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Visual Assessment of Genital Health in Menopausal Women

Video Author: Irwin Goldstein, MD
Published on: 08.09.2019
Associated with: Menopause. 26(9):994-1001, September 2019

This is a phase 3 pivotal trial of ospemifene versus placebo in women in menopause with moderate to severe vaginal dryness, a symptom of GSM. On physical examination, such women commonly have vulvar, vestibular and vaginal atrophy. This study, for the first time, utilized vulvar vestibular photography to objectively document changes in genital health. There were no changes noted in photography on placebo, however active therapy with a SERM resulted in regrowth of labia minora, normalization of the urethral gland prominence, resolution of the pallor and erythema of the vestibule and visualization of vestibular moisture. Visual assessment of genital health in such patients should be utilized in future trials.

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Lessons learned in clinical research recruitment of midlife Latinas during COVID-19

Creator: Mayra Duran, MD and Yamnia I. Cortés, PhD, MPH, FNP-BC

Duration: 4:53

This video summarizes lessons learned in the recruitment and enrollment of midlife Latinas for a pilot study to reduce cardiovascular disease risk during the menopause transition.

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Validation of the Menopause Transition Scale (MTS)

Creator: Missy Richeal, Leverage Marketing

Duration: 4:32

The MTS is a thorough patient-centric survey to measure symptoms of menopause as women transition in the outpatient setting.

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The association between shift work exposure and the variations in age at natural menopause among adult Canadian workers: Results from the Canadian Longitudinal Study on Aging (CLSA)

Creator: Durdana Khan

Duration: 3:03

This video summary provides a brief overview of the research investigating associations between shift work (SW) exposure (night and rotating shift) and the variations in age at natural menopause among adult Canadian workers. Secondary data analyses were performed using the Canadian Longitudinal Study on Aging (CLSA) database. Premenopausal women at baseline were followed prospectively for three years. Our results suggest a relationship between shift work, particularly rotating shift, and delayed onset of menopause. We speculate that disruptive circadian stimuli may play a role in menopausal onset and this warrants further investigation.

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Positive impact of a co-designed digital resource for women with early menopause

Creator: Clinical Associate Professor Amanda Vincent, Monash Centre for Health Research and Implementation, Monash University, Melbourne Australia

Duration: 4:17

Early menopause, defined as menopause before age 45 years, affects up to 12% of women. This video summarizes a study evaluating the first co-designed digital resource (www.healthtalkaustralia.org) specifically for women with early menopause.

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Goetsch - Where does postmenopausal dyspareunia hurt?

Creator: Linda Besant

Duration: 5:47

The video introduces an article presenting data from 55 participants eligible for a randomized intervention study to treat moderate/severe postmenopausal dyspareunia. It discusses whether it deserves a broader explanation than that of atrophy. Participants described dyspareunia as “burning” and “raw.” GU examinations carefully checked for painful locations. Vulvar vestibule tenderness, rather than vaginal sensitivity, was the consistent physical finding. Liquid lidocaine could extinguish the pain. A neural phenomenon in the vestibule may be responsible for postmenopausal dyspareunia.

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Meno presentation eVISIT

Creator: Marcus Ortega

Duration: 5:23

Pilot Study of Asynchronous Telehealth Visits Effectively Treats Overactive Bladder

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Managing Sexual Dysfunction in Women with Cancer: A Systematic Review of the Evidence

Creator: Dr. Jennifer Marino

Duration: 2:51

This video describes a systematic review of the efficacy of available interventions for sexual dysfunction in women after cancer.

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Toward a better measure of midlife sexual function: pooled analysis in nearly 1000 women participating in MsFLASH randomized trials

Creator: Caroline Mitchell

Duration: 5:36

In this video we discuss analysis of Female Sexual Function Index (FSFI) responses in close to 1000 women, and identify a score cutoff that more closely correlates with sexually-related personal distress (as measured by the FSDS-R) in postmenopausal and perimenopausal women.

