What is the menopause?
|
|
- Doris Welch
- 7 years ago
- Views:
Transcription
1 Dr Robyn Leake
2 What is the menopause? Permanent cessation of ovarian production of follicles and female hormones Clinically no periods for 12 months Can be assessed by day 2 FSH and LH Perimenopause is harder to define That time leading up to the menopause when ovarian activity is less dependable/more erratic. (average 4 yrs)
3
4 When can I stop the pill, doctor? Suggest FSH and LH on day 7 of the placebo pills. If they have risen, stay off pill and repeat in a month. Use other methods meanwhile. Mirena don t rush to remove may be useful beyond contraception If in doubt, put another Mirena in.
5 Peri-menopausal cycles may be: heavier (higher estrogen surges) lighter (less estrogen) closer together, (luteal phase defect) further apart (delayed ovulation) There may be episodes of menopausal Sx Breast tenderness, PMS, headaches can worsen.
6 The challenges of perimenopause. Hormones go on a rollercoaster ride. Ups are usually ok
7 but the downs really suck Some cycles might be relatively normal while others aren t The unpredictability upsets women
8 When oestrogen is low Hot flushes Insomnia Vaginal atrophy Irritable bladder, UTIs Cognitive disturbance Aches and pains Anxiety, depression, new or recurrence of Skin sensation changes
9 7 dwarves of menopause
10 Fuzzy headedness Not being able to find words, forgetting names, not being as sharp as usual
11 Misplacing things And finding them again
12 Middleaged spread As female hormones diminish, fat distribution tends to be more male Metabolism slows.
13 Does HRT cause weight gain? No, being 50 does. Studies comparing 50 yr olds on HRT vs placebo most gained weight. HRT may keep the distribution more female in type, but studies conflict.
14 Bedroom dramas Bedclothes on, bedclothes off. Bedclothes sopping wet Poor libido Vaginal dryness
15 Sleep disturbance May be unrelated to flushes, though flushes are more common at night Occurs in 30-40% of patients Don t forget sleep apnoea and depression
16 Vaginal symptoms Dryness, itch, poor lubrication, dyspareunia UTIs or urgency without infection Often self-treated as thrush BUT topical estrogens can predispose to Candidiasis Appearance in post-menopausal patients differs, so do a swab if in doubt Good quality lubricants Sylk, Pjur, Wet Stuff
17 What if they don t respond? Vaginal atrophy is exquisitely sensitive to estrogen replacement SO consider - dermatitis, lichen sclerosus, inflammatory vaginosis in non-responders Sometimes low dose systemic therapy penetrates poorly. Symptoms of menopause don t really affect the labia minora much, and the labia majora at all, so if these are the problem, reconsider your diagnosis.
18 Hot flushes Occur in 80% patients, trouble approx30% May be accompanied by anxiety, chills and palpitations Most stop within 5 yrs 9% have them indefinitely
19 Hot flushes cont. Worse in smokers Worse in obese pts Don t occur in Turner s syndrome (need exposure to estrogen to miss it) Respond well to estrogen replacement 50mcg patch or 1mg estradiol, but may respond to less
20 Mood disturbance Depression and anxiety may recur or occur for the first time in the perimenopause Sometimes difficult to know whether to use HRT, antidepressants or both.
21 Other symptoms Joint aches and pains Breast tenderness in perimenopause Pre-menstrual migraines in perimenopause.
22 How to manage all that? Lifestyle factors - important Medications
23 What helps? Breast tenderness evening primrose oil, flaxseed oil, tamoxifen, pill Migraines suppress cycle with pill, add estrogen when it seems to be missing, use antimigraine drugs like Imigran, avoid other triggers such as alcohol, caffeine, chocolate (OMG)
24 Exercise Good for flushes Good for bones Good for brain Good for heart Reduces risk of cancers incl breast cancer What s not to love?
