Menopause: changes, choice and HRT

How to use this book

Author's Note

Prologue

Introduction

Section 1. History, Menopause, HHT and the Women's Health Initiative Study

1. A History of the Menopause and HRT

A history of management of the menopause

Sex and its influence on the undemanding of menopause

The development of effective hormone therapy

The development of oral contraception and HRT

The development of Hormone Replacement Therapy (HRT)

Summary

2. The Anatomy and Physiology of the Menopause

Menopause

Peri-menopause

Post-menopause

Premature menopause

The endocrine system

Ovarian hormones

Anatomy of the reproductive organs of the pelvis

Ovarian physiology and the sex hormones

The end of female production of estradiol and progesterone

Physiological changes during peri-menopause

Summary

3. The Women's Health Initiative Study

The Study

The suitability of women selected for HRT studies

Unfortunate consequences of the WHI Study

Medical research reports, studies and their interpretation

Summary

Section 2. Menopause and Health

4. Hormones and Genital Cancer

Endometrial (uterine) cancer

Ovarian cancer

Breast cancer

Genetic mutations in pre-menopausal women

Risk factors associated with development of breast cancer

Cluster cancers

Summary

5. Estrogen and the Cardiovascular System

The protective effect of estrogen

Thrombosis (clot)

Varicose veins

Summary

6. Osteopaenia and Osteoporosis

Bone mineral density studies

The role of estrogen in prevention and treatment of osteoporosis

The increased risk of osteoporosis for a woman who stops HRT

Summary

7. Hormones, Brain Function, Memory and Dementia

Alzheimer's dementia

Summary

8. Loss of Libido (Hypoactive Sexual Desire Disorder)

Estrogen, progesterone and testosterone

Summary

Section 3. Management of Menopause

9. Hormone Replacement Therapy Regimens

The development of hormone therapy regimens

Progesterone and progestogens (progestins)

Testosterone

Prescribing advice and HRT

For how long should HRT be used?

Summary

10. Methods of Delivering HRT Regimens

Oral hormone therapy regimens

Transdermal therapy regimens

Hormone implants

Troches

Vaginal therapy

Summary

11. Adverse Side-Effects of HRT

Breakthrough bleeding

Mastalgia

Skin, hair growth and hair loss

Weight gain

Summary

12. Other Medical Treatments for Menopause

(SERMs) Specific estrogen receptor modulators

Neurotransmitter modulators

Summary

13. Complementary and Alternative Therapies for the Menopause

Proof of efficacy

Vitamins

Soy products

Red clover extract (Promensil)

Black cohosh (Remifemin)

Evening primrose oil

Traditional Chinese herbal medicines-Ginseng and Dong Quai

Progesterone cream

Wild yam cream

DHEAS (Dehydroepiandrosterone sulphate)

Over-the-counter products

Summary

14. HRT Following Breast Cancer, Endometriosis or Fibroids

HRT after breast cancer

HRT and endometriosis

HRT and fibroids (fibromyoma)

Summary

Section 4. Choices

15. The Balance and Beauty of Ageing

16. Menopause Today

Epilogue

Section 5.

Glossary

Acronyms

Appendices

Appendix 1. Therapeutic goods administration (TGA)

Appendix 2. Oral hormone preparations: estrogen/progesterone progestogens

Appendix 3. Progestogens for use with estrogens

Appendix 4. Transdermal therapy regimens - patches, creams, gels, sprays

Appendix 5. (SERMs)

Appendix 6. Neurotransmitter modulators used for menopause symptoms

Appendix 7. Treatments of osteopaenia and osteoporosis

Appendix 8. Hormones involved in homeostasis (balance) in humans

Appendix 9. Hormones and cancer

Appendix 10. Assessing research in medical studies

Endnotes

Acknowledgments

Index

About the Authors