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The Medical Management of Menopause and Premenopause: Their Endocrinologic Basis

©Published 1984, (275 pp.) Lippincott, Co

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This book is a medical textbook, in the authors’ words, “for the internist, the gynecologist/obstetrician, the general surgeon, the psychiatrist, or, in fact, anyone who comes in contact with and treats the problems of the maturing female.” (Preface.)

The contents by Chapter headings in this scholarly book are:

1) THE MENOPAUSAL TRANSITION AND BEYOND

2) OSTEOPOROSIS

3) SEXUALITY AND HORMONES

4) HORMONE REPLACEMENT THERAPY: AN INTRODUCTION

5) THE ENDOMETRIAL CANCER RISK

6) HORMONE REPLACEMENT THERAPY AND CORONARY HEART DISEASE

7) HORMONE REPLACEMENT THERAPY: DOSING

8) PERIMENOPAUSAL BLEEDING AND HYSTERECTOMY

9) COMMON PROBLEMS AND AVAILABLE SOLUTIONS

Professionals Respond: Reviews of the Medical Textbook

FROM FERTILITY AND STERILITY --

The past decade has witnessed a voluminous publication of reviews and studies on menopause. This emphasizes the interest expressed by various professionals in the care of menopausal patients. The authors, Cutler and Garcia, have provided an excellent and succinct review of the pertinent psychologic, endocrinologic, pathologic, and therapeutic considerations of menopause.

They assess the strengths and weaknesses of the often diverse literature with regard to the need, risks and benefits of estrogen replacement therapy. The book is lucid and well-referenced and has many fine characteristics

It begins with a discussion and review of the transitional phase into and beyond menopause. The first seven chapters address symptomatology, and indications for treatment followed by examination of the pros and cons of the risks, benefits, and contraindications of therapy. The chapters on the problems of osteoporosis and hormone dosing are particularly good.

A full extremely informative and well-written chapter is devoted to the relationship of sexual behavior to hormones in the aging woman. Another chapter reviews some caveats on abnormal uterine bleeding in the menopausal woman. Each chapter examines its topic in depth, ending in a summary of highlights or conclusions. The ninth and final chapter is problem-focused, with answers to common problems and issues covered throughout the book.

This book is not so much a diagnostic or prognostic guide as it is a unique review of the many common theoretical and bothersome problems experienced by the menopausal patient and the clinician who treats her. When recommendations and conclusions are made, data are presented to substantiate them.

The overall theme clearly emerges; it successfully identifies the problems and impacts upon the reader -- the significance of timely, uniform and effectual management of menopause.

This book should prove an informative and resourceful state-of-the-art guide for any health professional interested in care for menopausal patients.

FROM ANNALS OF INTERNAL MEDICINE:

Management of menopause is still controversial; Cutler and Garcia's timely book will undoubtedly help physicians involved in this problem. The book covers up-to-date information on the physiology and pathophysiology of the menstrual cycle, premenopause, menopause, and the climacteric.

The symptoms and signs of menopause and its immediate and late sequelae, are covered in detail. Because osteoperorsis is a major consequence of the late postmenopausal years with considerable public health and economic implications, treatment is important. The potential benefits and risks of hormone replacement therapy are thoroughly discussed. The risk of estrogen replacement leading to endometrial and breast carcinomas and coronary heart disease is discussed, and an objective and balanced opinion expressed.

The authors go into the practical details of estrogen replacement therapy and other supplements. Problems related to sexuality and menopause, and sexual problems not infrequently encountered after menopause and related to both women and men are discussed as well.

For the gynecologist or reproductive endocrinologist there is a detailed discussion of perimenopausal bleeding, hysterectomy, oophorectomy and their management. The text is lucid with up-to-date references. The index is detailed and well arranged, allowing ease in finding specific problems. This book will be an important asset in any physician's library, as a reliable text and reference to practical clinical problems or as an academic source for teaching or research.

" My research has consistently focussed on what behavior a woman can engage in to increase her power, well-being, and vitality."

---Winnifred B. Cutler, Ph.D.

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