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Women's Health

Transexual 2011.pdf   

Care of Patients post-Sexual Assault 2011.pdf  

Hormone Replacement Therapy 2010.pdf    

Menopause 2010 - Position Statement

Menopause 2008 - Position Statement  

Management of Menopausal Symptoms 2006 (NEJM)

Management of Menopausal Symptoms 2005 (NIH)    

Hot Flahses - Pathophysiology & Treatment   (Mayo Clinic Proceedings Nov. 2002)  

Female Sexual Dysfunction  
Deborah J. Lightner - Mayo Clinic Proceedings July 2002 Volume 77 Number 7  


In Vitro Fertilization 2007 (NEJM)     |   Contraceptives 2007.pdf    

Complementary and Alternative Medicine for Menopausal Symptoms: A Review of Randomized, Controlled Trials
Ann Intern Med. Nov. 11, 2002;137:805-813

WHI Study 2004 (Women's Health Initiative)

Alternatives Rx to Estrogen Therapy Therapy to Menopausal Symptoms:

Medroxyprogesterone acetate 10 mg po qd
Benefits:  Relieves hot flushes, prevents osteoporosis
Side effects/risks:  Worsening symptoms of urogenital atrophy, depression/sedation, decreased libido, decreased HDL, effect on breast cancer not known

Neurontin (Gabapentin) 300 mg 1-3x/day  (Mayo Clinic Proceedings Nov. 2002;77:1159 Charles Loprinzi, etc.)
Side effects/risk:  light-headedness & dizziness.

Antidepressant:  Venlafaxine 75 mg, or 150 mg daily  

SERMS (e.g., raloxifene) 60 mg/day
Benefits:  Prevents osteoporosis, may lower cardiac risk factors, may lower risk of breast cancer, may not cause endometrial hyperplasia
Side effects/risks:  May worsen hot flushes, more expensive than estrogen, no effect on HDL cholesterol, no cardioprotective effects

Bisphosphonate (as Alendronate/Fosamax) 10 mg/day
Benefits:  Prevents osteoporosis
Side effects/risks:  Esophageal irritation

Soy protein supplement

Calcium supplementation 1500 mg po qd
Benefits:  Minimal effect on osteoporosis prevention
Side effects/risks:  Unmask asymptomatic hyperparathyroidism

Clonidine 0.1 mg po qd or bid
Benefits:  Moderate relief of hot flushes
Side effects/risks:  Dry mouth, sedation

Bellergal 1 tablet bid  
Benefits:  Relieves hot flushes
Side effects/risks:  Drowsiness, paresthesias (rare)

Postmenopausal Hormone Replacement Therapy (Scientific Review)
Heidi D. Nelson; Linda L. Humphrey; Peggy Nygren; Steven M. Teutsch; Janet D. Allan
JAMA. August 21, 2002;288:872-881  
Benefits of HRT include prevention of osteoporotic fractures and colorectal cancer, while prevention of dementia is uncertain.
Harms include CHD, stroke, thromboembolic events, breast cancer with 5 or more years of use, and cholecystitis.

Emergency Contraception 2002
Emergency contraception is used to prevent pregnancy after a coital act not adequately protected by a regular method of contraception. In contrast to early medical abortion, emergency contraception prevents a pregnancy from starting and does not disrupt an established pregnancy.
The most commonly used approaches consist of two oral doses of contraceptive steroids.

In the largest randomized, controlled trial to date, levonorgestrel prevented about 85% of pregnancies that would have occurred without its use.  Hormonal emergency contraception has no known medical contraindications, although it is not indicated for suspected or confirmed pregnancy. However, if hormonal emergency contraception is inadvertently taken in early pregnancy, neither the woman nor the fetus will be harmed. Nausea and vomiting associated with the Yuzpe regimen can be reduced by prophylactic use of meclizine. A strong medical and legal case exists for making hormonal emergency contraception available over the counter, as has happened in countries other than the United States. Easier access to and wider use of emergency contraception could dramatically lower the high rates of unintended pregnancy and induced abortion in the United States.   Ann Intern Med. August 8, 2002;137:180-189.

Transdermal Testosterone Treatment in Women with Impaired Sexual Function after Oophorectomy
Jan L. Shifren, M.D
NEJM  Volume 343:682-688 September 7, 2000
In women who have undergone oophorectomy and hysterectomy, transdermal testosterone  (300 µg of testosterone per day transdermally for 12 weeks each) improves sexual function and psychological well-being.

"Clinical Challenges of Perimenopause: Consensus Opinion of The North American Menopause Society" --
(Menopause 2000;7:5-13).  

"A Decision Tree for the Use of Estrogen Replacement Therapy or Hormone Replacement Therapy in Postmenopausal Women: Consensus Opinion of The North American Menopause Society" --
(Menopause 2000;7:76-86).

Hormone Replacement Therapy

Ischemic Stroke Risk With Oral Contraceptives -   A Meta-analysis
JAMA. July 5, 2000;284:72-78   Leslie Allison Gillum, BA; Sai Kumar Mamidipudi, MBBS(India); S. Claiborne Johnston, MD

Chest Pain in Women with Normal Coronary Angiograms  NEJM-- March 23, 2000 -- Vol. 342, No. 12

Women's Health on the Web

AHA/ACC Scientific Statement: Consensus Panel Statement 1999
Guide to Preventive Cardiology for Women


Mifeprex / Mifepristone (RU 486 pill)  Information site



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