The Menopause at the Millennium

Table of Contents
List of principal contributors xi
Preface 1
Section 1 Plenary lectures
1 The hypothalamo-pituitary-ovarian axis during the
perimenopause 3
2 Menopause: implications for women`s health care in aging
societies 8
3 Mechanisms of action of estrogens and antiestrogens 14
4 Bone loss and bone gain: how to handle them 23
5 Culture and the menopause 29
6 Brain function, menopause and aging 36
7 Menopause and sexual functioning 46
8 Cancer diseases in the menopause: causes and prevention 54
9 Aging for men 65
10 Healthy aging: a gender perspective 75
Section 2 Healthy aging in the 21st century
11 The significance of the menopause in human life in the
present and next centuries 88
12 Healthy aging in the 21st century 95
13 Menopause in the aging society 101
14 The climacteric in Latin America: actual state and future
trends 108
15 Menopause and six chronic conditions of aging: the Study of
Women`s Health Across the Nation (SWAN) 117
Section 3 Quality of life in the menopause
16 Role of reproductive health in the quality of life of women
in the menopause 122
17 Quality of life for changing health: perimenopause among
Japanese in Japan and the USA 127
18 The use of hormones and psychopharmacy: women`s views 133
19 Determinants and quantification of quality of life after the
menopause: the Utian Menopause Quality of Life score 141
Section 4 Aging process of endocrine organs
20 The menopause and ovarian cell death 145
21 Estrogen replacement therapy: an endocrinologist`s
perspective 149
22 Morphological changes in reproductive organs during the aging
process in perimenopausal women 153
Section 5 Emerging biological actions of steroidal hormones
23 Xerostomia and other oral problems in the menopause 157
24 Connective tissue changes in the menopause and with hormone
replacement therapy 162
25 Estrogen regulates lymphopoiesis 171
26 Eye and ear as target organs for sex hormones 175
Section 6 Breast cancer and the menopause
27 The management of menopausal symptoms after breast cancer 179
28 Effects of progestogen on the breast 182
Section 7 Primary care in the menopause: an international
perspective
29 Primary care during the menopause in Latin America 186
30 Menopause in the Asia-Pacific region 191
31 Improvement of knowledge and perception of the menopause in
the Bulgarian population 196
32 Women`s health care in Sweden: primary care in the menopause,
actual versus ideal 201
Section 8 Lifestyle and the menopause
33 Diet and exercise: do they influence health outcomes during
the menopausal transition? 204
34 Exercise and bone in the postmenopausal years: a reality
check 212
35 Physical activity, obesity and menopause 216
36 Obesity, stress and menopause 221
Section 9 Culture and the menopause
37 Culture and medical consultation 229
38 Attitudes to and practice of hormone replacement therapy in
Central and Eastern Europe 233
39 Culture and aging of the female: a case of Japanese society
236
Section 10 Alternative treatments for menopausal disorders
40 The current status of Chinese traditional medicine treatment
of postmenopausal women in Taiwan 240
41 Dietary strategy for postmenopausal women 243
42 Optimal treatment of menopausal disorder based on
differential diagnosis of mental disorders 256
43 A patient-centered approach to managing the menopause 265
44 When hormone replacement therapy is not possible 269
Section 11 Biological actions of progesterone/progestogens
45 Biological actions of progesterone and progestins on breast
epithelial cell cycle progression 280
46 Endometrial effects of progesterone versus progestins 288
47 The vascular effects of progesterone/progestogens 293
48 Progestogens, progesterone: their clinical application and
problems 298
Section 12 Recent progress in bone metabolism
49 Potential roles of estrogen receptor-[alpha