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REFERENCES

I N T R OD U C T I ON

Kemp, N., ‘Marketing’s menopause: It’s time to disrupt ageing’, Campaign Live,
September 2018 <www.campaignlive.co.uk/article/marketings-menopause-its-
time-disrupt-ageing/1492281>

C H A PT E R 1 : S E T T I N G T H E R EC OR D
S T R A I GH T A B OU T HRT

The North American Menopause Society, ‘The 2017 hormone therapy position
statement of The North American Menopause Society’, Menopause: The Journal of
the North American Menopause Society, vol. 24, 2017 <www.menopause.org/docs/
default-source/2017/nams-2017-hormone-therapy-position-statement.pdf>
Singh, A., Kaur, S. & Walia, I., ‘A historical perspective on menopause and menopausal
age’, Bulletin of the Indian Institute of History of Medicine (Hyderabad), July/
December 2002 <www.ncbi.nlm.nih.gov/pubmed/15981376>
Stefanick, M.L., ‘Estrogens and progestins: Background and history, trends in use,
and guidelines and regimens approved by the US Food and Drug Administration’,
The American Journal of Medicine, 19 December 2005 <www.amjmed.com/article/
S0002-9343(05)00919-8/fulltext>
Wolff, J., ‘A Brief History of Treating Menopause’, AARP The Magazine, August/
September 2018 <www.aarp.org/health/conditions-treatments/info-2018/
menopause-symptoms-treatment-estrogen-hrt.html>
Wilson, R.A., Feminine Forever, New York, NY: Pocket Books, 1968

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Why did it all go wrong?
Langer, R.D., ‘The evidence base for HRT: What can we believe?’, Climacteric,
vol. 20, 10 March 2017 <www.imsociety.org/manage/images/pdf/
9a32c2843c497e275d1851b2bdff46a3.pdf>
Brower, V., ‘A second chance for hormone replacement therapy?’, EMBO Reports,
December 2003 <www.ncbi.nlm.nih.gov/pmc/articles/PMC1326430/>
Notelovits, M., ‘Why Individualizing Hormone Therapy Is Crucial: Putting the
Results of the WHI Trial into Perspective’, Medscape <www.medscape.com/
viewarticle/438356>
Busko, M., ‘Long-term HRT Tied to Greater Risk for Alzheimer Disease’, Medscape,
March 2019 <www.medscape.com/viewarticle/910006?src=wnl_edit_tpal&uac=
117094MG&impID=1902143&faf=1>
Goldstein, S.R., ‘The Clinical Impact of the Women’s Health Initiative (WHI): Entering
a New Era in Managing Postmenopausal Health Issues: WHI in Summary: What’s a
Practitioner to Do?’, Medscape <www.medscape.org/viewarticle/445476_5>
Notelovits, M., ‘Why Individualizing Hormone Therapy Is Crucial’

What were the WHI results?


Notelovits, M., ‘Why Individualizing Hormone Therapy Is Crucial’
Rossouw, J.E., Prentice, R.L., Manson, J.E., et al., ‘Postmenopausal hormone therapy
and risk of cardiovascular disease by age and years since menopause’, JAMA, 4 April
2007 <jamanetwork.com/journals/jama/fullarticle/206404>
Notelovits, M., ‘Why Individualizing Hormone Therapy Is Crucial’
Fitzpatrick, L.A., ‘The Women’s Health Initiative: A Heart-to-HRT Conversation’,
Mayo Clinic, June 2000 <www.mayoclinicproceedings.org/article/S0025-
6196(11)64580-1/fulltext>
Goldstein, S.R., ‘The Clinical Impact of the Women’s Health Initiative (WHI)’
British Menopause Society, ‘A new paper from Professor Robert D. Langer demonstrates
that WHI Study errors led to 15 years of unnecessary suffering for women’,
13 March 2017 <thebms.org.uk/2017/03/new-paper-professor-robert-d-langer-
demonstrates-whi-study-errors-led-15-years-unnecessary-suffering-women/>
Australian Menopause Society, ‘Postmenopausal cancer highlighted’, October 2013
<www.menopause.org.au/about-ams/media-info/661-postmenopausal-cancer-
highlighted-on-world-menopause-day>
Goldstein, S.R., ‘The Clinical Impact’
Langer, R.D., ‘The evidence base for HRT: What can we believe?’

