Benefits of a Multidisciplinary Women's Sexual Health Clinic in the Management of Sexual and Menopausal Symptoms After Pelvic Radiotherapy.

Objective: The objective of this study was to examine patterns of care and outcomes of female cancer patients treated for sexual and menopausal symptoms following pelvic radiotherapy (PRT) at our institution's multidisciplinary Sexuality, Intimacy, and Menopause (SIMS) Program.

Materials And Methods: We performed a retrospective review of 69 female patients who received PRT for gynecologic or gastrointestinal malignancies and were referred for SIMS Program intervention. Indications for referral and treatment patterns were summarized.

Effects of combined 17β-estradiol and progesterone on weight and blood pressure in postmenopausal women of the REPLENISH trial.

Objective: To examine the impact of a single-capsule 17β-estradiol (E2)/progesterone (P4) on weight and blood pressure (BP) when treating moderate to severe vasomotor symptoms in postmenopausal women with a uterus.

Methods: Healthy postmenopausal women with a uterus (aged 40-65, body mass index ≤34 kg/m2, BP ≤140/90 mm Hg) were randomized to daily E2/P4 (mg/mg; 1/100, 0.5/100, 0.

Menopause: Hormones, Lifestyle, and Optimizing Aging.

Although American women spend approximately 30% to 40% of their lives in menopause, a state defined by the cessation of estrogen production by the ovaries, obstetricians and gynecologists in North America receive little formal education about menopausal health. Hormonal therapy has been available for more than 75 years; however, controversies surrounding its use have impacted training of care providers in all specialties. This article offers updates on care for menopausal women, focusing on symptomatology and health issues that arise related to the decline in all reproductive hormones.

The International Society for the Study of Women's Sexual Health Process of Care for the Identification of Sexual Concerns and Problems in Women.

Sexual problems are common in women of all ages. Despite their frequency and impact, female sexual dysfunctions (FSDs) are often unrecognized and untreated in clinical settings. In response, the International Society for the Study of Women's Sexual Health convened a multidisciplinary, international expert panel to develop a process of care (POC) that outlines recommendations for identification of sexual problems in women.

The management of sexuality, intimacy, and menopause symptoms (SIMS) after prophylactic bilateral salpingo-oophorectomy: How to maintain sexual health in "previvors".

"Previvors", or "pre-survivors", are individuals who do not have cancer but have a genetic predisposition to cancer. One such example is women with BRCA mutations. As a result of their predisposition to cancer, many will undergo a bilateral salpingo-oophorectomy when they are premenopausal.

Sexual health and relationships after age 60.

A commonly used phrase describing aging is "60 is the new 40". Although in many aspects of life this may be correct, in discussing sexual health, challenges to maintaining excellent sexual health become more common around age 60. Biological aging challenges physical sexual activity and responsiveness.

Prevalence of postmenopausal symptoms in North America and Europe.

Objective: This study aims to evaluate differences and similarities in the prevalence of postmenopausal symptoms and their impact on postmenopausal women and male partners of postmenopausal women in North America and Europe.

Methods: The Internet-based survey Clarifying Vaginal Atrophy's Impact on Sex and Relationships (CLOSER) was conducted in North America and Europe. The questionnaire included questions on symptoms experienced by women after menopause and the impact of these symptoms overall and specifically on emotional and physical relationships.

Postmenopausal vaginal atrophy: evaluation of treatment with local estrogen therapy.

Postmenopausal vaginal atrophy, resulting from decreased estrogen production, frequently requires treatment. Estrogen preparations provide the most effective treatment; local application is preferred to systemic drugs when treating only vaginal symptoms. As local estrogen therapies have comparable efficacy, this study aimed to understand treatment practices, assess experiences with different forms of local estrogen-delivering applicators, and evaluate satisfaction.

Improved compliance and patient satisfaction with estradiol vaginal tablets in postmenopausal women previously treated with another local estrogen therapy.

Up to half of all postmenopausal women will experience changes in the genitourinary tract induced by the hypoestrogenic state, collectively known as vaginal atrophy. Vaginally administered local estrogen therapy (LET) is the standard of care for symptoms of vaginal atrophy that do not respond to nonhormonal interventions. Several LET formulations are available, and choice of therapy is based largely on patient needs and preferences.

Sexual satisfaction in the elderly female population: A special focus on women with gynecologic pathology.

