This book covers a topic of considerable current interest and presents many of the most significant research findings available to date. Workers at the forefront of research on hormone replacement therapy and the implications for the risk of breast cancer were invited to attend a special Conference at the Royal Society of Medicine in London in September, 1991, where the latest data were presented to a distinguished audience and the implications of this research were discussed. The volume reviews various aspects of HRT and breast cancer, the physiology of the menopause, the current use of HRT in practice, osteoporosis and epidemiology and presents results from a range of European, American and Australian studies on the role of breast cancer and HRT, finishing with an overview of benefits, use and cost-effectiveness and a general summary. The book represents a definitive statement of current knowledge in this field and an informative update on the implications of recent research. It will be a valuable addition of special significance to the libraries of all those concerned with hormone replacement therapy and the study of breast cancer.
Evaluates evidence for an increased risk of cancer in women using combined oral contraceptives, progestogen-only hormonal contraceptives, post-menopausal estrogen therapy, and post-menopausal estrogen-progestogen therapy. Although the carcinogenicity of these preparations has been extensively investigated, the book stresses the many complex methodological issues that must be considered when interpreting findings and weighing results. Evidence of an association between use of these preparations and positive effects on health, including a reduced risk of some cancers, is also critically assessed. The first and most extensive monograph evaluates evidence of an association between the use of combined oral contraceptives and cancer at nine sites. Concerning breast cancer, the evaluation concludes that, even if the association is causal, the excess risk for breast cancer associated with patterns of use that are typical today is very small. Studies of predominantly high-dose preparations found an increased risk of hepatocellular carcinoma in the absence of hepatitis viruses. Citing these findings, the evaluation concludes that there is sufficient evidence in humans for the carcinogenicity of combined oral contraceptives. The evaluation also found sufficient evidence for the carcinogenicity of some, but not all, combined preparations in animals. Combined oral contraceptives were classified as carcinogenic to humans. The evaluation also cites conclusive evidence that these agents have a protective effect against cancers of the ovary and endometrium. Progestogen-only contraceptives are evaluated in the second monograph, which considers the association with cancer at six sites. The evaluation found no evidence of an increased risk for breast cancer. Although the evaluation found sufficient evidence in animals for the carcinogenicity of medroxyprogesterone acetate, evidence for the carcinogenicity of progestogen-only contraceptives in humans was judged inadequate. Progestogen-only contraceptives were classified as possibly carcinogenic to humans. The third monograph, on post-menopausal estrogen therapy, considers evidence of an association with cancer at eight sites. Findings from a large number of epidemiological studies indicate a small increase in the risk of breast cancer in women who have used these preparations for five years or more. Studies consistently show an association between use of post-menopausal estrogen therapy and an increased risk for endometrial cancer. Data on the association with other cancers were either inconclusive or suggested no effect on risk. The evaluation concludes that post-menopausal estrogen therapy is carcinogenic to humans. The final monograph evaluates the association between the use of post-menopausal estrogen-progestogen therapy and cancer at four sites. The evaluation of limited data on breast cancer found an increased relative risk observed with long-term use. Data were judged insufficient to assess the effects of past use and of different progestogen compounds, doses, and treatment schedules. For endometrial cancer, the evaluation found an increase in risk relative to non-users when the progestogen was added to the cycle for 10 days or fewer. Post-menopausal estrogen-progestogen therapy was classified as possibly carcinogenic to humans. Concerning post-menopausal therapy in general, the book notes that evidence of carcinogenic risks must be placed in perspective of potential benefits. The prevention of osteoporotic fractures is cited as the best-established benefit. Evidence also suggests that estrogen prevents heart disease and may prevent memory loss and dementia.
