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Few topics in women's medicine today are as fraught with confusion and controversy as the question of appropriate treatment for menopausal symptoms and the prevention of negative long term health outcomes common to post-menopausal women. Cardiovascular disease (CVD), osteoporosis, and cancer -- the most common causes of death, disability and impaired quality of life for women -- can potentially be prevented or forestalled by dietary, behavioral, and drug interventions. A better understanding of the natural history of the menopause is critical to providing better care. If women and their physicians have a better understanding of predictors of risk, they could make more informed decisions about interventions related to menopausal symptoms, CVD, osteoporosis and gynecologic and breast cancer. Few other recently introduced medical interventions have as great a potential of affecting morbidity and mortality as does hormone replacement therapy (HRT). HRT has produced effect on health risk: some are reduced, some are raised, and some uncertain, and these data are interpreted differently by various scientific, medical and consumer groups.
List of contents
Preface. I: Introduction. 1. Menopause: Epidemiologic Aspects; W.R. Harlan. 2. Coronary Heart Disease in Postmenopausal Women: What we Know and What we Must Learn; N.K. Wenger. II: Introductory Issues. 3. Effects of HRT on Metabolic Risk Factors for Cardiovascular Disease; J.C. Stevenson. 4. Precocious Menopause: a Diagnostic Challenge; R. Rolland. 5. Effect of Ovarian Failure on Target Tissues; G. Samsioe. 6. Epidemiology of Cancer in Women; P. Boyle, T. Evstifeeva, L. Luchini. 7. Breast Cancer Risk in Hormone Replacement Therapy-Treated Women; C. La Vecchia. III: Estrogen Replacement Therapy and Cardiovascular Disease. 8. Benefits of Different Routes of Administration; M.H. Birkhäuser, W. Hänggi. 9. Atherosclerosis and Estrogen Replacement Therapy; J.M. Sullivan. 10. Cardiovascular Protection by Estrogen: a Hemodynamic Mechanism? S. Rozenberg, I. Liebens, J. Vandromme, A. Hotimsky, M. Van Rijsselberge. IV: Prophylactic Oophorectomy: a Debate. 11. Prophylactic Oophorectomy: Risks and Adverse Effects Outweigh Potential Benefits; G. Samsioe. 12. The Arguments in Favor of Prophylactic Oophorectomy at Hysterectomy; J. Studd, R. Sands. V: Behavior and Lifestyle in Perimenopausal Years. 13. Hypophysiotropic Peptides and Aging; D. Cocchi, E.E. Muller. 14. Psychosocial Factors Influencing Experience of the Menopause and Help-Seeking Behavior; M.S. Hunter. VI: Cardiovascular Disease and Hormone Replacement. 15. Lipoprotein(a) Changes in Perimenopausal Years; M. Meschia, F. Bruschi, M. Soma, F. Amicarelli, R. Paoletti, P. Crosignani. 16. Epidemiologic Studies on ERT and Cardioprotection: State of the Art on HRT and Cardiovascular Disease; F. Grodstein, M.J. Stampfer. 17. Vasoactive Effects of Estrogens; P.M. Sarrel. 18. HRT and Correction of Lipoprotein Disorders; C.R. Sirtori, M.R. Soma. 19. Menopause, Thrombosis, and Hormone Replacement Therapy; V.V. Kakkar. VIII: Menopause Management: Extensive Clinical Experience and Benefits of Natural Conjugated Estrogens. 20. Effects of Conjugated Estrogen Therapy: Medrogestone and Lipidic Metabolism; M.H. Birkhäuser, W. Hänggi. 21. Ovarian Hormones and Arterial Function; P.M. Sarrel. 22. Hormone Replacement Therapy and Gynecologic Cancers; P. Sismondi, N. Biglia, E. De Fabiani, L. Sgro, A. Sandri, C. Campagnoli. VIII: Hormone Replacement Therapy: Improved Quality of Life. 23. From Contraception to Menopause; R.J.E. Kirkman. 24. Choice of a Preparate in HRT. Clinical Aspects with Estradiol Valerate/Cyproterone Acetate; M. Oliveira da Silva. 25. Estrogens Modulation of Neuroendocrine Functions in Postmenopause; A.D. Genazzani, M. Gastaldi, A. Gallinelli, E. Esposito, F. Petraglia, A.R. Genazzani. IX: Prevention and Therapy (CNS, Connective Tissues, and Osteoporosis). 26. Estrogens and Depression in Women; J. Studd. 27. Estrogen Deficiency and Connective Tissues; M. Brincat, Y. Muscat Baron, R. Galea, A. Buhagiar. 28. Urinary Dysfunction and the Climacteric; C. Kelleher, L. Cardozo. Index.
Summary
This text focuses on the treatment for menopausal symptoms and the prevention of negative long-term health outcomes common to post-menopausal women. Cardiovascular disease, osteoporosis and cancer can potentially be prevented or forestalled by dietary, behavioural and drug interventions.