25 Menstrual disturbance Complicated. Periods will not be suppressed by HRT, so best not used at this stage for this problem. Low/normal dose pill or Nuva ring is safe for low risk women Mirena marvellous for periods, but not hormonal Sx Intermenstrual bleeding, new onset of menorrhagia or dysmenorrhoea should not be blamed on perimenopause or menopause and need Ix. Remember to check for thyroid dysfunction
26 Hot flushes Respond to estradiol 1mg or 50mcg patch May respond to lower doses Progestins may also help some women
27 Hot flushes cont What about those who absolutely cannot have estrogen? SSRIs such as venlafaxine. Work well but evidence suggests not sustained long term. Great if anxiety/depression are present. Some SSRIs interact with tamoxifen, so beware. Venlafaxine and citalopram best. Clonidine limited by drowsiness. 0.1mg daily Gabapentin limited by cost and initial drowsiness. Best dose 900mg daily (but can start lower) The menopause after cancer clinic at KEMH is a great resource (and the menopause clinic, too)
28 Treatment resistant hot flushes Consider hepatic interactions Measure serum levels if in doubt about absorption May need to stop then restart (esp with implants) Tachyphylaxis esp w implants Other causes malignancy, SSRIs, neurendocrine tumours, pheochromocytoma, hyperthyroidism
29 Sleep disturbance Exercise helps (not too close to bedtime) Cognitive behavioural techniques Address any exacerbating factors such as anxiety or depression Beware sleep apnoea Responds very well to estrogen replacement
30 Vaginal dryness May start before periods cease. Loss of elasticity combined with lack of lubrication can result in pain. Lack of estrogen in the urethra may predispose to UTIs. Vaginal estrogen is safe and effective Use Ovestin if previous breast cancer, consult with oncologist.
31 Who needs HRT? Women whose symptoms cannot be adequately controlled by lifestyle measures AND whose symptoms are distressing to them Each woman needs to weigh up the risks and benefits as they apply to her Use a dose that works Review regularly and discuss cessation.
32 What about those big studies? Examined whether HRT given to healthy women for the prevention of heart disease was worthwhile Mean age of patients was >60 There was an excess of heart disease, stroke VTE and breast cancer in these studies. Women in their 40s and 50s seeking relief of menopausal symptoms are a different group. Nevertheless, the suggestion is that combined therapy be limited to 5yrs of use, or less
33 What are the advantages of estrogen given on its own? Greatly reduces bone mineral resorption Markedly improves menopausal symptoms Reduces slightly colon cancer Slightly reduces/neutral to breast cancer. Often helps vaginal/bladder symptoms Helps keep blood vessels healthy in healthy women if given at the commencement of menopause.
34 What about e2 + progesterone? Still good for bones Still helps menopausal symptoms Reduces risk of uterine cancer Increases risk of breast cancer Not as good for bladder irritability, still helps reduce UTIs Still helps vaginal atrophy Not as good for cholesterol/vessels
35 The Risks: for women in 50s Not as much data avail as the WHI cohort were older Lower risk of CHD (0.9/1000 EP, 3.8/1000 E 5yrs use) Lower overall mortality (5/1000 5yrs use) Less fractures (5-6/1000 5yrs use) LESS breast cancer (1.5/1000 in E 5yrs use) MORE breast cancer (6.8/1000 EP 5yrs use) Less Type 2 diabetes (11/1000 5yrs use) Less colorectal cancer (1.2/1000 EP only) More strokes (1/1000 ).?less w transdermal route
36 The risks cont Increased VTE 5/1000 EP, 2/1000 E 5yrs use Possibly more gallstones Since the studies above, further studies of young women starting HRT in their 40s suggest no increased risk of heart disease and stroke.
37 Tibolone Good for flushes, bones, libido, vaginal symptoms Increased risk of stroke Doesn t stimulate endometrium Same risk of breast cancer as estrogen and progesterone in combination.
38 Vaginal therapy Useful for symptoms of atrophy and for recurrent UTIs Little systemic absorption (but not nil) Most relevant for women with breast cancer. Discuss with oncologist Generally safe (esp Ovestin) for women at low risk of recurrence who are not on aromatase inhibitors/tamoxifen.
39 Cases Anne, 48, presents with worsening PMS, breast tenderness, premenstrual headaches, poor sleep. Periods are still regular, heavier. Wonders if it is the menopause. What to do? Investigations? Mx options?
40 Anne Probably perimenopause with no added extras. Consider TSH Consider U/S Options include low or usual dose COCP, Nuvaring Exercise, fish oil, may help. If unwilling/unable to take estrogen Mirena +/- SSRI, triptans, evening primrose oil.
41 Emma 45 yr old woman with past history of hysterectomy for adenomyosis. Known to have severe endometriosis as well, controlled with Provera post-hysterectomy. Now having hot flushes, poor sleep. Mother and grandmother osteoporosis Options?
42 Emma cont Is at risk of endometriosis recurrence Need to either continue the Provera or use tibolone to avoid that Small risk of endometrioid adenocarcinoma as well, progesterone may protect
43 Jan 51 yrs Terrible symptoms Desperate for something despite family history of breast cancer. Options?
44 Jan cont. Lowest risk with estrogen alone, but with uterus must have endometrial protection Mirena plus estrogen a good choice Non-hormonal options such as SSRIs, gabapentin depending on Sx
45 Jackie 45 yrs old Sent in by husband to have hormones sorted out. Poor libido, dyspareunia Tearful, labile mood Still having periods, PMS prior, feels suicidal and homicidal prior to periods Headaches Poor sleep
46 Jackie cont Is this perimenopause or depression? Ask about diurnal mood variation, appetite, hair and skin changes, sleep pattern. Family history of mental illness? Probably benefit from lifestyle changes, counselling and probably SSRI. May not be much role for any hormonal therapy, though suppressing cycle might help.
