By Mary Jane Minkin
The declaration of the finishing of the Women's wellbeing and fitness Initiative (WHI) examine through the NIH in July 2002 astounded ladies and future health care execs during the international. placing the WHI info into point of view and featuring instructions for care of girls within the publish WHI period, this booklet specializes in peri- and post-menopausal girls. The authors talk about symptom aid via hormonal and non-hormonal scientific interventions and comprise insurance of complementary and substitute offerings. The ebook serves as a consultant on checking out for submit menopausal illnesses similar to osteoporosis and middle sickness and using hormonal and nonhormonal clinical techniques to conserving optimal put up menopausal well-being.
Read Online or Download Manual of Management Counseling for the Perimenopausal and Menopausal Patient: A Clinician's Guide PDF
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Additional info for Manual of Management Counseling for the Perimenopausal and Menopausal Patient: A Clinician's Guide
Example text
They state that although the ovaries are not making estrogen, they are still (if the operation is performed reasonably soon after the menopause) making substantial amounts of androgens, and that oophorectomy is undesirable because it will remove valuable hormones. Most gynecologic oncologists would disagree, and advocate oophorectomy and testosterone replacement as needed. There is also currently considerable controversy over the health value of replacing estrogens in younger women after oophorectomy.
Another promising new option would be a progestin-containing intrauterine device (IUD), such as Mirena®. Active for 5 years, the progestin released by the IUD is sufficient to protect the endometrium, if the patient wanted to take estrogen replacement therapy. Thus she would be obtaining contraception and hormonal benefit concurrently. Sexually transmitted diseases Although the risk of conception disappears at menopause, the risk of sexually transmitted diseases (STDs) does not. We have seen patients plagued by herpes that was acquired postmenopausally.
We explain to our patients that their bladder arises embryologically from the same tissue as does their vagina, and that it possesses similar estrogen receptors. Therefore it is not surprising that women can present with symptoms related to bladder atrophic changes. In a woman with recurrent urinary tract infections, a dose of vaginal estrogens (see above) once or twice a week may be all that she requires to prevent further infections. Some women will experience urinary symptoms such as frequency, urgency and nocturia, even without PERIMENOPAUSAL MANAGEMENT 37 infections, just related to atrophic symptoms.