In 1950 men and women in the United States had a combined life expectancy of 68.9 years, the 12th highest life expectancy at birth in the world. Today, life expectancy is up to 79.2 years, yet the country is now 28th on the list, behind the United Kingdom, Korea, Canada, and France, among others. The United States does have higher rates of infant mortality and violent deaths than in other developed countries, but these factors do not fully account for the country's relatively poor ranking in life expectancy. International Differences in Mortality at Older Ages: Dimensions and Sources examines patterns in international differences in life expectancy above age 50 and assesses the evidence and arguments that have been advanced to explain the poor position of the United States relative to other countries. The papers in this deeply researched volume identify gaps in measurement, data, theory, and research design and pinpoint areas for future high-priority research in this area. In addition to examining the differences in mortality around the world, the papers in International Differences in Mortality at Older Ages look at health factors and life-style choices commonly believed to contribute to the observed international differences in life expectancy. They also identify strategic opportunities for health-related interventions. This book offers a wide variety of disciplinary and scholarly perspectives to the study of mortality, and it offers in-depth analyses that can serve health professionals, policy makers, statisticians, and researchers.
A compelling, “fascinating” (Robert Cialdini) defense of hormone replacement therapy, exposing the faulty science behind its fall from prominence and giving women the evidence they need to make informed decisions about their health. Now fully revised and updated. "Estrogen Matters was my antidote to the misinformation surrounding menopause. This book should be the bible for every single person going through menopause.”―Naomi Watts For years, hormone replacement therapy (HRT) was the medically approved way to alleviate menopausal symptoms (ranging from hot flushes to brain fog) and reduce the risk of heart disease, Alzheimer's, and osteoporosis. But when a large study by the Women's Health Initiative (WHI) announced, with national fanfare, that women taking HRT had an increased risk of breast cancer, women were scared off, and the treatment was abandoned. Now, Dr. Bluming, a medical oncologist, and Dr. Tavris, a social psychologist, reveal the true story of the WHI’s efforts to distort their data to exaggerate unsupported claims of estrogen’s harms. Important updates in this edition include: Evidence that demolishes the WHI’s claim that HRT causes breast cancer. A list of the WHI’s retractions of their original scare stories. Updated findings on estrogen’s benefits on heart, brain, bones, and longevity. A critical review of the alternative products and medications being marketed to treat symptoms of menopause. A sobering and revelatory read, Estrogen Matters sets the record straight on estrogen’s benefits, providing a light to guide women through this inevitable phase of life.
This book provides an evidence-based approach to the universal experience of menopause. Its structured format clearly separates the biological basis from the clinical impact and quality of life, while also examining menopause within the context of healthy ageing in females. Accordingly, the book addresses factors including lifestyle, frailty, sarcopenia, and new ICT technologies. Written by respected experts in the field, the book offers a valuable guide for gynecologists and professionals devoted to women’s healthcare and ageing quality of life, while also sharing revealing insights for non-professionals.
Adjuvant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable.
The interplay of hormones, health and behavior across the female life cycle, especially during the menopausal transition, poses a special challenge to health care professionals.Written by experts, this book brings together the knowledge gained on the menopausal transition from clinical experience and medical research. Topics like 'what to expect' from the menopausal transition, sexuality, sociocultural changes, impact of life stressors, and emergence of depression are discussed. The physiology of thermoregulation and the occurrence of hot flashes are reviewed for a better understanding of vasomotor complaints. Another chapter offers an update on hormonal and nonhormonal treatment strategies by presenting an overview of the management of mood and anxiety during the menopausal transition. The emergence of psychotic symptoms associated with peri- and postmenopausal changes in sex hormone levels is also addressed. Lastly, the book includes an excellent review on the pros and cons of hormonal therapy in the post-Women's Health Initiative era. This book is a must for gynecologists, psychiatrists, endocrinologists, epidemiologists involved in the clinical care of mature women as well as researchers and students interested in obtaining an up-to-date overview of this topic.
This report reviews current research on the menopause, including studies on its symptons and their treatment, and its effects on the cardiovascular and skeletal systems. It also assesses the relevance of existing data to women in developing countries.
This new Concise Manual takes a straightforward look at menopause. What is it? When does it occur? What can be expected? How can it be managed? Dr Louise Newson is a well-known specialist in menopause and saw the need for a fact-based manual for women and their families. Menopause is a natural condition that affects all women at some stage of their life. At least one in four women have severe symptoms, which detrimentally affect their family, home and work life. This book will explain and clarify the stages and symptoms, and detail what treatments are safe and effective for particular needs. Migraines, depression, anxiety, osteoporosis, low libido, relationships, diet and HRT are just some of the areas covered in this new concise manual.