What was wrong with the WHI findings?


Vogel, L., ‘Trial overstated HRT risk for younger women’, CMAJ, May 2017
<www.ncbi.nlm.nih.gov/pmc/articles/PMC5415400/>
Sarrel, P.M., Njike, V.Y., Vinante, V., et al., ‘The mortality toll of estrogen avoidance:
An analysis of excess deaths among hysterectomized women aged 50 to 59 years’,
American Journal of Public Health, September 2013 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC3780684/>

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Vogel, L., ‘Trial overstated HRT risk for younger women’
Langer, R.D., ‘The evidence base for HRT: What can we believe?’

What happened after WHI?


Brower, V., ‘A second chance for hormone replacement therapy?’
Davis, J., ‘FDA Approves New HRT Warning Label’, Medscape, January 2003
<www.medscape.com/viewarticle/447629>
Wolff, J., ‘What Doctors Don’t Know About Menopause’, AARP, August/September
2018 <www.aarp.org/health/conditions-treatments/info-2018/menopause-
symptoms-doctors-relief-treatment.html>
Walker, E.P., ‘Pfizer Ordered to Pay $34.3 Million in HRT Lawsuit’, Medpage Today,
November 2009 <www.medpagetoday.com/obgyn/hrt/17175>
‘2,200 Lawsuits Have Reached a Settlement from Pfizer’s Prempro’, Gacovina Lake,
January 2013 <www.gacovinolake.com/news/2200-lawsuits-have-reached-a-
settlement-from-pfizers-prempro/>
de Villiers, T.J., Hall T.E., Pinkerton J.V., et al., ‘Revised Global Consensus
Statement on Menopausal Hormone Therapy’, Climacteric, 20 June 2016
<www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.
pdf> (paywall)
Beral, V., Peto, R., Pirie, K., et al., ‘Type and timing of menopausal hormone therapy
and breast cancer risk: Individual participant meta-analysis of the worldwide
epidemiological evidence’, The Lancet, August 2019 <www.thelancet.com/journals/
lancet/article/PIIS0140-6736(19)31709-X/fulltext>
Australasian Menopause Society, ‘MHT and breast cancer risk — Lancet 29 August
2019’, August 2019 <www.menopause.org.au/about-ams/media-info/1468-mht-
and-breast-cancer-risk-lancet-29-august-2019>
Royal College of Obstetricians & Gynaecologists & British Menopause Society,
‘RCOG/BMS response to Lancet study on HRT use and breast cancer risk’,
August 2019 <www.rcog.org.uk/en/news/rcog-bms-response-to-lancet-study/>

What about the future?


Ellis, L., ‘True Innovation In Women’s Health Hindered Because Conditions Are Not
Fatal’, PharmaIntelligence <pharmaintelligence.informa.com/resources/product-content/
true-innovation-in-womens-health-hindered-because-conditions-are-not-fatal>
Kemp, N., ‘Marketing’s menopause: It’s time to disrupt ageing’, Campaign Live,
September 2018 <www.campaignlive.co.uk/article/marketings-menopause-its-time-
disrupt-ageing/1492281>

WHI revisited — is opinion slowly turning?


British Menopause Society, ‘A new paper from Professor Robert D. Langer demonstrates
that WHI Study errors led to 15 years of unnecessary suffering for women’
Manson, J.E., Aragaki, A.K., Rossouw, J.E., et al., ‘Menopausal Hormone Therapy and
Long-term All-Cause and Cause-Specific Mortality’, JAMA, September 2017
<jamanetwork.com/journals/jama/fullarticle/2653735>

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Vogel, L., ‘Trial overstated HRT risk for younger women’
Gompel, A., ‘MHT and breast cancer risk’, European Menopause and Andropause
Society, April 2019 <www.emas-online.org/webinar_videos/customizing-menopausal-
hormone-therapy-in-the-context-of-breast-ovarian-and-endometrical-cancer-2-2-2/>

What do I need to know about HRT?