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Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism

Creator:

Duration: 5:16

This video is a summary of the manuscript titled ‘Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism.’ The video discusses briefly the background, purpose, results, and conclusions of this study. Peri-menopause may be the optimal window for intervention, and these women should aim to prevent losses of fat-free mass and decrements in metabolism by participating in resistance and high-intensity exercise.

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Psychological Well-Being of Midlife Women

Creator: Jiwon Lee, PhD

Duration: 4:01

This study used a structural equation model to test the significance of factors associated with the psychological well-being of midlife women in South Korea based on the transactional model of stress and coping. Self-efficacy (exogenous variable) was positively associated with the psychological well-being (endogenous variable) of middle-aged women and appeared to be mediated by perceived stress, menopausal management, menopausal symptoms, and self-compassion. The predictor variables had an explanatory power of 79.5% for psychological well-being. These results can be helpful in the future development of interventions to improve psychological well-being by improving self-efficacy and coping with stress in middle-aged women.

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Effects of E2/P4 oral capsules on bone turnover in women with vasomotor symptoms

Creator: Michael McClung, MD; Sponsored by TherapeuticsMD

Duration: 4:41

In this video, Dr. Michael McClung describes the effects of preparations combining 0.5 mg and 1.0 mg 17β-estradiol with 100 mg of progesterone on biochemical markers of bone metabolism in postmenopausal women with a uterus who were having moderate to severe vasomotor symptoms. This was a post hoc analysis in a subset of women in the REPLENISH study that evaluated the effects of these preparations on vasomotor symptoms. Both of the combined hormone preparations significantly reduced markers of bone resorption and formation at 6 and 12 months of therapy. The research described by Dr McClung suggests that these combinations of estradiol and progesterone may have skeletal benefit in addition to improving vasomotor symptoms in postmenopausal women.

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NT-proBNP, Menopause and Heart Failure

Creator: Aniekan Akpaffiong

Duration: 4:01

The influence of early menopause on the relationship between NT-proBNP and heart failure in postmenopausal women.

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Oral Contraceptives Tubal Ligation and AMH - Langton

Creator: Christine R. Langton

Duration: 3:28

This video provides a brief overview of research examining the association of oral contraceptives, tubal ligation, and anti-Müllerian hormone in the Nurses’ Health Study II cohort.

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Is the cognitive performance of women sensitive to the severity of menopausal symptoms?

Creator: Mankamal Kaur

Duration: 4:54

The video summarizes the statistical methods used and the major findings of the research article entitled ‘Is the cognitive performance of women sensitive to the severity of menopausal symptoms?’. The clinical implications of the current research has also been discussed in the video.

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Decision aids and shared decision making in urogynecology

Creator: May Wakamatsu, MD

Duration: 4:15

The video describes the importance of shared decision making and the use of decision aids with patients who are considering treatment for pelvic organ prolapse and urinary incontinence.

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Factors affecting surgical decision making in carriers of BRCA1/2 pathogenic variants undergoing risk reducing surgery at a dedicated hereditary ovarian cancer clinic

Creator: Michelle Jacobson MD FRCSC NCM

Duration: 3:54

This video summarizes the paper entitled “Factors Affecting Surgical Decision Making in Carriers of Pathogenic BRCA1/2 Variants at a Hereditary Ovarian Cancer Clinic” and describes the role of the dedicated hereditary ovarian cancer clinic at a tertiary care centre.

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Gastrointestinal symptoms in four major racial/ethnic groups of midlife women: race/ethnicity and menopausal status

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Duration: 6:07

The purpose of this study was to explore the associations of race/ethnicity and menopausal status to gastrointestinal (GI) symptoms experienced during the menopausal transition while considering multiple factors that could influence the symptoms.