What is the menopause and what are the symptoms?
What is the menopause and what are the symptoms? Strictly speaking, the menopause is the last menstrual period. However, most women think of the menopause as the time of life leading up to, and after,
More informationWOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Hormone Therapy
Hormone Therapy WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 At menopause, a woman's body makes less estrogen and she stops having menstrual periods. This is a natural stage in a woman's
More informationMenopause Guidance on management and prescribing HRT for GPs based on NICE guidance 2015
PRIMARY CARE WOMEN S HEALTH FORUM GUIDELINES Menopause Guidance on management and prescribing HRT for GPs based on NICE guidance 2015 Written by Dr Imogen Shaw This guidance is designed to support you
More informationThe menopausal transition usually has three parts:
The menopausal transition usually has three parts: Perimenopause begins several years before a woman s last menstrual period, when the ovaries gradually produce less estrogen. In the last 1-2 years of
More informationpatient education Fact Sheet PFS003: Hormone Therapy APRIL 2015
patient education Fact Sheet PFS003: Hormone Therapy APRIL 2015 Hormone Therapy Menopause is the time in a woman s life when she naturally stops having menstrual periods. Menopause marks the end of the
More informationNow that your Doctor has prescribed Livial for you
Now that your Doctor has prescribed Livial for you This educational brochure is only for use by patients prescribed LIVIAL The Menopause The term menopause refers to the very last menstrual period a woman
More informationMenopause: should I take HRT?
Patient information from the BMJ Group Menopause: should I take HRT? The menopause is when your periods stop for good. It isn't an illness. It's a normal part of every woman's life. But sometimes it causes
More informationBio-Identical Hormone FAQ s
Bio-Identical Hormone FAQ s What are bio-identical hormones? They are derived from a natural plant source and professionally compounded to be biologically identical to human form of estradiol and testosterone.
More informationWhat is the Menopause?
What is the Menopause? This information is also available on request in other formats by phoning 01387 241053. Information leaflet Produced by Dr H Currie & Sr. K Martin May 2005 Checked 2013 Review 2015
More informationHormone. Replacement. Therapy. Information leaflet. This information is also available on request in other formats by phoning 01387 241053.
Hormone Replacement Therapy This information is also available on request in other formats by phoning 01387 241053. Information leaflet Produced by Dr H Currie & Sr. K Martin May 2005 Updated Dec. 2013
More informationHormone replacement therapy:
www.bpac.org.nz keyword: hrt Hormone replacement therapy: latest evidence and treatment recommendations Key advisor: Dr Helen Roberts, Senior Lecturer, Department of Obstetrics and Gynaecology, Faculty
More informationShira Miller, M.D. Los Angeles, CA 310-734-8864 www.shiramillermd.com. The Compounding Pharmacy of Beverly Hills Beverly Hills Public Library
Shira Miller, M.D. Los Angeles, CA 310-734-8864 The Compounding Pharmacy of Beverly Hills Beverly Hills Public Library 2 Outline What is hormone therapy? Why would healthy men and women need to think about
More informationSmoking and Age of Menopause. Women who smoke experience menopause an average of 2 years earlier than women who do not smoke.