Furness, S., Roberts, H., Marjoribanks, J., et al., ‘Hormone therapy in postmenopausal
women and risk of endometrial hyperplasia’, Cochrane Database of Systematic
Reviews, April 2009 <www.cochranelibrary.com/cdsr/doi/10.1002/14651858.
CD000402.pub3/full>
Australasian Menopause Society, ‘Oestrogen Only Menopausal Hormone Therapy’, February
2017 <www.menopause.org.au/hp/information-sheets/552-oestrogen-only-mht>
Wren, B.G., ‘The benefits of oestrogen following menopause: Why hormone
replacement therapy should be offered to postmenopausal women’, The Medical
Journal of Australia, March 2009 <www.mja.com.au/journal/2009/190/6/
benefits-oestrogen-following-menopause-why-hormone-replacement-therapy-
should-be>
Australian Menopause Society, ‘Combined Menopausal Hormone Therapy (MHT)’
<https://www.menopause.org.au/images/infosheets/AMS_Combined_MHT.pdf>
Canonico, M., Plu-Bureau, G., Lowe, G.D., et al., ‘Hormone replacement therapy
and risk of venous thromboembolism in postmenopausal women: Systematic
review and meta-analysis’, BMJ, May 2008 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC2405857/>
Davison, S., ‘Initiating hormone replacement therapy’, Jean Hailes for Women’s
Health, March 2017 <jeanhailes.org.au/health-professionals/webinar-library/
initiating-hormone-replacement-therapy>

What are oestrogens in HRT?


Notelovitz, M., ‘Clinical Opinion: The Biologic and Pharmacologic Principles of
Estrogen Therapy for Symptomatic Menopause’, Medscape General Medicine,
March 2006 <www.ncbi.nlm.nih.gov/pmc/articles/PMC1682006/>
Kaunitz, A.M., ‘Is one oral estrogen formulation safer than another for menopausal
women?’, MD edge, January 2014 <www.mdedge.com/obgyn/article/79579/
menopause/one-oral-estrogen-formulation-safer-another-menopausal-women>
Notelovitz, M., ‘Clinical Opinion’

What are progestogens in HRT?


Gompel, A., ‘MHT and breast cancer risk’
Montplaisir, J., Lorrain, J., Denesle, R., et al., ‘Sleep in menopause: Differential effects
of two forms of hormone replacement therapy’, Menopause: The Journal of the
North American Menopause Society, January/February 2001 <journals.lww.com/
menopausejournal/Fulltext/2001/01000/Sleep_in_menopause__differential_
effects_of_two.4.aspx>

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Is there anyone who can’t take HRT?
Chen, W.Y., ‘Menopausal hormone therapy and the risk of breast cancer’, Up to Date,
March 2018 <www.uptodate.com/contents/menopausal-hormone-therapy-and-
the-risk-of-breast-cancer>

What about side effects of HRT?


Walsh, B.W., ‘The Individualized Approach to Menopause Management’, The Journal of
Clinical Endocrinology & Metabolism, vol. 84, June 1999 <academic.oup.com/jcem/
article/84/6/1900/2864442>
Australasian Menopause Society, ‘Combined Menopausal Hormone Therapy (MHT)’
Files, J.A., Miller, V.M., Cha, S.S., et al., ‘Effects of Different Hormone Therapies on
Breast Pain in Recently Postmenopausal Women: Findings from the Mayo Clinic
KEEPS Breast Pain Ancillary Study’, Journal of Women’s Health, October 2014
<www.ncbi.nlm.nih.gov/pmc/articles/PMC4195414/>
Jane, F., ‘MHT (HRT) — a step by step guide to prescribing’, Jean Hailes for Women’s
Health, August/September 2018 <www.healthed.com.au/wp-content/uploads/
2018/06/BWCH18-Fiona-Jane.pdf>

How long can I stay on HRT?


Cancer Australia, ‘Hormone Replacement Therapy (HRT) and risk of breast cancer’,
2008 <canceraustralia.gov.au/publications-and-resources/position-statements/
hormone-replacement-therapy-hrt-and-risk-breast-cancer>

How do I come off HRT?


The North American Menopause Society, ‘The 2017 hormone therapy position
statement of The North American Menopause Society’

What are bio-identical hormones?


Cleveland Clinic, ‘Bioidentical Hormones’, February 2014 <my.clevelandclinic.org/
health/articles/15660-bioidentical-hormones>
Thompson, J.J., Ritenbaugh, C. & Nichter, M., ‘Why women choose compounded
bioidentical hormone therapy: Lessons from a qualitative study of menopausal
decision-making’, BMC Women’s Health, October 2017 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC5625649/>
Australasian Menopause Society, ‘Bioidentical custom compounded hormone therapy’,
May 2018 <www.menopause.org.au/hp/information-sheets/212-bioidentical-
hormones-for-menopausal-symptoms>

Why are my friends taking bio-identical hormones?