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Prevalence and factors associated with overactive bladder and stress urinary incontinence in the Japan Nurses' Health Study

Creator: Kazue Nagai

Duration: 5:21

Symptoms of urinary incontinence (e.g., stress urinary incontinence [SUI]) are relatively common in women. Furthermore, overactive bladder (OAB) syndrome occurs in approximately 10% of women. Symptoms of these conditions affect health-related quality of life. Therefore, a better understanding of the prevalence and associated factors of these urinary symptoms is required for improving and preventing these symptoms. This study investigated the prevalence and factors associated with urinary symptoms using cross-sectional data from the Japan Nurses’ Health Study in 12,198 women. The prevalence of OAB was 9.5%, that of SUI was 13.9%, and that of mixed urinary incontinence was 2.1%. Age 45-54 years and postmenopausal status was significantly associated with OAB, and age group (45–49 and 50–54 years), body mass index, and parous status were significantly associated with the risk of SUI.

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Inner metacarpal bone diameter in adult women increases while bone mineral density decreases during and after menopause, assessed by Digital X Ray Radiogrammetry

Creator: Dr. Carl Samuelsson

Duration: 3:50

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Subtypes in menopausal symptoms

Creator: PING LI

Duration: 04:26

This video describes research investigating the existence of significant subgroups of women with similar menopausal symptoms. There are four subtypes of menopause symptoms in middle-aged women, namely, ‘severe symptoms’, ‘dominant sleep-emotion symptoms’, ‘physical/mental exhaustion symptoms’, and ‘no symptoms’ classes.

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Lessons learned in clinical research recruitment of midlife Latinas during COVID-19

Creator: Mayra Duran, MD and Yamnia I. Cortés, PhD, MPH, FNP-BC

Duration: 4:53

This video summarizes lessons learned in the recruitment and enrollment of midlife Latinas for a pilot study to reduce cardiovascular disease risk during the menopause transition.

Play Video |

Validation of the Menopause Transition Scale (MTS)

Creator: Missy Richeal, Leverage Marketing

Duration: 4:32

The MTS is a thorough patient-centric survey to measure symptoms of menopause as women transition in the outpatient setting.

Play Video |

Positive impact of a co-designed digital resource for women with early menopause

Creator: Clinical Associate Professor Amanda Vincent, Monash Centre for Health Research and Implementation, Monash University, Melbourne Australia

Duration: 4:17

Early menopause, defined as menopause before age 45 years, affects up to 12% of women. This video summarizes a study evaluating the first co-designed digital resource (www.healthtalkaustralia.org) specifically for women with early menopause.

Play Video |

Goetsch - Where does postmenopausal dyspareunia hurt?

Creator: Linda Besant

Duration: 5:47

The video introduces an article presenting data from 55 participants eligible for a randomized intervention study to treat moderate/severe postmenopausal dyspareunia. It discusses whether it deserves a broader explanation than that of atrophy. Participants described dyspareunia as “burning” and “raw.” GU examinations carefully checked for painful locations. Vulvar vestibule tenderness, rather than vaginal sensitivity, was the consistent physical finding. Liquid lidocaine could extinguish the pain. A neural phenomenon in the vestibule may be responsible for postmenopausal dyspareunia.

Play Video |

Managing Sexual Dysfunction in Women with Cancer: A Systematic Review of the Evidence

Creator: Dr. Jennifer Marino

Duration: 2:51

This video describes a systematic review of the efficacy of available interventions for sexual dysfunction in women after cancer.

Play Video |

Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism

Creator:

Duration: 5:16

This video is a summary of the manuscript titled ‘Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism.’ The video discusses briefly the background, purpose, results, and conclusions of this study. Peri-menopause may be the optimal window for intervention, and these women should aim to prevent losses of fat-free mass and decrements in metabolism by participating in resistance and high-intensity exercise.

Play Video |

Psychological Well-Being of Midlife Women

Creator: Jiwon Lee, PhD

Duration: 4:01

This study used a structural equation model to test the significance of factors associated with the psychological well-being of midlife women in South Korea based on the transactional model of stress and coping. Self-efficacy (exogenous variable) was positively associated with the psychological well-being (endogenous variable) of middle-aged women and appeared to be mediated by perceived stress, menopausal management, menopausal symptoms, and self-compassion. The predictor variables had an explanatory power of 79.5% for psychological well-being. These results can be helpful in the future development of interventions to improve psychological well-being by improving self-efficacy and coping with stress in middle-aged women.