SEXUAL FUNCTION IN AGING WOMEN: Sexuality is an integral part of human expressions. Mental health plays a major role in sexuality. Several psychological interventions are proposed to increase the sexual quality of life in older women with diverse gynecologic pathology.

Suspected black cohosh hepatotoxicity: no evidence by meta-analysis of randomized controlled clinical trials for isopropanolic black cohosh extract.

Objective: Black cohosh, a popular herbal treatment for menopausal symptoms, has been implicated in a number of hepatotoxicity case reports. The purpose of this investigation was to analyze data gained from clinical trials on the effect of black cohosh on liver function.

Methods: A meta-analysis of randomized, double-blind, and controlled clinical trials was conducted.

Sexually transmitted infections and the aging female: placing risks in perspective.

Gynecological literature is replete with multiple papers on sexually transmitted infections (STIs) in young women. Although those past the reproductive prime may well be at lower risk for STIs than women in the peak reproductive years, STIs are regularly seen in the older cohort and are a cause for significant morbidity and distress. Care givers reluctantly approach or are outright amiss in assessing sexual health of their aging patients, nor is this population adequately counseled regarding practices of safe sex.

Sexuality and intimacy after gynecological cancer.

Matters of sexuality and intimacy greatly impact quality of life of patients with gynecologic cancers. Vast amount of evidence exists showing that cancer dramatically impacts woman's sexuality, sexual functioning, intimate relationships and sense of self. Sexual functioning can be affected by illness, pain, anxiety, anger, stressful circumstances and medications.

Embryonic development and pregnancy test sensitivity: the importance of earlier pregnancy detection.

Embryogenesis research provides information on a time of heightened vulnerability in embryo development: the time from conception to the day a woman misses her menstrual period. During this period, it is vital for the woman to be aware of exposures, behaviors and nutritional factors that could negatively impact the developing embryo. This article discusses this critical, often-overlooked window of development and will review the various types of teratogens that affect pregnancy.

A randomized clinical trial for women with vulvodynia: Cognitive-behavioral therapy vs. supportive psychotherapy.

Many treatments used for women with vulvodynia are based solely upon expert opinion. This randomized trial aimed to test the relative efficacy of cognitive-behavioral therapy (CBT) and supportive psychotherapy (SPT) in women with vulvodynia. Of the 50 participants, 42 (84%) completed 10-week treatments and 47 (94%) completed one-year follow-up assessments.

Clinical application of antialdosterone-containing hormone therapy for postmenopausal women.

Increased awareness of the risk of cardiovascular disease (CVD) in postmenopausal women will aid clinicians in choosing the most appropriate hormone therapy (HT) for their patients. An antialdosterone-containing hormonal therapy offers postmenopausal women advantages beyond simply the relief of menopausal symptoms; drospirenone/estradiol therapy has a theoretical advantage for the modulation of postmenopausal cardiovascular target organ complications. Additionally, drospirenone/ estradiol therapy represents an attractive alternative to other forms of HT.

Assessing sexual function and dyspareunia with the Female Sexual Function Index (FSFI) in women with vulvodynia.

Using the Female Sexual Function Index (FSFI; Rosen et al., 2000), we assessed forty-two women with vulvodynia. Internal consistency was high (Cronbach's alphas = 0.

On the reliability and validity of physician ratings for vulvodynia and the discriminant validity of its subtypes.

Objective: This study aimed to test the reliability and validity of physician ratings in a broadly defined sample of women with vulvodynia and to examine the external validity of the vulvodynia subtypes.

Design: Participants were 50 women who were independently diagnosed with vulvodynia by two study gynecologists. Physician ratings corresponding to Friedrich's three criteria for vulvar vestibulitis were taken at the two examinations.

Considerations in the choice of oral vs. transdermal hormone therapy: a review.

The benefit/risk profile of postmenopausal hormone therapy has been under greater scrutiny since Women's Health Initiative study data were published in July 2002. A nominal analysis showed the study drug, a combination of 0.625 mg conjugated equine estrogens (CEE) and 2.

Protect yourself from malpractice suits.

There are many areas in the practice of gynecology that can lead to malpractice lawsuits for a practitioner who is not careful, even if he or she practices good medicine. Potential risks include failure to diagnose cancer, not following up with patients, failure to thoroughly check test results, and not keeping proper documentation. The cautious physician will attend to every problem that a patient presents, make sure that patients follow instructions, keep meticulous documentation, and always follow up to make sure his or her patient is progressing well.