Calcium in the prevention of postmenopausal osteoporosis: EMAS clinical guide

Abstract Introduction Postmenopausal osteoporosis is a highly prevalent disease. Prevention through lifestyle measures includes an adequate calcium intake. Despite the guidance provided by scientific societies and governmental bodies worldwide, many issues remain unresolved. Aims To provide evidence regarding the impact of calcium intake on the prevention of postmenopausal osteoporosis and critically appraise current guidelines. Materials and methods Literature review and consensus of expert opinion. Results and conclusion The recommended daily intake of calcium varies between 700 and 1200 mg of elemental calcium, depending on the endorsing source. Although calcium can be derived either fro…

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, r…

Comments on the USPSTF draft recommendation statement on menopausal hormone therapy: Primary prevention of chronic conditions

Personalized health care for midlife and beyond

EMAS position statement: Predictors of premature and early natural menopause.

Simoncini, Tommaso/0000-0002-2971-0079; Chung, Hsin-Fang/0000-0003-3261-5942; Mishra, Gita/0000-0001-9610-5904 WOS:000468709100014 PubMed ID: 31027683 Introduction: While the associations of genetic, reproductive and environmental factors with the timing of natural menopause have been extensively investigated, few epidemiological studies have specifically examined their association with premature (< 40 years) or early natural menopause (40-45 years). Aim: The aim of this position statement is to provide evidence on the predictors of premature and early natural menopause, as well as recommendations for the management of premature and early menopause and future research. Materials and methods…

140 Characteristics and Patterns of Care of Endometrial Cancer before and during COVID-19 pandemic

Introduction/Background* COVID-19 outbreak has correlated with the disruption of screening activities and diagnostic assessments. The risk of delayed diagnosis has consequently increased during the pandemic. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methodology This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: 03/01/2019 – 02/29/2020) and during (period 2: 01/04/…

On the use and abuse of register studies: The case of menopausal hormone therapy

Menopause: Women should not suffer in silence

Management of urinary incontinence in postmenopausal women: An EMAS clinical guide.

INTRODUCTION: The prevalence of urinary incontinence and of other lower urinary tract symptoms increases after the menopause and affects between 38 % and 55 % of women aged over 60 years. While urinary incontinence has a profound impact on quality of life, few affected women seek care. AIM: The aim of this clinical guide is to provide an evidence-based approach to the management of urinary incontinence in postmenopausal women. MATERIALS AND METHODS: Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS: Healthcare professionals should consider urinary incontinence a clinical priority and develop appropriate diagnostic skills. They should be able to identify and manage a…

The Impact of Estrogen Decline on Other Noncommunicable Diseases

Estrogens have specific receptors spread out in various systems of the organism. The drastic hormonal fall after menopause may be followed by a series of effects, which may be more or less relevant in the different areas of the organism. The bone constitutes a field that clearly reflects that impact, and postmenopausal osteoporosis has received attention in one ad hoc chapter. The present chapter reviews the impact on functions of the central nervous system, particularly cognition and mood, the skeletal system, specifically osteoarthritis, and the cardiovascular system. The obvious interest of the chapter derives from the importance of the selected systems, which may house highly prevalent …

The Impact of Hormone Therapy on Health

Hormone therapy (HT) has menopausal symptom control as the main indication. However, and because estrogens have receptors spread over many systems in the body, the use of hormones may have consequences on health. Hormone therapy consists of estrogens essentially, since menopausal symptoms mainly derive from estrogen deprivation at different target tissues. However, the normal ovarian cycle includes the regular secretion of progesterone during the days of the luteal phase. Progesterone has a neutralizing effect over endometrial proliferation, this being the reason for adding progestogens to HT formulations in order to protect endometrium. So, guidelines recommend that women with uterus use e…

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Objective Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results M…

Current management of pelvic organ prolapse in aging women : EMAS clinical guide

Management of pelvic organ prolapse (POP) is a common and challenging task. Nowadays older women are more active than they were in the past, and the development of POP disrupts quality of life and impairs social and personal activities. The menopausal transition is a time of vulnerability, during which many women start experiencing symptoms and signs of POP. The role of hormonal changes or of hormonal therapies in influencing the development or progression of POP has been explored extensively. The management of POP requires considerable clinical skills. Correct diagnosis and characterization of the prolapse and an identification of the individual woman's most bothersome symptoms are the hal…

Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders

Insomnia, vasomotor symptoms (VMS) and depression often co-occur after the menopause, with consequent health problems and reductions in quality of life. The aim of this position statement is to provide evidence-based advice on the management of postmenopausal sleep disorders derived from a systematic review of the literature. The latter yielded results on VMS, insomnia, circadian rhythm disorders, obstructive sleep apnea (OSA) and restless leg syndrome (RLS). Overall, the studies show that menopausal hormone therapy (MHT) improves VMS, insomnia, and mood. Several antidepressants can improve insomnia, either on their own or in association with MHT; these include selective serotonin reuptake …

Menopause and diabetes: EMAS clinical guide

Abstract Introduction Whether menopause increases the risk of type 2 diabetes mellitus (T2DM) independently of ageing has been a matter of debate. Controversy also exists about the benefits and risks of menopausal hormone therapy (MHT) in women with T2DM. Aims To summarise the evidence on 1) the effect of menopause on metabolic parameters and the risk of T2DM, 2) the effect of T2DM on age at menopause, 3) the effect of MHT on the risk of T2DM, and 4) the management of postmenopausal women with T2DM. Materials and methods Literature review and consensus of experts’ opinions. Results and conclusion Metabolic changes during the menopausal transition include an increase in and the central redis…