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Menopause Neerja Goel, Bindiya Gupta

SECTION I: BASIC SCIENCES
CHAPTER 1:Definitions and Epidemiology
- INTRODUCTION
- DEMOGRAPHICS
- DEFINITIONS
- STAGES OF REPRODUCTIVE AGING
- AGE OF MENOPAUSE
  - Trends in Age at Menopause
  - Factors Affecting Timing of Menopause
- EPIDEMIOLOGY OF MENOPAUSAL SYMPTOMS
- KEY POINTS
CHAPTER 2:Pathophysiology of Menopause
- FOLLICLE POPULATION
- OVARIAN-PITUITARY-HYPOTHALAMIC AXIS
- PERIMENOPAUSE
- HORMONAL CHANGES DURING MENOPAUSE
- IMPACT OF ESTROGEN DEFICIENT ENDOCRINOPATHY
- KEY POINTS
CHAPTER 3:Symptoms and Signs
- PERIMENOPAUSE
- MENOPAUSE
- MEASUREMENT OF MENOPAUSAL SYMPTOMS
- KEY POINTS
CHAPTER 4:Cancer Screening
- SCREENING OF CANCER CERVIX
- SCREENING FOR ENDOMETRIAL CANCER
  - Screening Modalities
  - Screening Guidelines 22
    - Screening of Average Risk and Increased Risk Asymptomatic Women
    - Screening of Women at Very High Risk
- SCREENING FOR OVARIAN CANCER
- SCREENING OF BREAST CANCER
- KEY POINTS
SECTION II: HORMONE THERAPY
CHAPTER 5:Pretreatment Evaluation
- PATIENT ASSESSMENT
- KEY POINTS
CHAPTER 6:Guidelines for Hormone Therapy
- ESTROGENS
- PROGESTOGEN
  - Side Effects
  - Commonly Used Progestogens
- DOSES AND ESTROGEN: PROGESTOGEN REGIMENS
- STARTING HORMONE THERAPY
- MONITORING
- DURATION
- DISCONTINUING HORMONE THERAPY
- HORMONE THERAPY TRIALS
  - Women's Health Initiative Trials
  - Million Women Study
- ANDROGEN THERAPY
- TIBOLONE
  - Tibolone Regime
- ROLE OF ORAL CONTRACEPTIVES DURING THE PERIMENOPAUSE
- BIOIDENTICAL HORMONE THERAPY
- BENEFITS OF HORMONE THERAPY
- ADVERSE EFFECTS OF HORMONE THERAPY
- HORMONE THERAPY IN SPECIAL CONDITIONS
- KEY POINTS
CHAPTER 7:Vasomotor Symptoms
- INCIDENCE
  - Occurrence of Hot Flush
- PATHOPHYSIOLOGY OF HOT FLUSHES
- MANAGEMENT
- KEY POINTS
CHAPTER 8:Osteoporosis
- DEFINITION
  - World Health Organization Criteria for Classification of Osteoporosis
- EPIDEMIOLOGY
  - Prevalence
  - Morbidity and Mortality
- PATHOPHYSIOLOGY
  - Estrogen Regulation on Bone Metabolism
- RISK FACTORS FOR OSTEOPOROTIC FRACTURE
- EVALUATION
- MANAGEMENT
  - Life Style and Nonpharmacological Measures for Bone Health
  - Pharmacological Therapy
- KEY POINTS
CHAPTER 9:Urogenital and Sexual Symptoms
- PREVALENCE
- PATHOPHYSIOLOGY
- SYMPTOMATOLOGY
- PATIENT EVALUATION
- TREATMENT
- PATIENT COUNSELING AND FOLLOW-UP
- SUMMARIES OF VARIOUS MENOPAUSE SOCIETIES ON MANAGEMENT OF UROGENITAL AND SEXUAL SYMPTOMS IN MENOPAUSE
- KEY POINTS
CHAPTER 10:End Organ and Connective Tissues
- MENOPAUSE AND SKIN
- MENOPAUSE AND HAIR
- MENOPAUSE AND ORAL CAVITY
- MENOPAUSE AND EYE
- KEY POINTS
CHAPTER 11:Follow-up of Hormone Therapy
- INTRODUCTION
- FREQUENCY OF FOLLOW-UP
- ASSESSMENT OF EFFECTIVENESS AND RISK BENEFIT RATIO
  - Monitor Effectiveness
  - Monitor Risk: Benefit Ratio
- MANAGEMENT OF SIDE-EFFECTS
  - Estrogen-related Side-effects
  - Progestogen-related Side-Effects
- SWITCHING FROM CYCLICAL HORMONE THERAPY TO CONTINUOUS COMBINED HORMONE THERAPY
- DURATION OF USE AND ASSOCIATED RISKS
- DISCONTINUATION OF HORMONE THERAPY
- KEY POINTS
SECTION III: SPECIAL ISSUES