Fields, S.W., ‘Human HRT Leads Compounding Renaissance’, Pharmacy Times,
September 2007 <www.pharmacytimes.com/publications/issue/2007/2007-09/
2007-09-6805>
Thompson, J.J., Ritenbaugh, C. & Nichter, M., ‘Why women choose compounded
bioidentical hormone therapy’

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Aren’t they tested?
Australasian Menopause Society, ‘Bioidentical custom compounded hormone therapy’
Elshafie, M.A., ‘Transdermal natural progesterone cream for postmenopausal women:
Inconsistent data and complex pharmacokinetics’, Journal of Obstetrics and
Gynaecology, vol. 27, October 2007 <www.tandfonline.com/doi/full/10.1080/
01443610701582727?scroll=top&needAccess=true> (paywall)
Satoro, N., Braunstein, G.D., Butts, C.L., et al., ‘Compounded Bioidentical Hormones
in Endocrinology Practice: an Endocrine Society Scientific Statement’, The Journal
of Clinical Endocrinology & Metabolism, vol. 101, April 2016 <academic.oup.com/
jcem/article/101/4/1318/2804494#59793952>
Templeman, C., Quinn, D., Hansen, R., et al., ‘An audit of oestrogen implant hormone
replacement therapy’, ANZJOG, November 1998 <obgyn.onlinelibrary.wiley.com/
doi/pdf/10.1111/j.1479-828X.1998.tb03112.x> (paywall)
The North American Menopause Society, ‘The 2017 hormone therapy position
statement of The North American Menopause Society’

HRT: the bottom line


Langer, R.D., ‘The evidence base for HRT: What can we believe?’
Sturdee, D.W. & Pines, A. on behalf of the International Menopause Society Writing
Group, ‘Updated IMS recommendations on postmenopausal hormone therapy
and preventative strategies for midlife health’, Climacteric, vol. 14, 2011
<https://www.tandfonline.com/doi/full/10.3109/13697137.2011.570590?
scroll=top&needAccess=true> (paywall)

C H A PT E R 2 : M E E T Y OU R H OR MONES

Cheung, A.M., Chaudhry, R., Kapral, M., et al., ‘Perimenopausal and Postmenopausal
Health’, BMC Women’s Health, August 2004 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC2096694/>
The North American Menopause Society, ‘Menopause 101: A primer for the
perimenopausal’ <www.menopause.org/for-women/menopauseflashes/menopause-
symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal>
Cheung, A.M., Chaudhry, R., Kapral, M., et al., ‘Perimenopausal and Postmenopausal
Health’
Gjelsvik, B., Rosvold, E.O., Straand, J., et al., ‘Symptom prevalence during menopause
and factors associated with symptoms and menopausal age. Results from the
Norwegian Hordaland Women’s Cohort study’, Maturitas: The European Menopause
Journal, vol. 70, December 2011 <www.sciencedirect.com/science/article/pii/
S037851221100332X>

What do my ovaries do?


Hewitt, S.C. & Koach, K.S., ‘Molecular biology and physiology of estrogen action’,
Up to Date, November 2017 <www.uptodate.com/contents/molecular-biology-
and-physiology-of-estrogen-action>