Play Video |

NT-proBNP, Menopause and Heart Failure

Creator: Aniekan Akpaffiong

Duration: 4:01

The influence of early menopause on the relationship between NT-proBNP and heart failure in postmenopausal women.

Play Video |

Is the cognitive performance of women sensitive to the severity of menopausal symptoms?

Creator: Mankamal Kaur

Duration: 4:54

The video summarizes the statistical methods used and the major findings of the research article entitled ‘Is the cognitive performance of women sensitive to the severity of menopausal symptoms?’. The clinical implications of the current research has also been discussed in the video.

Play Video |

Gastrointestinal symptoms in four major racial/ethnic groups of midlife women: race/ethnicity and menopausal status

Creator: Gayeong Kim

Duration: 6:07

The purpose of this study was to explore the associations of race/ethnicity and menopausal status to gastrointestinal (GI) symptoms experienced during the menopausal transition while considering multiple factors that could influence the symptoms.

Play Video |

Prevalence and factors associated with overactive bladder and stress urinary incontinence in the Japan Nurses' Health Study

Creator: Kazue Nagai

Duration: 5:21

Symptoms of urinary incontinence (e.g., stress urinary incontinence [SUI]) are relatively common in women. Furthermore, overactive bladder (OAB) syndrome occurs in approximately 10% of women. Symptoms of these conditions affect health-related quality of life. Therefore, a better understanding of the prevalence and associated factors of these urinary symptoms is required for improving and preventing these symptoms. This study investigated the prevalence and factors associated with urinary symptoms using cross-sectional data from the Japan Nurses’ Health Study in 12,198 women. The prevalence of OAB was 9.5%, that of SUI was 13.9%, and that of mixed urinary incontinence was 2.1%. Age 45-54 years and postmenopausal status was significantly associated with OAB, and age group (45–49 and 50–54 years), body mass index, and parous status were significantly associated with the risk of SUI.

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The Women’s Study for the Alleviation of Vasomotor Symptoms (WAVS)

Creator: Physicians Committee for Responsible Medicine

Duration: 04:44

Author of the Women’s Study for the Alleviation of Vasomotor Symptoms (WAVS), Neal Barnard, MD, FACC, and WAVS study participants, discuss how eating a plant-based diet, which includes soybeans, can reduce the severity and frequency of hot flashes.

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Effect of an educational intervention on women's healthcare provider knowledge gaps about breast density, breast cancer risk, and screening

Creator: Robin Seitzman, PhD, MPH

Duration:

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Equol and Obesity

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Duration: 3:28

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Dr. Juliana Kling - Good Sleep Quality Matters

Creator:

Duration: 4:52

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Genitourinary syndrome of menopause: A systematic review on prevalence and treatment

Creator: Nikoletta Mili

Duration: 6:03

Video summary of the article entitled “Genitourinary syndrome of menopause: A systematic review on prevalence and treatment”. This article aimed to systematically review the literature to investigate the prevalence of GSM and its treatment. GSM is a highly prevalent condition among women. Nevertheless, women are frequently not aware of its cause and its treatment options. The findings of this review underline the need for education of patients and health care professionals regarding GSM diagnosis and treatment options.

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Hormone therapy as a possible solution for postmenopausal women with nocturia

Creator: Kim Pauwaert

Duration: 5:00

Video summary for “Hormone therapy as a possible solution for postmenopausal women with nocturia: results of a pilot trial”

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Efficacy of progesterone-only treatment for the management of menopausal symptoms: A systematic review

Creator: Sarah Sheehan Stadler, MD

Duration: 3:51

Review of literature regarding progesterone only for the management of menopausal symptoms

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The ewe as an animal model of vaginal atrophy and vaginal Er:YAG laser application

Creator: Martin Hájek

Duration: 3:46

In sheep of reproductive age, we aimed to document decrease in epithelial thickness, glycogen amount and other vaginal changes after castration and the effect of Er:YAG laser as used clinically.

