Biomedical subjects
Publications and source records attributed to M E Rousseau.
For the large number of women who become menopausal each year, the decision of whether to use hormone replacement therapy is central. The author outlines treatment options, risks, and benefits of hormone therapy and examines likelihoods of outcomes. Based on the latest research, types of hormones available, prescription regimens, side effects, and alternatives to hormone therapy are discussed.
Skin signs and symptoms were examined in 46 menopausal women prior to estrogen replacement therapy. Several symptoms such as pruritus, bruising, dryness and thinning were seen more frequently in sun-exposed skin emphasizing the contribution of photoaging. At the end of a 6-mth treatment period, no significant difference was observed in the prevalence or severity of the cutaneous signs and symptoms when patients receiving transdermal 17 beta-estradiol (Estraderm) were compared with controls (the only exception was cutaneous flushing). Elastic fibers from sun-protected (buttock) skin of menopausal women were studied by light and electron microscopy. In 3 women (ages 30-37) with a history of premature menopause, the elastic fibers had several degenerative changes including coalescence of cystic spaces into lacunae, peripheral fragmentation, granular degeneration and splitting of the fibers into strands. Similar age-related ultrastructural changes are normally found in individuals that are at least 20 yrs older than these patients. These findings are suggestive of a relationship between premature aging of the dermal elastic fibers and estrogen deprivation.
In primary care and gynecologic settings, midwives will manage the care of women during the perimenopause transition as well as throughout the postmenopausal period. As such, they will need to understand the issues that are at the heart of the debate regarding menopause and aging. This article reviews the endocrinology of menopause, the history of menopause treatment in this century, and the various physical, psychological, and role changes that accompany the developmental processes of menopause. Bleeding pattern changes, hot flashes, sleep disturbances, and genital, skin, and weight changes are discussed. Sexuality, breast, cardiovascular, skeletal, as well as hormone therapy issues are examined. The basics of the midlife health office visit are included.
Menopause and its effects on women's health status and needs have only recently received the increased attention of scholars and clinicians that many feel is long overdue. However, one major area of neglect that continues today regards the climacteric in minority populations within the United States, including the largest minority group, African Americans. This review summarizes issues that have potentially limited the amount of information available regarding menopause in African Americans. These issues include differing perspectives on the climacteric within research and clinical arenas, the difficulty of studying race as a variable in scholarly investigations, and methodological factors that have led to underrepresentation of minorities in studies of menopause. General considerations, as well as specific suggestions, for research questions when investigating the climacteric experiences of African American women are offered.
Hormonal agents are used to treat many conditions, including endometriosis, amenorrhea, fibroids, and dysfunctional uterine bleeding. Because women visit their care provider for various gynecologic problems more than any other reason, application of therapeutic uses in this rapidly expanding field is essential for nurses working in endocrine gynecology. Strategies for hormone use are discussed in light of the goals of patient education and treatment in the areas of pain relief, fertility, and cycle regulation.
Osteoporosis is a major health problem facing women and men, and the number of people affected is likely to increase substantially as the population ages. The gold standard for treatment has always been prevention. This article reviews therapeutic options, with an emphasis on nutrition; outlines current recommendations for calcium and vitamin D throughout the life span; and discusses food and supplemental sources of calcium. Guidelines are given for identifying high- and low-risk patients, and appropriate interventions are highlighted.