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Managing the Menopause: 21st Century Solutions
  1. Marian Everett
  1. Consultant in Sexual and Reproductive Health, City Healthcare Partnership Community Interest Company, Hull, UK; m.everett{at}

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Nick Panay, Paula Briggs, Gab Kovacs (eds). Cambridge, UK: Cambridge University Press, 2015. ISBN-13: 978-1-107-45182-7. Price: £39.99. Pages: 264 (paperback)

This is a truly international collaboration with contributions from experts from all over the world. The book aims to clarify much of the confusion produced by publication of data from the Women's Health Initiative (WHI) and the Million Women Study (MWS). These have left many health care professionals confused and reluctant to prescribe hormones or even to discuss management options for women going through the menopause. This has resulted in many women being denied treatment or discontinuing their treatment unnecessarily.

The book begins with good clear explanations of the physiology of the menstrual cycle and menopause and predicting ovarian reserve. I found the information on anti-Mullarian hormone for predicting ovarian reserve interesting, particularly after chemotherapy in a paediatric oncology context. Also there is a review of the latest evidence around cryopreservation of ovarian tissue before treatment in young women.

There is an excellent overview of the history and politics of the menopause and a useful review of the whole saga of WHI, putting the outcomes into perspective.

The chapters on diagnosis of menopause with assessment of symptoms rather than measurement of hormone profiles for the vast majority of menopausal women, explanation of the risks and benefits of hormone replacement therapy, and managing symptoms with non-hormonal alternatives are all very useful and practical.

Other sections of the book review the evidence around cardiovascular disease, osteoporosis, venous thrombosis and cancers, and put the research into perspective with clear guidance on how to explain the risks and benefits and compare the advantages and disadvantages of the different management options.

There are sections on sexual function, contraception and vulvovaginal atrophy. These are areas often neglected by health care professionals but which can be very significant for women.

I particularly like the case studies focusing on common menopause presentations that precede, and are subsequently discussed in, many of the chapters.

This book is very broad in scope and covers all aspects of menopause in women. It deals with the latest research and puts this into perspective, making this book a very useful resource for all those involved in the care of women going through the menopause. The final chapter on male menopause is perhaps a slightly surprising addition but makes for interesting reading. Overall this is a very useful book and a good reference source.

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