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Migraine and Menopause: Introductory video

Creator:

Duration: 6:02

Brief summary and key points from article

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Improving the Identification of Genitourinary Syndrome of Menopause through the Utilization of the Day-to-Day Impact of Vaginal Aging Questionnaire

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Duration: 5:18

Genitourinary syndrome of menopause (GSM) affects nearly 50% of postmenopausal women. Yet, it is a problem that is difficult for both providers and patients to discuss—particularly the impact of GSM symptoms on a women’s daily activities. This quality improvement project implemented the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire to improve the identification and diagnosis of GSM. Our findings support the use of the DIVA questionnaire as an efficient tool in a busy women’s health practice setting to facilitate GSM identification and diagnosis.

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Perimenopausal vasomotor symptoms and the cortisol awakening response

Creator: Jennifer Gordon

Duration: 3:45

Summary of “Perimenopausal vasomotor symptoms and the cortisol awakening response”

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Memory and vasomotor symptoms in women with breast cancer

Creator: Pauline M. Maki, PhD., Senior Author

Duration: 4:00

This video summarizes findings from a study by Fogel et al. entitled “Physiologic Vasomotor Symptoms are Associated with Verbal Memory Dysfunction in Breast Cancer Survivors”

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The role of commonly prescribed medications and weight gain in menopause- A Women’s Health Initiative study

Creator: Fatima Cody Stanford, MD, MPH, MPA

Duration: 5:25

This video explains how weight promoting medications may lead to weight gain in women during menopause. It should be noted that hormonal changes associated with menopause already lead to weight gain. However, weight gain may be exacerbated with the use of several commonly prescribed medications.

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A multicenter, randomized study to select the minimum effective dose of estetrol (E4) in postmenopausal women (E4Relief) on vasomotor symptoms

Creator: Mithra Pharmaceuticals (sponsor)

Duration: 4:29

This video summarizes the results of a study to select the minimum effective dose of estetrol (E4) for the treatment of postmenopausal women with vasomotor symptoms (VMS, hot flushes). The reduction in frequency and severity of VMS was most pronounced for 15 mg E4, and was significant at week 4 and 12. E4 was well tolerated and there were no unexpected adverse events. It was concluded that oral E4 15 mg is the minimum effective daily oral dose for treatment of VMS.

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Introduction to the Role of Sex Steroid Hormones in Pelvic Organ Prolapse

Creator: Christina Dancz, MD

Duration: 2:54

In this video abstract, Dr. Christina Dancz from the Keck School of Medicine of the University of Southern California (USC) comments on the role of sex steroid hormones in pelvic organ prolapse. More specifically, she introduces the viewer to the effects of estrogen and progestin on ligament strength, tissue remodeling, the extracellular matrix, and clinical presentation. Taken altogether, these findings suggest that there may be a role for the exogenous administration of hormones in the prevention of pelvic organ prolapse. This topic is more fully explored in our published review in Menopause.

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“Associations of Pituitary-Ovarian Hormones and White Matter Hyperintensities in Recently Menopausal Women using Hormone Therapy.”

Creator: No sponsor
Created by Mayo Clinic

Duration: 4:22

The video reviews the findings from our paper entitled “Associations of Pituitary-Ovarian Hormones and White Matter Hyperintensities in Recently Menopausal Women using Hormone Therapy.” In recently menopausal women participating in the Kronos Early Estrogen Prevention Study (KEEPS), greater increases in estrone associated with smaller increases in WMH volume in both the transdermal estradiol and oral conjugated equine estrogen groups. In addition, greater decreases in FSH associated with smaller increases in WMH volume over time but only in women using the transdermal estrogen. Our results demonstrate that the type of hormone therapy used during menopause contributes to different levels of circulating hormones which then may have different impact on brain structure during treatment.