Menopause Menopause Feared event To many, it indicates old age - a sign of life coming to a close. Many expect a difficult psychological adjustment to menopause (bad press, bad jokes). Menopause Effect
More informationNeuroendocrine Evaluation
Neuroendocrine Evaluation When women have health concerns they usually prefer to discuss them with another woman. Dr. Vliet is a national expert on hormone-related problems and specializes in neuroendocrine
More informationPellet Implant FAQ Provided By: Rebecca Glaser, MD, FACS www.hormonebalance.org
Understanding BHRT Pellet Implants Pellet Implant FAQ Introduction Data supports* that hormone replacement therapy with pellet implants is the most effective and the most bioidentical method to deliver
More informationHull & East Riding Prescribing Committee
Hull & East Riding Prescribing Committee Guideline on Prescribing of Gonadorelin (GnRH) Analogues and Progesterone Receptor Modulators in treatment of Endometriosis or prior to Endometrial Ablation, or
More informationAlthough the flush is the classic menopausal symptom that we ve
24 MENOPAUSE: ANSWERS AT YOUR FINGERTIPS HOW LONG DO SYMPTOMS LAST? The duration of early symptoms is very variable from a few months to many years and the severity varies between individuals. On average,
More informationHormone Restoration: Is It Right for You? Patricia A. Stafford, M.D. Founder, Wellness ReSolutions
Hormone Restoration: Is It Right for You? Patricia A. Stafford, M.D. Founder, Wellness ReSolutions IMPORTANCE OF HORMONE BALANCE Importance of Hormone Balance Help you live a long, healthy life Help you
More informationPolycystic Ovarian Syndrome
Polycystic Ovarian Syndrome What is Polycystic Ovarian Syndrome? Polycystic ovary syndrome (or PCOS) is a common condition affecting 3 to 5% of women of reproductive age. It is linked with hormonal imbalances,
More informationDEPRESSION DURING THE TRANSITION TO MENOPAUSE: A Guide for Patients and Families
DEPRESSION DURING THE TRANSITION TO MENOPAUSE: A Guide for Patients and Families David A. Kahn, MD, Margaret L. Moline, PhD, Ruth W. Ross, MA, Lori L. Altshuler, MD, and Lee S. Cohen, MD www.womensmentalhealth.org
More informationWOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Endometriosis
Endometriosis WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The lining of the uterus is called the endometrium. Sometimes, endometrial tissue grows elsewhere in the body. When this happens
More informationAbigail R. Proffer, M.D. October 4, 2013
Abigail R. Proffer, M.D. October 4, 2013 Topics Human Papillomavirus (HPV) Vaccines Pap smears Colposcopy Contraception Polycystic Ovary Syndrome (PCOS) Can I get pregnant? Miscarriage Abnormal Uterine
More informationLakeview Endocrinology and Diabetes Consultants. 2719 N Halsted St C-1. Chicago IL 60614 P: 773 388 5685 F: 773 388 5687. www.lakeviewendocrinolgy.
Lakeview Endocrinology and Diabetes Consultants 2719 N Halsted St C-1 Chicago IL 60614 P: 773 388 5685 F: 773 388 5687 www.lakeviewendocrinolgy.com Patient information: Early menopause (premature ovarian
More informationHormone Therapy with Tamoxifen
What is hormone-receptor-positive breast cancer? Many breast cancers need estrogen and/or progesterone (female hormones), to grow and spread. When breast cancer is found, the cancer is tested for two proteins,
More informationIf you are still in your fertility years If you are past your fertility years and need surgery for a mass or for pain and have normal ovaries
If you are still in your fertility years, an ovary should be removed only if there is a large, complex or persistent mass on it or if you have intolerable pain from endometriosis. There should be an attempt
More informationDr. Friedman s Guide to Estrogen Replacement
Dr. Friedman s Guide to Estrogen Replacement There are risks and benefits with all medicines and estrogen replacement is no exception. In fact, estrogen replacement is one of the most controversial topics
More informationMenopause and Hormone Replacement Therapy
Menopause and Hormone Replacement Therapy Daniel Breitkopf, MD Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston, Texas USA Objectives Define the indications and contraindications
More informationHormonal Oral Contraceptives: An Overview By Kelsie Court. A variety of methods of contraception are currently available, giving men and
Hormonal Oral Contraceptives: An Overview By Kelsie Court A variety of methods of contraception are currently available, giving men and women plenty of options in choosing a method suitable to his or her
More informationFrom Menses to Menopause: How Hormones Can Affect Blood Glucose Levels. Christine Day, RN, MS, CNS-BC Lake Superior College
From Menses to Menopause: How Hormones Can Affect Blood Glucose Levels Christine Day, RN, MS, CNS-BC Lake Superior College Overview Will review hormonal changes over the female lifespan Discuss the effects
More informationCombination Birth Control Pills - FAQ
Combination Birth Control Pills - FAQ How does the birth control pill work? prevents ovulation thickens cervical mucus, which makes it hard for sperm to enter the uterus thins the lining of the uterus,
More informationPatient information. Goserelin Zoladex Breast Services Directorate PIF 1005 V3
Patient information Goserelin Zoladex Breast Services Directorate PIF 1005 V3 What is Goserelin? Goserelin is a tried and tested drug used to treat breast cancer. It can be used alone or given with other
More informationCenter for Specialized Gynecology Susan Kaufman, DO * Jodi Benett, DO * Beverly Mikes, MD Mary Steen, NPC, APN. Hot flashes
Definition Center for Specialized Gynecology Susan Kaufman, DO * Jodi Benett, DO * Beverly Mikes, MD Mary Steen, NPC, APN Hot flashes Hot flashes can happen at any time, leaving you sweaty and red-faced.
