Menopause: Biology and Pathobiology

by Rogerio A. Lobo MD (Editor), Jennifer Kelsey (Editor), Robert Marcus MD (Editor)

Overview

Menopause: Biology and Pathobiology is a comprehensive volume covering all aspects of the biology, anatomy, physiology, pathobiology, and pharmacology of menopause, as well as its diagnosis and management.
The book is divided into four sections: Basic Biology, Epidemiology, Menopausal Systems Pathophysiology, and Intervention. Basic Biology covers such fundamentals as ovarian anatomy and physiology, mechanisms of steroid hormone action, chronobiological effects, and premature menopause. Epidemiology includes, among others, chapters on methodology challenges in the study of menopause, how to distinguish the effects of age from those of menopause, and a discussion of the key differences in demographics, environmental factors, and ethnicity in the menopause experience. The Pathophysiology section contains chapters on menopause and its various effects on the body, including sexuality, skin, brain, the cardiovascular system, cancers, and mood. The final section includes detailed chapters on intervention and management techniques, with topics including alternative therapies to hormone replacement, exercise, and estrogens and osteoporosis.

* Well-referenced to allow easy look up of anything related to menopause
* Presents the latest thinking on basic science and clinical topics
* Exposes what the current gaps in our knowledge are
* Presents current expert opinions

Product Details

ISBN-13:	9780080536200
Publisher:	Elsevier Science
Publication date:	05/22/2000
Sold by:	Barnes & Noble
Format:	eBook
Pages:	672
File size:	12 MB
Note:	This product may take a few minutes to download.

About the Author

Dr. Lobo, formerly Rappleye Professor and Chair of the Department of Obstetrics and Gynecology, and Director of the Center for Reproductive Sciences, Columbia University, has done extensive research in various areas of reproductive endocrinology and infertility including estrogen metabolism and menopause. Dr. Lobo has a primary interest in hyperandrogenic disorders and polycystic ovary syndrome. He frequently serves as editor for peer-review journals and has authored over 300 articles and 16 books.
Dr. Marcus is Professor-Emeritus, Stanford University, where he served on the full-time medical faculty for almost 25 years, before joining the Emeritus faculty in 2001. At Stanford, he was located at the Veterans Affairs Medical Center, Palo Alto California, where he served as Director of the Aging Study Unit of the Geriatrics Research, Education,&Clinical Center from 1982-2001. Dr. Marcus enjoyed a long career as a clinical investigator in the fields of bone and mineral metabolism and osteoporosis medicine. His own research interests included diagnosis and therapy of primary hyperpara-thyroidism, interactions of the parathyroid-vitamin D axis with estrogen, age-related changes in the growth hormone-IGF axis, effects of growth hormone replacement for older men and women, metabolic and musculoskeletal effects of resistance exercise in older men and women, adolescent bone acquisition, and osteoporosis therapeutics. Dr. Marcus’ laboratory was a study site for many of the pivotal clinical trials in the osteoporosis field. These include the NIH Post-menopausal Estrogen/Progestin Interventions Trial (PEPI), Merck’s Fracture Intervention Trial (FIT), Lilly’s Multiple Outcomes of Raloxifene Intervention (MORE), and Lilly’s registration trial of recombinant PTH(1-34) in the treatment of postmenopausal women with osteoporosis. In 2001. Dr. Marcus joined the US Affiliate of Eli Lilly&Company to support Lilly’s program in Osteoporosis and Skeletal Medicine. From 2003 until his retirement from Lilly in 2008, Dr. Marcus was the lead physician for the Forteo team at Lilly. He has published more than 150 research papers, editorials, and reviews. Dr. Marcus served as President of the American Society for Bone&Mineral Research in 2000-2001.

