Management of the Perimenopause (Practical Pathways in Obstetrics and Gynecology)

A UNIQUE DECISION-MAKING TOOL FOR DAILY PRACTICE

This evidence-based resource provides easy-to-use, expert guidance on the assessment and treatment of common perimenopausal problems seen in daily office practice. After a brief overview of physiologic and endocrinologic changes, and the staging of the perimenopause (by STRAW definition), you'll find practical, easy-to-access coverage of:

Management of specific symptoms and problems, such as hot flashes, cognitive changes, breast masses, and osteoporosis
Preventive clinical practice, featuring in-depth coverage of hormone replacement therapies
Alternative therapies, including vitamins, herbs, and phytoestrogens
Separate sections cover screening tests and all major alternative therapies.

About the Practical Pathways Series:

Practical Pathways in Obstetrics & Gynecology is a unique new series especially designed to tackle the challenging clinical topics encountered in daily practice. Each title in the series features a standardized, user-friendly approach that guides you systematically through evaluation, diagnosis, and management:

A high-yield, algorithmic Pathway at the start of most chapters provides an “at-a-glance” summary of recommended management
What's the Evidence? questions summarize major clinical trials and their application to daily practice
Guiding Questions review what strategic questions clinicians should ask themselves when first evaluating a patient
Key Points are highlighted in the margins
Case Studies demonstrate the clinical application of concepts, and further hone diagnostic skills
References facilitate further research or study

Contents

Management of the Perimenopause
Introductory information
Approach to the patient
Staging of the Perimenopause (STRAW definition)
Perimenopausal Symptom Complex
Intermittent hot flashes
Cognitive changes
Depression, moodiness, irritability, and midlife stress
Sleep dysfunction
Sexual function and change in libido
Migraine and cluster headaches
Physical changes
Role of growth hormone in perimenopause
Management of specific clinical problems
Fertility and contraception
Abnormal uterine bleeding (menorrhagia and menometrorrhagia)
Uterine myoma
Pelvic pain
Ovarian cyst or mass
Breast pain, mass, or discharge
Depression, moodiness, and PMS
Vulvodynia
Androgens and androgen therapy
Hormone therapy: observational studies to clinical trials
Hormone therapy: when and how
Preventive clinical practice
Cancer screening and prevention
Cardiovascular health and lipoprotein disorders
Preventing osteoporosis
Thyroid dysfunction
Alternative Medicine Use
Alternative Medicine Use in Management of Perimenopause
5. Alternative medicine use
a. Supplements
b. Soy and phytoestrogens
c. Herbs
d. Vitamin E
e. Aspirin
f. DHEA
g. Megavitamins and antioxidants