More informationThe Menopause and Subtotal Hysterectomy
Oxford University Hospitals NHS Trust Women s Health The Menopause and Subtotal Hysterectomy Information for patients The menopause At the menopause the ovaries stop working. This means that the female
More informationWOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Birth Control Pills
Birth Control Pills WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 Birth control pills (also called oral contraceptives or "the pill") are used by millions of women in the United States to
More informationManaging Menopause. Signs
Managing Menopause Menopause is a stage in a woman s life when the hormone levels of estrogen and progesterone decrease in the body. As hormone levels decrease, menstruation may be irregular and will eventually
More informationHormone Replacement Therapy For Women
Hormone Replacement Therapy For Women Bio-identical Hormone Replacement Therapy Gail Eberharter M.D. May 10, 2009 There are three main hormones that are responsible for the menstrual cycle, sexual drive
More information(212) 733-2324 mackay.jimeson@pfizer.com
For immediate release: July 9, 2012 Media Contacts: MacKay Jimeson (212) 733-2324 mackay.jimeson@pfizer.com Pfizer Recognizes 10 th Anniversary Of The Women s Health Initiative: A Modern Day Perspective
More informationI will be having surgery and radiation treatment for breast cancer. Do I need drug treatment too?
What is node-positive breast cancer? Node-positive breast cancer means that cancer cells from the tumour in the breast have been found in the lymph nodes (sometimes called glands ) in the armpit area.
More informationAll methods of birth control are MUCH SAFER than being pregnant! If 100 women use each method for a year, how many of them get pregnant?
The Correct Use of Birth Control: In order for any method of birth control to be effective, it must be used correctly ALL THE TIME. This means: One condom every time you have sex One pill every day One
More informationHormone therapy and breast cancer: conflicting evidence. Cindy Farquhar Cochrane Menstrual Disorders and Subfertility Group
Hormone therapy and breast cancer: conflicting evidence Cindy Farquhar Cochrane Menstrual Disorders and Subfertility Group The world of hormone therapy in the 1990 s Throughout the 1970s, 1980s and 1990s
More informationAspen Chiropractic & Wellness
WELCOME TO OUR OFFICE We are committed to providing you the best of care and are pleased to discuss our professional fees with you at any time. Please ask any questions you may have regarding our fees
More informationStay Healthy at Any Age!
+ Stay Healthy at Any Age! February 28, 2013 Kimberly Kelstone A Deaf Health Talk DHCC Partnership with REAP + Overview Introduction Normal healthy processes Diseases specific to women Screening tests
More informationWomen & Men s Health
ChiroCredit.com/OnlineCE.com Presents: Intro To Hormones 102 Salivary Hormone Testing Part 2 Women & Men s Health Ronald Steriti, ND, PhD 2008 Salivary Hormones The following hormones are typically in
More information7720 Rivers Edge Dr., Suite 121 Columbus, OH 43235 Ph: 614-888-8923 Fax: 614-888-8931 www.integrativehormoneconsulting.com
7720 Rivers Edge Dr., Suite 121 Columbus, OH 43235 Ph: 614-888-8923 Fax: 614-888-8931 www.integrativehormoneconsulting.com Bioidentical Hormone Replacement Therapy for Women Menstrual Cycle Days 1 5: Estrogen
More informationBreast Cancer. Breast Cancer Page 1
Breast Cancer Summary Breast cancers which are detected early are curable by local treatments. The initial surgery will give the most information about the cancer; such as size or whether the glands (or
More informationUnderstanding Your Risk of Ovarian Cancer
Understanding Your Risk of Ovarian Cancer A WOMAN S GUIDE This brochure is made possible through partnership support from Project Hope for Ovarian Cancer Research and Education. Project HOPE FOR OVARIAN
More informationObesity and the Menopause. Vanessa M. Barnabei, MD, PhD Professor and Chair Department of Obstetrics and Gynecology
Obesity and the Menopause Vanessa M. Barnabei, MD, PhD Professor and Chair Department of Obstetrics and Gynecology Educational Objectives Review normal menopausal transition Review health risks of obesity
More informationAlternatives to hormone replacement therapy for symptoms of the menopause
Information for you Published in December 2011 (next review date: 2015) Alternatives to hormone replacement therapy for symptoms of the menopause This information is for you if you are considering alternatives
More informationDepressive disorders among older residents in a Chinese rural community. Risk for Depression by Age and Sex. Risk for Depression by Age and Sex