CHAPTER 12:Menopausal Transition: A Signal to Prevent and Offset Sarcopenic Obesity
- INTRODUCTION
- SARCOPENIC OBESITY
- RESISTANCE EXERCISE
- DIET
- KEY POINTS
- ACKNOWLEDGMENTS
CHAPTER 13:Cancers and Hormone Therapy
- RISK OF MALIGNANCIES IN PATIENTS ON HORMONE THERAPY
- STARTING HORMONE THERAPY AFTER CANCER TREATMENT
- REDUCING CANCER RISKS OF HORMONE THERAPY
- KEY POINTS
CHAPTER 14:Cardiac Disease and Menopause
- GENDER DIFFERENCES IN CORONARY ARTERY DISEASE
- CHANGE IN THE RISK OF CARDIOVASCULAR DISEASE AFTER MENOPAUSE
  - Sex Hormones and Cardiovascular Disease Risk
    - Estrogen
    - Testosterone
- MENOPAUSAL HORMONE THERAPY AND HEART DISEASE
  - Summary of Evidence
- COUNSELING PATIENTS
- KEY POINTS
CHAPTER 15:Menopause and Cognitive Function
- THE ESTROGENS AND BRAIN
  - Cognitive Function and Estrogen
- ALZHEIMER'S DISEASE AND DEMENTIA
  - Hormone Therapy and Alzheimer's Disease
- CURRENT GUIDELINES
- ALTERNATIVE THERAPIES TO HELP IMPROVE COGNITIVE FUNCTION
- KEY POINTS
CHAPTER 16:Nonpharmacological Management of Menopause
- PROBLEM STATEMENT
- VASOMOTOR SYMPTOMS
- SLEEP AND MOOD DISTURBANCE
- GENITOURINARY SYMPTOMS
- MUSCULOSKELETAL SYMPTOMS
- CARDIOVASCULAR DISEASE
- OTHER COMPLEMENTARY INTERVENTIONS
- CONCLUSION
- KEY POINTS
CHAPTER 17:Contraception in Perimenopause
- PERIMENOPAUSE
  - Determination of the Perimenopause Age andDiagnosis of Menopause
- NEED OF CONTRACEPTION DURING PERIMENOPAUSE
- CHOICES FOR CONTRACEPTION
- STOPPING CONTRACEPTION
- HORMONE THERAPY AND CONTRACEPTION
- FOLLOW-UP
- KEY POINTS
CHAPTER 18:Perimenopausal and Postmenopausal Obstetrics: Current Scenario
- INFERTILITY IN PERIMENOPAUSAL WOMEN
- TREATMENT OPTIONS FOR PERIMENOPAUSAL WOMEN
  - Ovarian Stimulation with In Vitro Fertilization
  - Oocyte Donation
- ACHIEVING PREGNANCY IN POSTMENOPAUSAL WOMEN
- PREGNANCY COMPLICATIONS IN PERI- AND POSTMENOPAUSAL WOMEN
  - Early Pregnancy Complications
  - Late Pregnancy Complications
- POINTS TO PONDER
  - Can a Postmenopausal Woman be a Surrogate Mother?
  - Can a Postmenopausal Woman Donate her Uterusfor Uterine Transplantation?
- KEY POINTS
CHAPTER 19:Abnormal Menopause
- PREMATURE MENOPAUSE
- SURGICAL MENOPAUSE/INDUCED MENOPAUSE
- DELAYED MENOPAUSE
  - Investigations
  - Treatment
- KEY POINTS
SECTION IV: DISPENSING HORMONE THERAPY
CHAPTER 20:Counseling
- RELATIONSHIP
- GRIEF AND PERSONAL LOSS
- EMOTIONAL CHAOS
- EARLY MENOPAUSE
- KEY POINTS
CHAPTER 21:Prescription Writing
- TERMINOLOGY IN HORMONE THERAPY
- INDICATIONS FOR ESTROGEN THERAPY/ESTROGEN PROGESTOGEN THERAPY
- CONTRAINDICATIONS AND PRECAUTIONS
- HORMONAL PREPARATIONS
  - Estrogens
  - Progestogens
- SHOULD PROGESTINS BE ADMINISTERED TO WOMEN AFTER HYSTERECTOMY?
- REGIMENS OF HORMONE THERAPY
- FOLLOW-UP
  - Management of the Patient with Persistent Symptoms10
  - Dealing with Estrogen Therapy/Estrogen Progestogen Therapy Side Effects11
- PRESCRIBING HORMONE THERAPY
- KEY POINTS
SECTION V: APPENDICES
APPENDIX A:Hormonal Drugs
APPENDIX B:Nonhormonal Drugs
APPENDIX C:Contraception

INDEX

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Index

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Chapter Notes