The endometrium undergoes a series of well-recognised cycles of proliferation, differentiation and tissue breakdown on a monthly basis, in response to exposure to the circulating sex steroids oestrogen and progesterone.
Joint hypermobility is a common problem, particularly in women, and can cause significant morbidity to a minority of affected patients. In women, hormonal changes during menstruation, pregnancy and menopause can impact on symptoms of joint hypermobility, while manipulation of hormones can have both positive and negative effects for patients.
All women, if they live long enough, will go through the menopause. For some women, especially if they have few symptoms, the menopause transition comes as a welcome relief from menstruation and the possibility of pregnancy. Others experience disabling menopausal symptoms, and may feel psychological distress from their loss of fertility. Supporting these women is one of the most rewarding parts of clinical practice, especially as there is now a much more balanced approach, at least among knowledgeable clinicians,1 to the risks and benefits of hormone replacement therapy (HRT).
Heavy menstrual bleeding (HMB) prompts one in 20 women aged 30-49 years to visit their general practitioner. There are many treatment options for HMB, but endometrial ablation is recommended before hysterectomy when symptoms do not respond to medical treatment. This article discusses NovaSure, a method of endometrial ablation that may have advantages for some patients.
Most women with heavy menstrual bleeding (HMB) can be managed according to NICE guidance. But GPs and practice nurses need to be aware that up to one in five women with menorrhagia, especially young women, could also have a bleeding disorder. It is important to identify these patients since, if left untreated, bleeding disorders reduce quality of life and may result in significant, long-term complications.
The menopause is an inevitable event in the lives of all women. For some, it is very positive, ending menstruation, the need for contraception and the threat of unwanted pregnancy. But for others, it is a time of unpredictable hormone activity, and troublesome and unpleasant symptoms that seriously compromise quality of life. This article discusses the options available to women to manage their health and well-being during the menopausal transition or perimenopause.
Heavy periods have a major impact on a woman’s quality of life. In the past, hysterectomy was the firstline treatment. But there is now a wide range of NICE-endorsed options that very effectively lift the curse of heavy menstrual bleeding.