Chapter 11 – Menopause
CONTENTS
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Menopause: An introduction
- Normal physiological and endocrine changes at perimenopause and post menopause
- Menopausal symptoms
- The menopause consultation
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Menopausal Hormone Therapy (MHT)
- Systemic menopausal hormone therapy
- Women with an intact uterus
- After hysterectomy (with ovaries retained)
- Systemic MHT preparations and delivery systems
- Tibolone
- Selective estrogen receptor modulators
- Contraindications to systemic MHT including Tibolone and SERMs (consider referral to menopause specialist):
- Side effects and adverse events of systemic MHT
- Topical vaginal estrogen and genitourinary symptoms of menopause (vulvovaginal atrophy)
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Non-hormonal pharmacological treatments for menopausal vasomotor symptoms
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Alternative and herbal treatments
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Treating menopausal symptoms after breast cancer
- Premature ovarian insufficiency
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Other issues to consider
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- Low bone mass/ osteoporosis
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Cardiovascular disease
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Resources
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References
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