Table Of ContentISGE Series
Series Editor: Andrea R. Genazzani
Martin Birkhaeuser
Andrea R. Genazzani Editors
Pre-Menopause,
Menopause and
Beyond
Volume 5
Frontiers in Gynecological
Endocrinology
ISGE Series
Series Editor
Andrea R. Genazzani
More information about this series at http://www.springer.com/series/11871
Martin Birkhaeuser • Andrea R. Genazzani
Editors
Pre-Menopause,
Menopause and Beyond
Volume 5: Frontiers in Gynecological
Endocrinology
Editors
Martin Birkhaeuser Andrea R. Genazzani
Professor emeritus for Gynaecological International Society of Gynecological
Endocrinology and Reproductive Medicine Endocrinology
University of Bern Pisa, Italy
Bern, Switzerland
Copyright owner: ISGE (International Society of Gynecological Endocrinology)
ISSN 2197-8735 ISSN 2197-8743 (electronic)
ISGE Series
ISBN 978-3-319-63539-2 ISBN 978-3-319-63540-8 (eBook)
https://doi.org/10.1007/978-3-319-63540-8
Library of Congress Control Number: 2017960823
© International Society of Gynecological Endocrinology 2018
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims
in published maps and institutional affiliations.
Printed on acid-free paper
This Springer imprint is published by Springer Nature
The registered company is Springer International Publishing AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
Proceedings of the International Society of Gynecological
Endocrinology (ISGE) Winter School 2017
This volume contains the lectures presented at the 6th ISGRE 2017 Winter School,
held in Madonna di Campiglio between 22 and 26 January 2017.
Important recent developments in our knowledge of premenopause and meno-
pause, with their respective clinical implications and therapies, have encouraged the
faculty to organize this Winter School. The following chapters have been selected:
• Menopause: symptoms and neuroendocrine impact: endocrine and neuroendo-
crine biological changes from menopause to aging—brain impact of sex steroids
withdrawal of the menopause—importance and modern management of climac-
teric symptoms
• Intracrinology: its role in menopause
• Menopause: bone and cardiovascular impact: how to maintain healthy bones
after menopause—the effect of menopause and HRT on coronary heart disease—
how to prevent cardiovascular disorders: influence of gonadal steroids
• Menopause symptoms: the optimal therapies—recent changes and advances
• The breast: benign breast diseases, BRCA mutation, and breast cancer
• Infertility in late reproductive age: importance of autoimmunity—treatment after
the age of 40—oocyte donation in menopausal women
• Thyroid function and pregnancy outcome after ART—what is the evidence?
Thyroid disorders in climacteric women
• Polycystic ovary and metabolic syndrome: implications of cardiometabolic dys-
function—metabolic changes during menopausal transition—role of Metformin
in climacteric women—weight and body composition management after
menopause
• Surgical challenges after menopause: problems and solutions linked to them pel-
vic floor, bladder dysfunction, and urinary incontinence
v
vi Preface
On behalf of the ISGRE faculty, it is our pleasure to invite you to profit from the
accumulated scientific and clinical knowledge assembled in these proceedings of
our highly successful Winter School 2017.