Table of Contents

Basic Biology:
The Molecular Pharmacology of the Estrogen and Progesterone Receptors.
Ovarian Anatomy and Physiology.
Regulation of the Hypothalamic-Pituitary-Gonadal Axis: Role of Gonadal Steroids and Implications for the Menopause.
Gonadotropins and Menopause: New Markers.
Genetic Programming in Ovarian Development and Oogenesis.
Neuroendocrine Regulation of the Perimenopause Transition.
Changes in Men as They Age: The "Manopause."
Premature Ovarian Failure.
Perimenopausal Changes in FSH, the Inhibins and the Circulating Steroid Hormone Milieu.
Epidemiology:
Methodologic Challenges in the Study of Menopause.
SWAN: A Multi-center, Multi-ethnic, Commnity-based Cohort Study of Women and the Menopausal Transition.
Demographics, Environmental Influences, Ethnic And International Differences In The Menopausal Experience.
Distinguishing the Effects of Age From Those of Menopause.
Menopausal Systems Pathophysiology:
Menopausal Hot Flashes.
Menopause and Cardiovascular Disease.
Insulin Resistance, Body Weight, Obesity, Body Composition and the Menopausal Tradition.
Influence of Estrogen on Collagen.
The Growth Hormone IGF-I Axis and Menopause.
Bone&Calcium.
Menopause and the Skin.
Estrogen Therapy and the Brain.
Gyno-Urinary System.
Is There a Relationship Between Menopause and Mood?
Immunologic Aspects of Menopause.
Cancers.
Sexuality.
Intervention:
Historical Perspectives.
Prevention Trials in Perimenopausal Women and Postmenopausal Women.
Estrogens: Different Types, Properties.
Progestogens.
Androgens.
The Alternative Therapies to Hormone Replacement Therapies.
Calcium Nutriture: A Model System for Understanding Menopause-Nutrient Interactions.
Exercise.
Estrogens and Osteoporosis.
Osteoarthritis and Menopause.
The Epidemiology of Cardiovascular Disease and Postemenopausal Hormone Therapy.
Interventions for the Control of Symptoms. Effects of Steroids on Mood/Depression.
Hormone Replacement Therapy and Breast Cancer.
HRT and Risk of Endometrial Cancer.
Risk of Pulmonary Embolism/Venous Thrombosis.
Combined Estrogen-Androgen Replacement Therapy: Benefits and Risks.
Biology of DHEA.
Menopausal Issues for Older Women.
Decision Analysis Applied to Postmenopausal Hormone Replacement Therapy.

Editorial Reviews

This scholarly book covers virtually all aspects of postmenopausal health...Everything is here: the complexity of premature ovarian failure, reproductive options during the perimenopause, the variability in the symptoms of the perimenopause, and the physiology and treatment of hot flashes.
—Ego Seeman

The New England Journal of Medicine

This text is broad in its presentation. Readers who care for menopause-age women will find ample material on physiology, symptom treatment, and health promotion, with accompanying information on the supportive literature.
—Mary Ellen Rousseau

Psychosomatic Research

Reviewer: Tessa E Madden, MD, MPH(Washington University School of Medicine)
Description: This is an extensive review of both the basic science of the menopause, and the provision of clinical care to menopausal or perimenopausal women. Thorough discussions cover the physiologic effects of the menopause and appropriate, evidence-based management. This update of the 1999 edition is appropriate as the results of the Women's Health Initiative (WHI) have greatly impacted hormonal therapy and expanded our knowledge of physiologic changes associated with menopause.
Purpose: The purpose is to provide the scientific basis and rationale for management of menopausal women and the associated symptoms. This is a substantial and growing population in the United States. This edition incorporates the new clinical information from the WHI and it is valuable to have a single book that can serve as a reference for a wide range of topics, from understanding the molecular pharmacology of estrogen and progesterone receptors to alternative medical therapies for menopausal symptoms. In covering a diverse array of topics, the book succeeds in its mission.
Audience: According to the editor, the book is appropriate reading for all providers of women's healthcare and medical professionals in training. I would argue that the intended audience varies from chapter to chapter. Some of the basic science chapters are very dense and may not be appropriate for someone without a strong scientific background, but the chapters with clinical relevance are much more accessible. Dr. Lobo is a well known and respected expert in the field of reproductive endocrinology with over 300 publications.
Features: "Chapters covering basic science and research aspects of the menopause transition, including estrogen and progesterone receptors, genetic programming and ovarian physiology begin the book. A thorough and up-to-date chapter details the epidemiology of menopause. Sections cover the varying effects of the menopause on physiologic systems, including cardiovascular, bone, and brain. A further section provides a comprehensive review of observational studies and clinical trials conducted on the effects of hormone therapy. The preface to each section by the editor greatly facilitates understanding of the key points contained in each chapter. A strength of the book is the inclusion of sections on traditional hormone therapy, other medical therapies, and complementary and alternative medicines. It's important for clinicians to be aware of these therapies, since greater numbers of women are choosing to avoid hormone therapy. Unfortunately, there is no discussion of the use of SSRIs for the treatment of menopausal symptoms. The chapter on contraception in older women is important as women over 40 have the second highest rate of unintended pregnancy in the U.S., but it contains outdated information about intrauterine devices (IUD). In addition, a discussion about use of the levonorgestrel IUD to protect the endometrium in women taking hormone therapy is lacking, particularly as the evidence suggests the addition of oral progesterones is problematic. "
Assessment: Overall, this is an extremely useful and pertinent reference for any clinician providing care to peri- and postmenopausal women and competes as one of the most comprehensive and current menopause books available. The new edition is timely as we incorporate the WHI results and the lessons learned about hormonal therapy into our practices and our management of women in the menopause.