Risk for Depression by Age and Sex Risk for Depression by Age and Sex Depressive disorders among older residents in a Chinese rural community. Liu CY, et al: Psychological Medicine 1997:27: 943-949 Male
More informationEfficacy and Tolerability of Antidepressant Duloxetine for Treatment of Hot Flushes in Menopausal Women
Efficacy and Tolerability of Antidepressant Duloxetine for Treatment of Hot Flushes in Menopausal Women Irina Shestakova, MD, PhD Research Center of Obstetrics, Gynecology and Perinatology Department of
More informationPolycystic ovary syndrome: what it means for your long-term health
Polycystic ovary syndrome: what it means for your long-term health Information for you Published in February 2005, minor amendments in June 2005 Revised 2009 What is polycystic ovary syndrome? Polycystic
More informationTestosterone Therapy for Women
Testosterone Therapy for Women The Facts You Need Contents 2 INTRODUCTION: The Facts You Need... 3-4 CHAPTER 1: Testosterone and Women... 5-9 CHAPTER 2: Testosterone Therapy for Women... 10-14 CONCLUSION:
More informationEndometriosis: An Overview
Endometriosis: An Overview www.bcwomens.ca Welcome to the BC Women s Centre for Pelvic Pain and Endometriosis. This handout will give you some basic information about endometriosis. It will also explain
More informationinjections injections injections injections injections injection injections injections injections tions njections injections injections injections
your guide to contraceptive Helping you choose the method of contraception that is best for you ions ections injection njections injection tions 2 Contraceptive Contraceptive contain a progestogen hormone
More informationAbnormal Uterine Bleeding FAQ Sheet
Abnormal Uterine Bleeding FAQ Sheet What is abnormal uterine bleeding? Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period. Bleeding that occurs between
More informationMale menopausal symptoms during and after cancer treatment
Male menopausal symptoms during and after cancer treatment Some treatments given to male cancer patients can cause side effects similar to those experienced by women during menopause. For example, men
More informationSubcutaneous Testosterone-Anastrozole Therapy in Breast Cancer Survivors. 2010 ASCO Breast Cancer Symposium Abstract 221 Rebecca L. Glaser M.D.
Subcutaneous Testosterone-Anastrozole Therapy in Breast Cancer Survivors 2010 ASCO Breast Cancer Symposium Abstract 221 Rebecca L. Glaser M.D., FACS Learning Objectives After reading and reviewing this
More informationAppendix A_TAMOXIFEN AND AROMATASE INHIBITOR Survey
Article title: Patient-reported discontinuation of endocrine therapy and related side effects among women with early stage breast cancer Authors: Erin J. Aiello Bowles, Denise M. Boudreau, Jessica Chubak,
More informationX-Plain Chemotherapy for Breast Cancer - Adriamycin, Cytoxan, and Tamoxifen Reference Summary
X-Plain Chemotherapy for Breast Cancer - Adriamycin, Cytoxan, and Tamoxifen Reference Summary Introduction Breast cancer is a common condition that affects one out of every 11 women. Your doctor has recommended
More informationLinda Lea, APRN-CNP, PLLC 4771 NW 122 nd Street, Suite C Oklahoma City, Oklahoma, 73120 Office: 405-607-6770 Fax: 405-607-6774
4771 NW 122 nd Street, Suite C FEMALE NEW PATIENT PELLET PACKET Please carefully read and complete the contents of this package so we can be ready for your appointment to regain optimal hormone balance.
More informationReduce Your Risk of Breast Cancer
Reduce Your Risk of Breast Cancer Reduce Your Risk of Breast Cancer There was no history in my family. But the test was positive and it was breast cancer. I was so shocked, I couldn t believe it. ~ Colette
More informationUnderstanding Hormone Excess and Deficiency
Understanding Hormone Excess and Deficiency The comments provided here are for educational purposes only. They should not be interpreted as being diagnostic or treatment recommendations. Those decisions
More informationPellet Implant FAQ. Tel:800-888-9358 / 719-262-0022 Fax:800-556-5893 / 719-262-0035 info@collegepharmacy.com
Introduction Data supports* that hormone replacement therapy with pellet implants is an effective bio-identical method to deliver hormones in both men and women. Implants, placed under the skin, consistently
More informationPROVERA (medroxyprogesterone acetate) Product Monograph Page 34 of 38
PART III: CONSUMER INFORMATION PR PROVERA* (medroxyprogesterone acetate) This leaflet is part III of a three-part "Product Monograph" published when PROVERA was approved for sale in Canada and is designed
More informationTestosterone deficiency men have hormones, too!
