Menopause : the journal of the North American Menopause Society
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Editorial Comparative Study
Risk factors for low back pain in women: still more questions to be answered.
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The menopausal transition is characterized by irregular menstrual cycles and unpredictable hormone levels, including dramatic swings in estradiol (E2). An increasing number of studies have found variable high E2 and low luteal phase progesterone occur with progression of Stages of Reproductive Aging Workshop (STRAW)stage, but the cause remains unclear. To explore the causes of the erratic changes in E2, individual within-cycle secretion patterns of E2, progesterone, follicle-stimulating hormone, luteinizing hormone, inhibin A, and inhibin B were explored in detail. ⋯ Many of the marked increases in ovulatory cycle E2 and cycle irregularities during the menopausal transition may be due to LOOP events and appear to be triggered by prolonged high follicular phase follicle-stimulating hormone levels.
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Randomized Controlled Trial Multicenter Study
Measuring symptom relief in studies of vaginal and vulvar atrophy: the most bothersome symptom approach.
To assess the importance and usefulness of self-reported symptom data, especially the most bothersome symptom, in the evaluation of treatment for vulvovaginal atrophy. ⋯ : The most bothersome symptom approach represents a meaningful new standard for measurement of self-assessed vulvovaginal atrophy symptom change, but evaluation of change in individual symptoms remains an important, unbiased primary analysis of efficacy in vulvovaginal atrophy studies.
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The North American Menopause Society (NAMS) provides a forum through which researchers can present scientific abstracts. After presenting an abstract, the goal is to publish the research as a full-length article. The objective for this study was to determine the publication rate of abstracts presented at NAMS meetings. ⋯ The percentage of abstracts published by NAMS is within the range and within a similar time frame compared with other scientific meetings. Oral presentations are more likely to be rapidly published and may therefore be of higher interest and clinical relevance along with sound methodology and results. Menopause contained the most manuscripts, demonstrating a possible preference of submission to the Society's journal.
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Decision making about menopausal therapies is complex because of the number of clinical factors that must be considered. Menopausal hormone therapy can relieve the vasomotor symptoms of menopause, but the most common preparation, combination estrogen and progesterone, increases the risk of breast cancer. Both tamoxifen and raloxifene can reduce the risk of developing invasive breast cancer, but the adverse effects of these drugs differ substantially. ⋯ Any woman with a family history of breast cancer should be assessed as to whether she is likely to carry a BRCA mutation and referred for genetic counseling and possible genetic testing. Decisions about treatment options should be based on the presence or absence of bothersome vasomotor symptoms, an intact uterus, and risk factors for cardiovascular disease. A simple algorithm is presented to streamline identification and management of menopausal women at high risk for breast cancer.