never received therapy."

Breast Cancer Drop Tied To Less Hormone Use "New federal statistics provide powerful evidence that the sharp drop in hormone use by menopausal women that began in 2002 caused a dramatic decline in breast cancer cases, according to an analysis being published today. The statistics show that the number of breast cancer cases being diagnosed began falling abruptly after concerns emerged about the safety of hormone treatment and that the decrease persisted into the following year, strengthening the case that the trends are related, researchers said. … Some researchers, however, questioned the findings, saying the drop in breast cancer occurred too soon to have been caused by the decline in hormone use."

Excess ovarian cancer deaths blamed on HRT use

Breast response to menopausal hormone therapy--aspects on proliferation, apoptosis and mammographic density. (Ann Med. 2007)

Effect of Hormone Therapy on Risk of Heart Disease May Vary by Age and Years Since Menopause,

Postmenopausal Hormone Therapy and Risk of Cardiovascular Disease by Age and Years Since Menopause (JAMA. 2007) "Conclusions Women who initiated hormone therapy closer to menopause tended to have reduced CHD risk compared with the increase in CHD risk among women more distant from menopause, but this trend test did not meet our criterion for statistical significance. A similar nonsignificant trend was observed for total mortality but the risk of stroke was elevated regardless of years since menopause. These data should be considered in regard to the short-term treatment of menopausal symptoms."

Hormone replacement therapy and breast cancer in former users of oral contraceptives-The Norwegian Women and Cancer study. (Int J Cancer. 2007) "The increased risk of breast cancer in current HRT users with a history of former OC use could have potential great impact on postmenopausal breast cancer risk as the proportion of postmenopausal women with former OC use will continue to increase."

Age and Menopausal Effects of Hormonal Birth Control and Hormone Replacement Therapy in Relation to Breast Cancer Risk. (Am J Epidemiol. 2007) "These results emphasize that timing of exogenous hormone use is important. Women who used these hormones before menopause had elevated risks, but the harmful effects began to decline with age after menopause."

Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. (Breast Cancer Res Treat. 2007) "These findings suggest that the choice of the progestagen component in combined HRT is of importance regarding breast cancer risk; it could be preferable to use progesterone or dydrogesterone."

The relationship between sex hormones and extent of coronary artery disease in postmenopausal women. (Chin Med J (Engl). 2007) "The results of our study suggest a possible protective role of FSH against the progression of coronary atherosclerosis in postmenopausal women."

Hormone replacement therapy and headache prevalence in postmenopausal women. The Head-HUNT study. (Eur J Neurol. 2007) "Both migraine and non-migrainous headache were more probably amongst users of postmenopausal HRT than amongst those who had never used HRT. Whether HRT caused headache or was used partly because of headache cannot be determined in this cross-sectional study."

Drugs

Gabapentin for the treatment of menopausal hot flashes: a randomized controlled trial. (Menopause. 2007)

Postmenopausal hormones and coronary artery disease: potential benefits and risks. (Climacteric. 2007)

Menopause and stroke and the effects of hormonal therapy. (Climacteric. 2007)

Missed symptoms of menopause. (Int J Clin Pract. 2007) "Objective: This review examines the available data on the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) for treating the commonly missed climacteric symptoms of menopause."

A prospective, randomized, double-blind, placebo-controlled study on the influence of a hormone replacement therapy on skin aging in postmenopausal women. (Climacteric. 2007)

Estrogen-Only Hormone Replacement Therapy May Lower Coronary Artery Disease "A new analysis of the Women's Health Initiative (WHI) trial has found that younger postmenopausal women treated with estrogen-only hormone replacement therapy (HRT) had significantly less coronary artery calcification than their counterparts taking placebo."

Effects of hormone replacement therapy and aging on cognition: evidence for executive dysfunction. (Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2007)

Postmenopausal hormone therapy in clinical perspective. (Menopause. 2007)

Historical perspectives in postmenopausal hormone therapy: defining the right dose and duration. (Mayo Clin Proc. 2007)

Consumer Reports Best Buy Drugs: Relieving the Symptoms of Menopause

Exercise

Exercise for vasomotor menopausal symptoms. (Cochrane Database Syst Rev. 2007)

Exercise in the menopause - an update. (Climacteric. 2007)

Physical Activity And Risk of Hot Flashes among Women in Midlife. (J Womens Health (Larchmt). 2007)

Long-term four-year exercise has a positive effect on menopausal risk factors: the erlangen fitness osteoporosis prevention study. (J Strength Cond Res. 2007) "Thus, the study demonstrated that multipurpose high-intensity exercise programs significantly affect relevant menopausal risk factors and, therefore, may be individually considered as an alternative to hormone replacement therapy."