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Depression, hormone therapy and the menopausal transition among women aged 45-64 years using Canadian Longitudinal Study on Aging baseline data

Creator: Alison Shea

Duration: 5:07

The menopause transition is a vulnerable time for mental health and it is important to better understand the risk factors for depression during this time. This study using baseline data from the Canadian Longitudinal Study on Aging shows that premature menopause and the use of hormone therapy, as well as low education, low household income, living alone, being nulliparous, and having low social support are associated with current depression measured using the Center for Epidemiologic studies Short Depression Scale.

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Mental well-being and menopause

Creator: Dmitriy Bondarev

Duration: 4:32

Mental well-being and menopause

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Uterine Fibroids in Menopause and Perimenopause

Creator: Paige Wynne
Video Production Specialist
Creative and Digital Services
University of Illinois at Chicago

Duration: 3:34

In this video, we glimpse the significance of Uterine fibroid disease and highlights their unusual persistence in menopause women. Moreover, we discuss the possible available treatment options as well as the advantages and disadvantages of using hormonal therapy in this specific population.

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A Question Prompt List for Early Menopause

Creator: Melanie Gibson-Helm

Duration: 4:01

In this video we describe a multiple-methods study to develop a Question Prompt List (QPL) for Early Menopause. The research resulted in a QPL for Early Menopause that is stakeholder informed, evidence-based, acceptable to women, and feasible to use in a clinic setting.

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What do healthcare professionals and high-risk women need to know about risk-reducing salpingo-oophorectomy?

Creator: Martha Hickey

Duration: 6:46

What do healthcare professionals and high-risk women need to know about risk-reducing salpingo-oophorectomy?

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Hysterectomy and its association with Mental Health

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Duration:

In this video, we discuss how hysterectomy, even with ovarian conservation, increased the long-term risks of depression and anxiety by over 20% compared with referent women. In this population-based cohort with 20 years of follow-up, hysterectomy with ovarian conservation was associated an absolute risk increase of 7% for depression and 5% for anxiety. Women who had a hysterectomy before age 36 had even higher absolute risk increases: 12% for depression and 10% for anxiety.

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Yearly zoledronic acid use in combination of proper self-oral hygiene management for osteoporosis patients can prevent symptomatic periodontal disease

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Are women still sexually active after menopause?

Creator: Sussex Health Outcomes Research & Education in Cancer; filmed and edited by Matt Bemment, Communication Assistant, Brighton and Sussex Medical School

Duration: 4:35

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Play Video |

Visual Assessment of Genital Health in Menopausal Women

Creator: Irwin Goldstein, MD

Duration: 3:48

This is a phase 3 pivotal trial of ospemifene versus placebo in women in menopause with moderate to severe vaginal dryness, a symptom of GSM. On physical examination, such women commonly have vulvar, vestibular and vaginal atrophy. This study, for the first time, utilized vulvar vestibular photography to objectively document changes in genital health. There were no changes noted in photography on placebo, however active therapy with a SERM resulted in regrowth of labia minora, normalization of the urethral gland prominence, resolution of the pallor and erythema of the vestibule and visualization of vestibular moisture. Visual assessment of genital health in such patients should be utilized in future trials.

Play Video |

Validation of the CBT-Meno Protocol: A summary of a recent RCT

Creator: Eleanor Donegan, Ph.D., C.Psych.

Duration: 3:03

The menopausal transition is associated with a number of adverse changes for many women, including vasomotor and depressive symptoms, anxiety, poor sleep, urogenital and sexual concerns. Pharmacotherapy is effective but can be associated with health-related concerns for some women and there is a need for non-pharmacological interventions that target a range of menopausal symptoms. Our research group developed a new cognitive behavioral therapy protocol (CBT-Meno) to target a range of commonly-reported menopausal symptoms. In this video, we summarize the results of a recent randomized controlled trial evaluating the effectiveness of the CBT-Meno protocol compared to a waitlist condition.

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