Bern, Switzerland Martin Birkhaeuser
Pisa, Italy Andrea R. Genazzani
Contents
Part I Menopause: Symptoms and Neuroendocrine Impact
1 Intracrinology: The New Science of Sex
Steroid Physiology in Women ................................ 3
Fernand Labrie
2 From Menopause to Aging: Endocrine
and Neuroendocrine Biological Changes ....................... 17
Alessandro D. Genazzani, Andrea Giannini,
and Antonella Napolitano
3 Brain Impact of Sex Steroid Withdrawal at Menopause .......... 35
Nicola Pluchino and Andrea R. Genazzani
4 Climacteric Symptoms: Importance and Management ........... 43
Martin Birkhaeuser
Part II Fertility
5 Progress in Recommendations on Menopause, MHT and POI ..... 79
Nick Panay
6 Female Infertility and Autoimmunity .......................... 85
Paolo Giovanni Artini and Patrizia Monteleone
Part III Thyroid Disorders, Polycystic Ovary and Metabolic Syndrome
7 Oocyte Donation in Perimenopausal and Menopausal Women ..... 95
Basil Tarlatzis and Julia Bosdou
8 Thyroid Disorders in Climacteric Women ...................... 103
Anna Brona, Andrzej Milewicz, Justyna Kuliczkowska- Płaksej,
and Marek Bolanowski
vii
viii Contents
9 Thyroid Function and Pregnancy Outcome After ART:
What Is the Evidence? ...................................... 113
Gesthimani Mintziori, Dimitrios G. Goulis, and Basil C. Tarlatzis
10 PCOS: Implications of Cardiometabolic Dysfunction ............. 119
Bart C.J.M. Fauser
11 Why Metformin Is so Important for Prevention and Therapy
in Climacteric Women ...................................... 127
Justyna Kuliczkowska-Plaksej, Andrzej Milewicz, Anna Brona,
and Marek Bolanowski
12 Metabolic Changes and Metabolic Syndrome During
the Menopausal Transition ................................... 141
Alessandro D. Genazzani, Alessia Prati, and Giulia Despini
13 Weight and Body Composition Management After Menopause:
The Effect of Lifestyle Modifications .......................... 153
Irene Lambrinoudaki, Eleni Armeni, and Nikolaos Tsoltos
Part IV Bone and Cardiovascular Impact
14 Healthy Bones After Menopause: What Has to Be Done? ......... 165
Martin Birkhaeuser
15 The Effect of Menopause and HRT on Coronary Heart Disease .... 187
John C. Stevenson
16 How to Prevent Cardiovascular Disorders: Influence
of Gonadal Steroids on the Heart ............................. 195
Svetlana Vujovic, Milina Tancic-Gajic, Ljiljana Marina,
Zorana Arizanovic, Zorana Stojanovic, Branko Barac,
Aleksandar Djogo, and Miomira Ivovic
Part V Benign Breast Diseases, BRCA Mutation and Breast Cancer
17 Risk-Reducing Surgery and Treatment of Menopausal Symptoms
in BRCA Mutation Carriers (and Other Risk Women) ........... 205
Piero Sismondi, Marta D’Alonzo, Paola Modaffari, Viola Liberale,
Valentina Elisabetta Bounous, Andrea Villasco, and Nicoletta Biglia
18 Benign Breast Disease During Women’s Life .................... 215
Svetlana Vujovic
Contents ix
19 Treatment of Menopausal Symptoms in Breast
Cancer Survivors ........................................... 223
Piero Sismondi, Valentina Elisabetta Bounous, Valentina Tuninetti, Viola
Liberale, Martina Gallo, and Nicoletta Biglia
20 Myoinositol and Inositol Hexakisphosphate in the Treatment
of Breast Cancer: Molecular Mechanisms ...................... 233
Mariano Bizzarri, Simona Dinicola, and Alessandra Cucina
Part VI Menopause Symptoms: The Therapies
21 The True Risks of HRT ...................................... 245
John C. Stevenson
22 Menopause Hormone Therapy Customization .................. 253
Irene Lambrinoudaki and Eleni Armeni
23 GSM/VVA: Advances in Understanding and Management ........ 261
Nick Panay
24 Intravaginal DHEA for the Treatment of Vulvovaginal Atrophy,
Intracrinology at Work ...................................... 269
Fernand Labrie
Part VII Surgical Challenges After Menopause: Problems and Solutions
25 Bladder Dysfunction and Urinary Incontinence After
the Menopause: Hormones, Drugs, or Surgery? ................. 287
Eleonora Russo, Andrea Giannini, Marta Caretto,
Paolo Mannella, and Tommaso Simoncini
26 When is Tubectomy and When Ovarectomy/Adnexectomy
Indicated at Necessary Hysterectomies Beyond
the Reproductive Age? ...................................... 293
Liselotte Mettler
27 Pelvic Floor Reconstructive Surgery in Ageing Women:
Tailoring the Treatment to Each Woman’s Needs ................ 303
Marta Caretto, Andrea Giannini, Eleonora Russo,
Paolo Mannella, and Tommaso Simoncini
Index ......................................................... 317
Part I
Menopause: Symptoms and Neuroendocrine
Impact
