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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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This video provides significance and motivations for the current work, which is a genome-wide association study of age of menopause in a sample enriched for longevity (the Long Life Family Study and Health and Retirement Study). Contrary to previously published results that focused on age of menopause in the general population, our analysis looked at age of menopause in a population enriched for longevity. Therefore, some novel associations may be specifically linked to healthy aging and longer survival.
Creator: Sussex Health Outcomes Research & Education in Cancer; filmed and edited by Matt Bemment, Communication Assistant, Brighton and Sussex Medical School
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What do we really know about sex after menopause? This video summary reports on the results of a free-text analysis on sexual activity in over 4,400 postmenopausal women who took part in UKCTOCS, a large UK ovarian cancer screening trial. It shows that sexuality can change when we get older and that relationship status and health have a direct effect on sexuality and satisfaction. We believe it is important to raise awareness among women and healthcare professionals to increase the understanding of sexual issues women may face in later life.
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This video is the author's summary of the Men's Perceptions and Attitudes Towards Menopause (MATE) survey, which is one of the first large studies surveying male partners of menopausal women. These men provided valuable insight into the impact of menopause on them and their partners, and revealed that most men discuss symptoms and are influential in helping their partners select treatments. Results support expanding patient education to include the male partners of menopausal women, who communicate with their partners about symptoms, may be influential in fostering lifestyle changes, and participate in decision-making regarding treatment.
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Despite the large burden of due to depression/anxiety, few studies have examined the risk factors of depression and anxiety, especially in a multiethnic Asians. This study shows that of the multiple risks factors for depression and/or anxiety, objectively measures of physical performance such as hand grip strength and lower body strength increases risk of depression and anxiety in mid-life Asian women. Exercises to improve muscle strength may reduce risks of depression and/or anxiety.
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.
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Hormone preparations such as topical progesterone creams and oral progesterone capsules are used by many postmenopausal women using estrogens to prevent endometrial hyperhidrosis. These preparations are prepared from compounding pharmacies, which are not regulated by the FDA. Our study showed significant variability in estradiol and progesterone doses in capsules, and somewhat less in creams, obtained from 13 different compounding pharmacies. In addition, there is uncertainty regarding whether or not progesterone capsules and creams protect the endometrium. These findings should be concerning to postmenopausal women using compounded hormonal preparations, which warrant regulation by the FDA.
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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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Creator: Harold Bae
Duration: 3:02
This video provides significance and motivations for the current work, which is a genome-wide association study of age of menopause in a sample enriched for longevity (the Long Life Family Study and Health and Retirement Study). Contrary to previously published results that focused on age of menopause in the general population, our analysis looked at age of menopause in a population enriched for longevity. Therefore, some novel associations may be specifically linked to healthy aging and longer survival.
Creator: EU LEONG YONG
Duration: 5:00
Despite the large burden of due to depression/anxiety, few studies have examined the risk factors of depression and anxiety, especially in a multiethnic Asians. This study shows that of the multiple risks factors for depression and/or anxiety, objectively measures of physical performance such as hand grip strength and lower body strength increases risk of depression and anxiety in mid-life Asian women. Exercises to improve muscle strength may reduce risks of depression and/or anxiety.
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.
Creator: Frank Stanczyk
Duration: 5:28
Hormone preparations such as topical progesterone creams and oral progesterone capsules are used by many postmenopausal women using estrogens to prevent endometrial hyperhidrosis. These preparations are prepared from compounding pharmacies, which are not regulated by the FDA. Our study showed significant variability in estradiol and progesterone doses in capsules, and somewhat less in creams, obtained from 13 different compounding pharmacies. In addition, there is uncertainty regarding whether or not progesterone capsules and creams protect the endometrium. These findings should be concerning to postmenopausal women using compounded hormonal preparations, which warrant regulation by the FDA.
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.
Creator: Beate Sydora
Duration: 4:52
The video highlights the clinical significance of assessing quality of life in addition to menopause symptom severity in specialized menopause clinics. Considering both, QOL and symptom severity enables clinicians and health care workers to be able to consider each woman’s unique experience with menopause and propose treatment options to each woman’s specific needs. Furthermore, the video stresses the benefits of specialized menopause clinics offering multidisciplinary care and encourages the establishment of more clinics of this kind.