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Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier MENOPAUSAL SYMPTOMS Menopause is a very positive occurrence in the life of many women. It marks the end of cyclic bleeding and the need for birth control. It occurs at an age when children generally have become independent adults, thereby reducing family […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 262 – MENOPAUSE Deborah Grady   Elizabeth Barrett-Connor Definition All healthy women transition from a reproductive or premenopausal period marked by regular ovulation and cyclic menstrual bleeding to a postmenopausal period marked by infertility and amenorrhea ( Fig. 262-1 ). The onset of the menopausal transition is […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS   Centers for Disease Control and Prevention: U.S. Public Health Service Recommendations for the Use of Antiretroviral Drugs in Pregnant Women for Maternal Health and Interventions to Reduce Perinatal HIV-1 Transmission in the United States. Available at www.aidsinfo.nih.gov. Reviews current […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 261 – HIRSUTISM Ricardo Azziz Definition Hirsutism is defined as the presence of terminal (coarse) hairs in women in a male-like pattern, and it affects between 5 and 22% of women. Hirsutism is often a sign of an androgen excess disorder, including the polycystic […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 259 – PREGNANCY: HYPERTENSION AND OTHER COMMON MEDICAL PROBLEMS Diane L. Elliot Caring for women of reproductive age requires knowing how to diagnose pregnancy and how to provide the appropriate initial care during a pregnancy. Managing pregnant women’s medical problems necessitates understanding gestation’s influence […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 260 – HUMAN IMMUNODEFICIENCY VIRUS IN PREGNANCY Stephen A. Spector Epidemiology The World Health Organization and the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that by the end of 2004 approximately 40 million people were living with human immunodeficiency virus (HIV) infection, including […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 257 – CONTRACEPTION Daniel R. Mishell Jr. CONTRACEPTIVE USE AND EFFECTIVENESS Contraceptive Use Reversible contraception, the temporary prevention of fertility, includes all contraceptive methods except sterilization. Sterilization should be considered permanent despite the possibility of surgical reversal. There are advantages and disadvantages of each contraceptive […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier TYPES OF CONTRACEPTIVES Spermicides and Barriers All spermicidal agents contain a surfactant, usually nonoxynol 9, that immobilizes or kills sperm on contact. They also provide a mechanical barrier and need to be placed into the vagina before each coital act. There is […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 18 – RADIATION INJURY Arthur C. Upton Definition The term radiation injury denotes any abnormality of form or function caused by electromagnetic waves or accelerated atomic particles. The term is also often applied to the harmful effects of high-intensity ultrasound and electromagnetic fields. The […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SUGGESTED READINGS Grady D: Clinical practice. Management of menopausal symptoms.  N Engl J Med  2006; 355:2338-2347.A clinical review National Center for Health Statistics: Health, United States, 2004, with Chartbook on Trends in the Health of Americans,  Hyattsville, MD, U.S. Department of Health and Human Services, Centers for […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier CYCLIC CHANGES IN TARGET ORGANS Endometrium During the menstrual cycle, the endometrium undergoes remarkable histologic and cytologic changes that culminate with menstrual bleeding when the corpus luteum ceases to secrete progesterone (see Fig. 256-1 ). The basal layer of the endometrium, which […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier MORBIDITY AND MORTALITY IN WOMEN Mortality At the turn of the 20th century, the average lifespan of women in the United States was 48 years, compared with 46 years in men. Since then, the life expectancy in women has increased more than […]

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