Perimenopause, An Issue of Obstetrics and Gynecology Clinics

Santoro Nanette

Description

Perimenopause has not been covered in the Obstetrics and Gynecology Clinics for over 10 years. This timely issue includes articles on BMI and its influence, Androgens, Cognition and Menopause, and Sexual Activity/Quality of Life.

Sujets

• Médecine
• Gynécologie et Obstétrique
• Gynecology
• Medical
• Obstetrics

Informations

• Publié par: Saunders
• Date de parution: 28 septembre 2011
• Nombre de lectures: 1
• EAN13: 9781455712465
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Obstetrics and Gynecology Clinics of North America , Vol. 38, No. 3, September 2011
ISSN: 0889-8545
doi: 10.1016/j.ogc.2011.08.001

CME
CME Accreditation Page and Author Disclosure

Goal Statement
The goal of Obstetrics and Gynecology Clinics of North America is to keep practicing physicians up to date with current clinical practice in OB/GYN by providing timely articles reviewing the state of the art in patient care.

Accreditation
The Obstetrics and Gynecology Clinics of North America is planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Virginia School of Medicine and Elsevier. The University of Virginia School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
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The American Medical Association has determined that physicians not licensed in the US who participate in this CME enduring material activity are eligible for a maximum of 15 AMA PRA Category 1 Credit (s)™ for each issue, 60 credits per year.
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The University of Virginia School of Medicine requires that all CME activities accredited through this institution be developed independently and be scientifically rigorous, balanced and objective in the presentation/discussion of its content, theories and practices.
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The faculty and staff of the University of Virginia Office of Continuing Medical Education have no financial affiliations to disclose.
The authors/editors listed below have identified no professional or financial affiliations for themselves or their spouse/partner: Nancy E. Avis, PhD; Joyce T. Bromberger, PhD; Claudia U. Chae, MD, MPH; Sybil Crawford, PhD; Sheila Dugan, MD; Joel S. Finkelstein, MD; Ellen B. Gold, PhD; Robin Green, PSYD; Gail A. Greendale, MD; Siobán D. Harlow, PhD; Carla Holloway, (Acquisitions Editor); William Irvin, MD (Test Author); Howard M. Kravitz, DO, MPH; Bill L. Lasley, PhD; Pauline M. Maki, PhD; Daniel S. McConnell, PhD; Pangaja Paramsothy, MPH; John F. Randolph, Jr., MD; William F. Rayburn, MD, MBA (Consulting Editor); MaryFran R. Sowers, PhD; Barbara Sternfeld, PhD; Kim Sutton-Tyrrell, PhD; Rebecca C. Thurston, PhD; and Rachel P. Wildman, PhD.
The authors/editors listed below identified the following professional or financial affiliations for themselves or their spouse/partner:Sherri-Ann M. Burnett-Bowie, MD, MPH is an industry funded research/investigator for Amgen. Carol A. Derby, PhD is an industry funded research/investigator for Bristol Meyers-Squibb. Hadine Joffe, MD, MSc is an industry funded research/investigator for Bayer HealthCare Pharmaceuticals, Forest Laboratories, and GlaxoSmithKline, and is a consultant for Pfizer. Joan C. Lo, MD is an industry funded research/investigator for Amgen, Johnson and Johnson, and GlaxoSmithKline. Nanette Santoro, MD (Guest Editor) is a stock and patent holder with Menogenix.

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The University of Virginia School of Medicine, as an ACCME provider, requires that all faculty presenters identify and disclose any off-label uses for pharmaceutical and medical device products. The University of Virginia School of Medicine recommends that each physician fully review all the available data on new products or procedures prior to clinical use.

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Obstetrics and Gynecology Clinics of North America , Vol. 38, No. 3, September 2011
ISSN: 0889-8545
doi: 10.1016/S0889-8545(11)00086-6

Contributors
Obstetrics and Gynecology Clinics of North America
Perimenopause
GUEST EDITOR: Nanette Santoro, MD
CONSULTING EDITOR: William F. Rayburn, MD, MBA
ISSN  0889-8545
Volume 38 • Number 3 • September 2011

Contents
Cover
CME Accreditation Page and Author Disclosure
Contributors
Forthcoming/Recent Issues
Perimenopause
Preface
The SWAN Song: Study of Women’s Health Across the Nation’s Recurring Themes
The Timing of the Age at Which Natural Menopause Occurs
Adiposity and the Menopausal Transition
Reproductive Hormones and the Menopause Transition
Adrenal Androgens and the Menopausal Transition
The Menopausal Transition and Cardiovascular Risk
Vasomotor Symptoms and Menopause: Findings from the Study of Women's Health across the Nation
Bone and the Perimenopause
Perimenopause and Cognition
Physical Activity and Health During the Menopausal Transition
Sleep During the Perimenopause: A SWAN Story
The Perimenopause and Sexual Functioning
Menstruation and the Menopausal Transition
Mood and Menopause: Findings from the Study of Women's Health Across the Nation (SWAN) over 10 Years
Index
Obstetrics and Gynecology Clinics of North America , Vol. 38, No. 3, September 2011
ISSN: 0889-8545
doi: 10.1016/S0889-8545(11)00088-X

Forthcoming/Recent Issues
Obstetrics and Gynecology Clinics of North America , Vol. 38, No. 3, September 2011
ISSN: 0889-8545
doi: 10.1016/j.ogc.2011.07.003

Foreword
Perimenopause

William F. Rayburn, MD, MBA, Email: [e-mail]
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, MSC 10 5580; 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
This issue of the Obstetrics and Gynecology Clinics , edited by Nanette Santoro, MD, provides an important update about the perimenopause and its impact on American women. A clearer picture of this transition period is provided by the authors using survey results from women through the National Institutes of Health's funded Study of Women's Health Across the Nation (SWAN). Menopause is the permanent cessation of any vaginal bleeding. Those years before menopause that encompass the change from normal ovulatory cycles to the cessation of menses are known as the perimenopause or the menopausal transition. The median age for the onset of the perimenopause process is 47–48 years, while this transition period from reproductive to postreproductive status lasts between 2 to 8 years for most women.
Throughout the perimenopause, vaginal bleeding results from an increasing dysfunction of ovulation with a proliferating endometrium from estrogen effects not fully modulated by progesterone. Most women report hot flushes for up to several years that range daily from less than 1 to more than 15 episodes. In addition to this nuisance, women have frequent concerns about the relation between a lack of estrogen and any potential harm on their mental health, metabolism, coronary artery function, cancer risk, and bone integrity.
This Obstetrics and Gynecology Clinics issue addresses many of these health issues common to an aging female population. For example, the perimenopause and menopause are not supported by the medical literature to have a deleterious effect on mental health. Emotional stability during this transition period may be disrupted by impaired sleep resulting from hot flushes. Supplemental estrogen may improve sleep quality by shortening the time to sleep onset and by increasing the proportion of sleep that is rapid eye movement. Estrogen is also believed to protect against neuronal cytotoxicity by several mechanisms. Beneficial effects from estrogen supplementation have been reported on cognition, especially verbal memory. Any positive influences are likely only in select populations and of very limited value, especially among healthy women.
Reproductive-age women lag behind men in the incidence of coronary heart disease and by 20 years for myocardial infarction and sudden death. After menopause, the risk of coronary heart disease doubles for women, with atherogenic lipid levels rising to levels that are equivalent to or above those in men.