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Stocco, C., ‘Tissue Physiology and Pathology of Aromatase’, Steroids, January 2012
<www.ncbi.nlm.nih.gov/pmc/articles/PMC3286233/>
Lemke, T.L. & Williams, D.A., ‘Foye’s Principles of Medicinal Chemistry’, Wolters
Kluwer, 2013 <www.fundamentalpharmacy.com/wp-content/uploads/2018/06/
Foye-medichem-7th-edn.compressed.pdf>
Graham, J.D. & Clarke, C.L., ‘Physiological Action of Progesterone in Target Tissues’,
Endocrine Reviews, vol. 18, August 1997 <academic.oup.com/edrv/article/18/4/502/
2530774>
Jane, F.M. & Davis, S.R., ‘A Practitioner’s Toolkit for Managing the Menopause’,
Climacteric, 2014 <www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-
MEDIA/Women’s%20Health/Statement%20and%20guidelines/Clinical%20-%20
Gynaecology/Practitioners-Toolkit-Managing-Menopause.pdf?ext=.pdf>
Tyagi, V., Scordo, M., Yoon, R.S., et al., ‘Revisiting the role of testosterone: Are we
missing something?’, Reviews in Urology, vol. 19, 2017 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC5434832/>
Lasley, B.L., Crawford, S. & McConnell, D.S., ‘Adrenal Androgens and the Menopausal
Transition’, Obstetrics and Gynecology Clinics of North America, September 2012
<www.ncbi.nlm.nih.gov/pmc/articles/PMC3185242/>
Yasui, T., Matsui, S., Tani, A., et al., ‘Androgen in postmenopausal women’, The Journal
of Medical Investigation, vol. 59, 2012 <www.jstage.jst.go.jp/article/jmi/59/1,2/
59_1,2_12/_article>
Markopoulos, M.C., Kassi, E., Alexandraki, K.I., et al., ‘Hyperandrogenism after
menopause’, European Journal of Endocrinology, 2015 <eje.bioscientifica.com/
downloadpdf/journals/eje/172/2/R79.xml>
Akk, G., Bracamontes, J. & Steinbach, J.H., ‘Pregnenolone sulfate block of GABAA
receptors: Mechanism and involvement of a residue in the M2 region of the α
subunit’, The Journal of Physiology, May 2001 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC2278584/>
Mayo, W., Lemaire, V., Malaterre, J., et al., ‘Pregnenolone sulfate enhances neurogenesis
and PSA-NCAM in young and aged hippocampus’, Neurobiology of Aging, vol. 26,
January 2005 <www.sciencedirect.com/science/article/pii/S0197458004001630>
(paywall)
Jankoski, C.M., Wolfe, P., Schmiege, S.J., et al., ‘Sex-Specific Effects of
Dehydroepiandrosterone (DHEA) on Bone Mineral Density and Body Composition’,
Clinical Endocrinology, 2019 <www.medscape.com/viewarticle/908180_4>
Harvard Men’s Health Watch, ‘DHEA and health: More questions than answers’,
Harvard Health Publishing, April 2007 <www.health.harvard.edu/newsletter_article/
dhea-and-health-more-questions-than-answers> (paywall)
PubChem, ‘Compound Summary: Androstenedione’, US National Center for
Biotechnology Information, September 2004 <pubchem.ncbi.nlm.nih.gov/
compound/androstenedione>

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What happens to all these hormones during perimenopause and
menopause?
Hantsoo, L. & Epperson, C.N., ‘Anxiety Disorders Among Women: A Female Lifespan
Approach’, Focus, Spring 2017 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC5613977/>
Su, H.I. & Freeman, E.W., ‘Hormone changes associated with the menopausal
transition’, Minerva Ginecologica, December 2009 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC3823936/>
Worsley, R., ‘Menopause & Mood’, webinar, Jean Hailes for Women’s Health,
July 2016 <jeanhailes.org.au/health-professionals/webinar-library/oestrogen-
mood>

C H A PT E R 3 : B A PT I S M B Y F IR E

The North American Menopause Society, ‘Menopause 101: A primer for the
perimenopausal’ <www.menopause.org/for-women/menopauseflashes/menopause-
symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’,
Climacteric, April 2017 <www.researchgate.net/publication/315801438_The_
menopausal_hot_flush_a_review/download>

What causes my hot flushes?


Freedman, R.R., ‘Menopausal Hot Flashes: Mechanisms, Endocrinology, Treatment’,
The Journal of Steroid Biochemistry and Molecular Biology, July 2014 <www.ncbi.nlm.
nih.gov/pmc/articles/PMC4612529/>
Shapiro, M., ‘Advances in Our Understanding of the Etiology/Mechanisms
of Vasomotor Symptoms’, MenopauseSociety, January 2019 <youtu.be/
s2HqeCEftP0>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’
Australasian Menopause Society, ‘Reducing the number and severity of hot flushes:
New class of menopause drugs’, March 2018 <www.menopause.org.au/hp/studies-
published/1132-reducing-the-number-and-severity-of-hot-flushes-new-class-of-
menopause-drugs>
Shapiro, M., ‘Advances in Our Understanding’
Avis, N.E., Brockwell, S. & Colvin, A., ‘A universal menopausal syndrome?’, The
American Journal of Medicine, vol. 118, December 2005 <www.amjmed.com/article/
S0002-9343(05)00917-4/fulltext#section.0030>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’

How long will I have hot flushes?


