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.
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.
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.
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.
RADICALLY REIMAGINE THE SECOND HALF OF LIFE “There can be a certain perverse pleasure, as well as a sense of rightness and beauty, in insisting on flowering just when the world expects you to become quiet and diminish.” — from the book For any woman over fifty who has ever asked “What now? Who do I want to be?” comes a life-changing book showing how your next phase of life may be your most dynamic yet. As mythologist and psychologist Sharon Blackie describes it, midlife is the threshold to decades of opportunity and profound transformation, a time to learn, flourish, and claim the desires and identities that are often limited during earlier life stages. This is a time for gaining new perspectives, challenging and evolving belief systems, exploring callings, uncovering meaning, and ultimately finding healing for accumulated wounds. Western folklore and mythology are rife with brilliantly creative, fulfilled, feisty, and furious role models for aging women, despite our culture’s focus on youthfulness. Blackie explores these archetypes in Hagitude, presenting them in a way sure to appeal to contemporary women. Drawing inspiration from these examples as well as modern mentors, you can reclaim midlife as a liberating, alchemical moment rich with possibility and your elder years as a path to feminine power.
Removing the shroud of complexity that had engulfed the field of menopause research and management for more than a decade, this unique, case-based resource discusses a range of topics relevant to the reproductive health of the aging female. The opening section includes chapters covering the symptomatology, epidemiology and impact of the menopausal burden, and reviews in depth the most current evidence on the efficacy, risks and benefits of pharmacological and alternative therapies. Utilizing vibrant case material, the second section details common symptoms of menopause and an individualized approach to management, such as sleep loss, skeletal fragility, sexual dysfunction, hirsutism and alopecia, primary ovarian insufficiency and failure, and vasomotor symptoms. Chapters reviewing therapeutic options and considerations tailored to gynecologic and breast cancer patients and survivors comprise the third and final section. Developed as a multidisciplinary collaboration and addressing the needs of practicing reproductive medicine clinicians and researchers providing care to an aging female population, Essentials of Menopause Management provides clear, up-to-date information and recommendations on the range of current treatment strategies for menopause and its symptoms.
Despite the fact that the average woman spends one third of her life after the menopause, medical research has been devoted almost entirely to the repro ductive period of her life span. This is perhaps not surprising in our youth orientated society and yet there is increasing evidence that properly applied and supervised hormonal therapy could alleviate many of the severe physical symptoms which are associated with the ovarian menopause and that in the long term other aspects of physical deterioration could be modified. This lack of scientific research has made it difficult to assess which symptoms are due to the altered hormonal status of the post-menopausal period and which are due to the normal process of ageing, or the various psychological pressures which build up around most women in the fourth and fifth decades of life. In America doctors have been treating the 'menopausal syndrome' with estrogens for over 30 years, but in the United Kingdom gynaecologists and family doctors have been reticent to prescribe these steroid preparations. As a consequence, they have been labelled reactionary by the media and while there may be some truth -in this, it should be remembered that the hazar. ds associated with synthetic estrogens in the contraceptive pill were first brought to light by British epidemiological surveys.
As no two menopause journeys are identical, this highly practical and accessible nutrition and lifestyle guide enables women to build a bespoke menopause diet that specifically targets their symptoms, with the minimum of fuss and effort. This practical nutrition and lifestyle guide provides women with the tools to build their own menopause diet which specifically targets the symptoms that are relevant to them. There are so many ways that nutrition can support a healthy and happy menopause, but a one-size-fits-all approach simply won’t work. The reality is that there are many different menopausal symptoms and no two women have the same experience. Jackie explains how the menopause and perimenopause can change your body and how your diet can make a tangible difference to the way that you feel, whether you’re using HRT or not. Each symptom section provides a range of targeted nutritional solutions, practical lifestyle advice and simple recipe tips that you can incorporate into your daily routine. A highly experienced clinician, Jackie specialises in providing real-world guidance to busy women. This book is designed to make the key information as easily accessible as possible and reflects her trademark practical style, which makes it the ideal one-stop solution for anyone juggling their menopause with the demands of a busy job and a hectic family life.
This new edition of the comprehensive and renowned textbook Principles and Practice of Geriatric Medicine offers a fully revised and updated review of geriatric medicine. It covers the full spectrum of the subject, features 41 new chapters, and provides up-to-date, evidence-based, and practical information about the varied medical problems of ageing citizens. The three editors, from UK, USA and France, have ensured that updated chapters provide a global perspective of geriatric medicine, as well as reflect the changes in treatment options and medical conditions which have emerged since publication of the 4th edition in 2006. The book includes expanded sections on acute stroke, dementia, cardiovascular disease, and respiratory diseases, and features a new section on end-of-life care. In the tradition of previous editions, this all-encompassing text continues to be a must-have text for all clinicians who deal with older people, particularly geriatric medical specialists, gerontologists, researchers, and general practitioners. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from Google Play or the MedHand Store. Praise for the 4th edition: "...an excellent reference for learners at all clinical and preclinical levels and a useful contribution to the geriatric medical literature." —Journal of the American Medical Association, November 2006 5th edition selected for 2012 Edition of Doody's Core TitlesTM