C h a p t e r 7 CHAPTER 7 Testosterone deficiency men have hormones, too! Testosterone deficiency is a rare cause of ED. If it is suspected, then blood should be taken at 9am to confirm the diagnosis and
More informationBreast cancer and early menopause. a guide for younger women
Breast cancer and early menopause a guide for younger women Breast cancer and early menopause a guide for younger women Breast cancer and early menopause a guide for younger women First edition published
More informationCancer Facts for Women
2006, American Cancer Society, Inc. No.200700-Rev.03/08 The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem
More informationAdjuvant Therapy for Breast Cancer: Questions and Answers
CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Adjuvant Therapy for Breast
More informationPolycystic Ovary Syndrome
Polycystic Ovary Syndrome Polycystic ovary syndrome (PCOS) is a disorder that affects as many as 5 10% of women. PCOS has three key features: 1) high levels of hormones called androgens; 2) irregular menstrual
More informationBirth Control Options
1 of 5 6/2/2014 9:46 AM Return to Web version Birth Control Options What is contraception? Contraception means preventing pregnancy, also called birth control. Most people know about options such as birth
More informationPolycystic Ovarian Syndrome (PCOS)
UW MEDICINE PATIENT EDUCATION Polycystic Ovarian Syndrome (PCOS) Signs, symptoms, and treatments What is PCOS? Polycystic ovarian syndrome (PCOS) is a disorder that affects up to 1 in 10 women of reproductive
More informationWhat Athletic Trainers Need to Know About Gynecology
What Athletic Trainers Need to Know About Gynecology Mona M. Shangold,, M.D. Director The Center for Women s Health and Sports Gynecology Philadelphia, PA Main Topics Normal development and function Effects
More informationPILLS & RING INFORMATION AND INSTRUCTIONS ON COMBINED HORMONAL CONTRACEPTION INCLUDING BIRTH CONTROL PILLS & NUVA RING
PILLS & RING INFORMATION AND INSTRUCTIONS ON COMBINED HORMONAL CONTRACEPTION INCLUDING BIRTH CONTROL PILLS & NUVA RING What is combined hormonal contraception? Birth control which contains two hormones
More informationLIVING WATERS MEDICAL SPA AND WELLNESS CENTER
November 2014 LIVING WATERS MEDICAL SPA AND WELLNESS CENTER Contents Benefits and Risks of Hormone Replacement 1-3 Liposuction Pictures 4-6 Remember to get your Botox before Christmas! Menopause and male
More informationFrom this site: http://www.energeticnutrition.com /vitalzym/fibroid_tumors.html Uterine Fibroid Tumors
From this site: http://www.energeticnutrition.com /vitalzym/fibroid_tumors.html Uterine Fibroid Tumors Uterine Fibroid Tumors A woman s fibroisis condition usually associated with estrogen dominance. Uterine
More informationPresenting Genital Symptoms and Physical Signs of Vaginal Atrophy
Sexual Health in the Menopause Presenting Genital Symptoms and Physical Signs of Vaginal Atrophy Symptoms Dryness Itching Burning Dyspareunia Signs on Physical Exam Pale, smooth, or shiny vaginal epithelium
More informationHormones and Healthy Bones
Hormones and Healthy Bones Helping Midlife Women Make Better Choices for a Healthy Future 1 Hormones and Healthy Bones helps midlife women make better choices for a healthy future. Midlife women are the
More informationPOLYCYSTIC OVARY SYNDROME
POLYCYSTIC OVARY SYNDROME Information Leaflet Your Health. Our Priority. Page 2 of 6 What is polycystic ovary syndrome? (PCOS) Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women
More informationAbnormal Uterine Bleeding: Simple evaluation and management in premenopausal women
Objectives Abnormal Uterine Bleeding: Simple evaluation and management in premenopausal women Provide a framework to evaluate abnormal uterine bleeding (AUB) Review medical and surgical management options
More informationTESTOSTERONE IMPLANT DOSING WOMEN
TESTOSTERONE IMPLANT DOSING WOMEN Serum testosterone ranges are based on endogenous hormone production. There is no evidence to support that dosing for exogenous testosterone therapy should be based on
More informationBIO-BALANCE 4 WOMEN. Menopause Treatment Options
Estrogen was first synthesized in the 1920 and was used to treat postmenopausal hot flashes in the 1930 s. The role of estrogen in osteoporosis prevention was not understood until the 1940 s. The positive
More informationMedications to Prevent and Treat Osteoporosis
Medications to Prevent and Treat Osteoporosis National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD 20892-3676 Tel: (800) 624-BONE or
More informationWOMEN AND ADDICTION RECOVERY & HORMONAL SHIFTS