Avis, N.E., Crawford, S.L., Greendale, G., et al., ‘Duration of menopausal
vasomotor symptoms over the menopause transition’, JAMA Internal Medicine,
April 2015 <jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110996>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’

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Women’s Health Committee (RANZCOG), ‘Menopausal Hormone Therapy Advice’,
The Royal Australian and New Zealand College of Obstetricians and
Gynaecologists, July 2012 <www.ranzcog.edu.au/RANZCOG_SITE/media/
RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/
Clinical%20-%20Gynaecology/Menopausal-Hormone-Therapy-Advice-(C-Gyn-
16)-Re-write-July-2015.pdf?ext=.pdf>

What lifestyle measures are worth pursuing?


Greendale, G.A. & Gold, E.B., ‘Lifestyle factors: Are they related to vasomotor
symptoms and do they modify the effectiveness or side effects of hormone therapy?’,
The American Journal of Medicine, vol. 118, December 2005 <www.amjmed.com/
article/S0002-9343(05)00907-1/fulltext>
Greendale, G.A. & Gold, E.B., ‘Lifestyle factors’
The North American Menopause Society, ‘Nonhormonal management of menopause-
associated vasomotor symptoms: 2015 position statement of The North American
Menopause Society’, Menopause: The Journal of The North American Menopause
Society, vol. 22, 2015 <www.menopause.org/docs/default-source/professional/
pap-pdf-meno-d-15-00241-minus-trim-cme.pdf>
Greendale, G.A. & Gold, E.B., ‘Lifestyle factors’
Neff, M.J., ‘NAMS Releases Position Statement on the Treatment of Vasomotor
Symptoms Associated with Menopause’, American Family Physician, July 2004
<www.aafp.org/afp/2004/0715/p393.html>
Schilling, C., Gallicchio, L., Miller, S.R., et al., ‘Current Alcohol Use, Hormone Levels,
and Hot Flashes in Midlife Women’, Fertility and Sterility, June 2007 <www.ncbi.
nlm.nih.gov/pmc/articles/PMC1949018/>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’
Daley, A., Stokes-Lampard, H., Thomas, A., et al., ‘Exercise for vasomotor menopausal
symptoms (review)’, Cochrane Database of Systematic Reviews, 2014 <www.
cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006108.pub4/epdf/full>

What about the placebo effect?


Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’

My flushes are still interfering with my quality of life: what could I take?
Women’s Health Committee (RANZCOG), ‘Menopausal Hormone Therapy Advice’
Formoso, G., Perrone, E. & Malroni, S., ‘Short-term and long-term effects of tibolone in
postmenopausal women’, Cochrane Database of Systematic Reviews, October 2016
<www.ncbi.nlm.nih.gov/pmc/articles/PMC6458045/>
Women’s Health Committee (RANZCOG), ‘Menopausal Hormone Therapy Advice’
Jean Hailes for Women’s Health, ‘Menopause management’, December 2017
<jeanhailes.org.au/health-a-z/menopause/menopause-management>
Reeves, G.K., Beral, V., Green, J., et al., ‘Hormonal therapy for menopause and breast-
cancer risk by histological type: A cohort study and meta-analysis’, The Lancet:
Oncology, vol. 7, November 2006 <www.thelancet.com/journals/lanonc/article/
PIIS1470-2045(06)70911-1/fulltext> (paywall)

