Climacteric : the journal of the International Menopause Society
-
The gynecologist is often the only physician a woman consults on a regular basis and therefore gynecologists play a crucial role in the primary prevention of cardiovascular disease. Cardiovascular risk factors in women entering the menopausal transition are poorly managed, partly due to the fact that primary-care physicians, gynecologists and cardiovascular physicians often fail to identify cardiovascular risk factors and also undertreat women at increased cardiovascular risk. ⋯ Gynecologists and cardiologists should work together as a team in identifying and managing cardiovascular risk factors. European cardiologists and gynecologists have written a Consensus statement and a short guide to help menopause physicians to assess and manage the cardiovascular risk in women.
-
Soon after combined estrogen/progestogen oral contraceptives (COCs) were introduced in the 1950s, it was established that they cause venous thromboembolism (VTE), that the risk is related to estrogen dose, and that COCs also increase the risk of myocardial infarction among female smokers over age 35. Stroke risk is also increased. early studies of supplemental hormone therapy were inconclusive. ⋯ It is likely that the WHI studies were biased and that they overestimated the overall and time- and duration-specific risks of VTE, myocardial infarction and stroke. Particularly for myocardial infarction, a protective effect, perhaps strongest among the youngest women, but present at all ages, may correctly have been identified in earlier observational studies, and have been missed in the WHI studies. This paper was presented by Professor Shapiro as a Plenary Lecture at the 12th World Congress on Menopause, Madrid, May 2008.
-
To investigate the long-term effects of a levonorgestrel-releasing intrauterine system on the endometrium and lipid profile of breast cancer patients taking tamoxifen. ⋯ The levonorgestrel-releasing intrauterine system does not affect serum lipid levels significantly and may prevent the increased risk of endometrial polyps and hyperplasia associated with the use of tamoxifen in women with breast cancer. This may reduce the need for investigation of side-effects in women taking tamoxifen and also reduce patient discomfort while improving treatment adherence.