WOMEN AND ADDICTION RECOVERY & HORMONAL SHIFTS HANLEY CENTER, INC. CENTER FOR WOMEN S RECOVERY Presented by: Jeannie Provost Program Manager 561-841-1000 jprovost@hanleycenter.org OBJECTIVES OBJECTIVES
More informationAnatomy and Physiology of Human Reproduction. Module 10a
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
More informationInformed Consent Form for Testosterone Therapy
Student Health Services Oregon State University, 201 Plageman Building, Corvallis, Oregon 97331-8567 Tel 541-737-9355 General Fax 541-737-4530 Medical Fax 541-737-9665 http://studenthealth.oregonstate.edu/
More informationDepression in the Menopause and Perimenopause
Depression in the Menopause and Perimenopause David A. Forstein, DO, FACOOG, (Dist) Associate Professor of Obstetrics and Gynecology University of South Carolina School of Medicine Greenville Residency
More informationManaging Menopausal Symptoms Kirsten J. Lund, M.D. Associate Professor, OB-GYN University of Colorado
Managing Menopausal Symptoms Kirsten J. Lund, M.D. Associate Professor, OB-GYN University of Colorado Disclosures No ties, financial or otherwise, to pharmaceutical companies Will identify non-fda approved
More informationWomen s Health Issues
Women s Health Issues Chapter 22 Objectives Discuss toxic shock syndrome Discuss premenstrual syndrome Discuss dysmenorrhea and menstrual irregularities Discuss menopause and osteoporosis Identify screening
More informationClient Information for Informed Consent TESTOSTERONE FOR TRANSGENDER PATIENTS
Client Information for Informed Consent TESTOSTERONE FOR TRANSGENDER PATIENTS You want to take testosterone to masculinize your body. Before taking it, there are several things you need to know about.
More informationAbnormal Uterine Bleeding
Abnormal Uterine Bleeding WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 Abnormal uterine bleeding is one of the most common reasons women see their doctors. It can occur at any age and has
More informationHormone Replacement Therapy:
Hormone Replacement Therapy: Exploring the Options for Women I N V E S T I N G I N A U S T R A L I A S H E A L T H Hormone Replacement Therapy: Exploring the Options for Women Endorsed March 2005 Commonwealth
More informationGARY S. DONOVITZ, M.D., F.A.C.O.G.
Sub-Cutaneous Hormone Pellet Therapy- The Comprehensive Treatment to Optimize and Balance Hormones Using the BioTE Method GARY S. DONOVITZ, M.D., F.A.C.O.G. The BioTE method of hormone replacement is a
More informationForm ### Transgender Hormone Therapy - Estrogen Informed Consent SAMPLE
What are the different medications that can help to feminize me? Estrogen - Different types of the hormone estrogen can help you appear more feminine. Estrogen is the female sex hormone. Androgen blocker
More informationFemale Reproductive System. Unit 8 Lesson 2 Continued
Female Reproductive System Unit 8 Lesson 2 Continued Female Reproductive System Female Reproductive System Female produce ovum or egg cells. The egg (ovum) cell is the female sex cell. Female Reproductive
More informationPRESCRIBING SUPPORT TEAM AUDIT: Hormone Replacement Therapy DATE OF AUTHORISATION: AUTHORISING GP: PRESCRIBING SUPPORT TECHNICIAN:
PRESCRIBING SUPPORT TEAM AUDIT: Hormone Replacement Therapy DATE OF AUTHORISATION: AUTHORISING GP: PRESCRIBING SUPPORT TECHNICIAN: SUMMARY This audit aims to ensure that patients on HRT are reviewed annually
More informationMENOPAUSE WOMAN'S TEST (Assessment of hormone balance)
ATTACHMENT: Useful remarks for patient and doctor, to be associated to the analytical results. Your doctor should interpret this report. Cod. ID: 123456 CCV: 6bf Date: 01/01/2013 Patient: Rossi Mario Rapport
More informationUnderstanding Endometriosis - Information Pack
What is endometriosis? Endometriosis (pronounced en- doh mee tree oh sis) is the name given to the condition where cells like the ones in the lining of the womb (uterus) are found elsewhere in the body.
More informationHIRSUTISM. What are the aims of this leaflet?
HIRSUTISM What are the aims of this leaflet? This leaflet has been written to help you understand more about hirsutism. It tells you what it is, what causes it, what can be done about it, and provides
More informationMale New Patient Package
Male New Patient Package The contents of this package are your first step to restore your vitality. Please take time to read this carefully and answer all the questions as completely as possible. Thank
More informationDr. Dan Purser, M.D. Answers Frequently Asked Questions about Progessence Plus Summer 2010
Dr. Dan Purser, M.D. Answers Frequently Asked Questions about Progessence Plus Summer 2010-1 - Hi, My name is Dan Purser. I m an M.D. and I have written several books on wellness and disease prevention
More information