General Information

Recent epidemiological evidence relevant to the clinical management of the menopause. (Climacteric. 2007)

Hormone replacement therapy comes full circle. "So postmenopausal hormone therapy has come full circle.9 It was originally used to treat menopausal symptoms, and now the indications for use are again hot flushes, night sweats, and vaginal dryness. It is the best treatment we have at present for these symptoms. Hot flushes and night sweats are mostly self limiting, and current advice recommends short term use with the lowest dose needed for relief of symptoms. Healthy women in early menopause are at a low absolute risk whether they take hormones or not, and they are unlikely to face substantially increased risks when using hormones for a few years.9 Long term use of hormone replacement therapy to prevent chronic disease is no longer recommended, because available randomised evidence shows that the negative outcomes outweigh the positive benefits. Menopausal genitourinary symptoms, however, usually last a long time and require ongoing treatment. Current low dose vaginal oestrogen preparations have minimal systemic absorption, and recent position statements support long term use of these preparations as long as distressing symptoms remain.10"

Estrogen Therapy and Coronary-Artery Calcification (NEJM 2007)

Should Menopausal Women at Increased Risk for Breast Cancer Use Tamoxifen, Raloxifene, or Hormone Therapy?: A Framework for Personalized Risk Assessment and Counseling. (J Cancer Educ. 2007)

Discontinuing Hormone Replacement Therapy Attenuating the Effect on CVD Risk With Lifestyle Changes. (Am J Prev Med. 2007) "CONCLUSIONS: Lifestyle modification was effective for CVD risk factor reduction in post-menopausal women. HRT discontinuation resulted in increased total cholesterol and LDL-C, which were successfully attenuated by a lifestyle intervention incorporating weight loss, physical activity, and dietary modification."

Hearing in women at menopause. Prevalence of hearing loss, audiometric configuration and relation to hormone replacement therapy. (Acta Otolaryngol. 2007)

Updated Statement on Hormone Therapy

Estrogen and progestogen use in peri- and postmenopausal women: March 2007 position statement of The North American Menopause Society.

Guidelines

NGC - Estrogen and progestogen use in peri- and postmenopausal women: March 2007 position statement of The North American Menopause Society. (2007)

New Guidelines Issued for Treatment of Vaginal Atrophy "About 10% to 40% of postmenopausal women have symptoms related to vaginal atrophy, most of whom require treatment. However, only about 25% of symptomatic women seek medical attention. The therapeutic standard for moderate to severe vaginal atrophy is estrogen therapy, administered either vaginally at a low dose or systemically. There has been a relative lack of randomized controlled trials performed to date, but they have shown that low-dose, local vaginal estrogen delivery is effective and well tolerated for treating vaginal atrophy."

NGC - Menopause and hormone therapy (HT): collaborative decision-making and management. (2006)

Immunotherapy

Internet Sites

Treatment Information

DrugBank (drug structure)

FDA - MedWatch (Drug Alerts)

Drug-Food-Supplement Information

Drug Information Online

Drug Interaction Checker

DrugDigest (drug interactions)

FDA - Drug Interactions: What You Should Know

NIH - Botanical Dietary Supplements: Background Information

NIH - Drug, Supplements, and Herbal Information

NIH - Herbal Supplements: Consider Safety, Too

NIH - Medicines

NIH - Vitamin and Mineral Supplement Fact Sheets

Nutrition

Phytoestrogens for vasomotor menopausal symptoms. (Cochrane Database Syst Rev. 2007)

Isoflavone treatment for acute menopausal symptoms. (Menopause. 2007)

Other

Other Treatments

Experimental

Radiotherapy

Supplements-Vitamins-CAM

Summaries for patients. Effects of the phytoestrogen genistein on bone health in postmenopausal women. "The phytoestrogen genistein, when taken with vitamin D3 and calcium, has favorable effects on bone health compared with vitamin D3 and calcium alone."

Black cohosh with or without St. John's wort for symptom-specific climacteric treatment-Results of a large-scale, controlled, observational study. (Maturitas. 2007)

Dehydroepiandrosterone (DHEA) and the menopause: an update. (Menopause Int. 2007) "Overall, we conclude that DHEA is not currently to be recommended for therapeutic use in the majority of postmenopausal women. However, DHEA supplementation may be of benefit in two specific groups of women: those with the lowest circulating levels of DHEA; and those for whom osteoporosis is a particular problem."

Effects of dietary calcium compared with calcium supplements on estrogen metabolism and bone mineral density. (Am J Clin Nutr. 2007) "CONCLUSION: Calcium from dietary sources is associated with a shift in estrogen metabolism toward the active 16alpha-hydroxyl metabolic pathway and with greater BMD and thus may produce more favorable effects in bone health in postmenopausal women than will calcium from supplements."

Black Cohosh and St. John's Wort (GYNO-Plus(R)) for Climacteric Symptoms. (Yonsei Med J. 2007) "Conclusion: Black cohosh and St. John's wort combination was found to be effective in alleviating climacteric symptoms and might provide benefits to lipid metabolism."

Calcium and vitamin D - for whom and when. (Menopause Int. 2007) " … calcium with or without vitamin D therapy can lead to reductions in the rate of bone loss in postmenopausal women of all ages. Furthermore, with certain caveats, calcium with vitamin D therapy in the older postmenopausal woman can lead to useful reductions infracture rates and falls, especially in populations with reduced exposure to sunlight, which is potentially the majority of postmenopausal women in both developed and developing countries."

Surgery

Transplantation

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