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Cummings, S.R., Ettinger, B. & Delmas, P.D., ‘The effects of tibolone in older
postmenopausal women’, The New England Journal of Medicine, August 2008
<www.nejm.org/doi/10.1056/NEJMoa0800743?url_ver=Z39.88-2003&rfr_
id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dwww.ncbi.nlm.nih.gov>
Renoux, C., Dell’Aniello, S. & Suissa, S., ‘Hormone replacement therapy and the risk
of venous thromboembolism: a population-based study’, Journal of Thrombosis
and Haemostasis, vol. 8, May 2010 <onlinelibrary.wiley.com/doi/full/10.1111/
j.1538-7836.2010.03839.x>
Medicines and Healthcare Products Regulatory Agency, Gov.UK, ‘Tibolone: Benefit-risk
balance’, Drug Safety Update, September 2007 <www.gov.uk/drug-safety-update/
tibolone-benefit-risk-balance>
Hall, M.J., Levant, S. & DeFrances, C.J., ‘Hospitalization for Stroke in U.S. Hospitals,
1989–2009’, National Center for Health Statistics, CDC, May 2012 <www.cdc.
gov/nchs/products/databriefs/db95.htm>
Pfizer Australia Pty Limited, ‘New paradigm in menopause hormone therapy’, Medical
Republic, November 2017 <medicalrepublic.com.au/new-paradigm-menopause-
hormane-therapy/11969>
Archer, D.F., Freeman, E.W., Komm, B.S., et al., ‘Pooled Analysis of the Effects of
Conjugated Estrogens/Bazedoxifene on Vasomotor Symptoms in the Selective
Estrogens, Menopause, and Response to Therapy Trials’, Journal of Women’s Health,
vol. 25, November 2016 <www.liebertpub.com/doi/abs/10.1089/jwh.2015.
5558?journalCode=jwh> (paywall)
Jane F.M. & Davis S.R., ‘A Practitioner’s Toolkit for Managing the Menopause’,
Climacteric, 2014 <www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-
MEDIA/Women’s%20Health/Statement%20and%20guidelines/Clinical%20-%20
Gynaecology/Practitioners-Toolkit-Managing-Menopause.pdf?ext=.pdf>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’
Neff, M.J., ‘NAMS Releases Position Statement’
Davison S., ‘Initiating hormone replacement therapy’, Jean Hailes for Women’s Health,
March 2017 <jeanhailes.org.au/health-professionals/webinar-library/initiating-
hormone-replacement-therapy>
Neff, M.J., ‘NAMS Releases Position Statement’
Pandya, K.J., Raubertas, R.F., Flynn, P.J., et al., ‘Oral clonidine in postmenopausal
patients with breast cancer experiencing tamoxifen-induced hot flashes:
A University of Rochester Cancer Center Community Clinical Oncology
Program Study’, Annals of Internal Medicine, May 2000 <www.ncbi.nlm.nih.gov/
pubmed/10819701>
Harrison, P., ‘“It’s Going to Be a Useful Agent”: Oxybutynin for Hot Flashes’, Medscape,
December 2018 <www.medscape.com/viewarticle/906249>
Allameh, Z., Rouholamin, S. & Valaie S., ‘Comparison of Gabapentin with Estrogen
for treatment of hot flashes in post-menopausal women’, Journal of Research in
Pharmacy Practice, April/June 2013 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC4076904/>

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Umland, E.M. & Falconieri, L., ‘Treatment options for vasomotor symptoms in
menopause: Focus on desvenlafaxine’, International Journal of Women’s Health,
July 2012 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3410701/>

What about complementary and herbal remedies for hot flushes?


‘Menopausal Symptoms: Comparative Effectiveness Review of Therapies’, Report from
the Agency for Healthcare Research and Quality, March 2015 <effectivehealthcare.
ahrq.gov/topics/menopause/research-protocol>
Lethaby, A., Marjoribanks, J., Kronenberg, F., et al., ‘Phytoestrogens for menopausal
vasomotor symptoms’, Cochrane Database of Systematic Reviews, December 2013
<www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001395.pub4/
abstract>
Thalheimer, J.C., ‘Women’s Health: Are Menopause Supplements Effective?’, Today’s
Dietitian, vol. 18, March 2016 <www.todaysdietitian.com/newarchives/0316p18.
shtml>
Shifren, J.L., MD, NCMP, & Gass, M.L.S., MD, NCMP, for the NAMS
Recommendations for Clinical Care of Midlife Women Working Group, ‘The
North American Menopause Society Recommendations for Clinical Care of
Midlife’, Menopause: The Journal of the North American Menopause Society, vol. 21,
2014 <www.menopause.org/publications/clinical-care-recommendations/
chapter-6-complementary-and-alternative-medicine>
Lethaby, A., Marjoribanks, J., Kronenberg, F., et al., ‘Phytoestrogens for menopausal
vasomotor symptoms’
National Institutes of Health, ‘Black Cohosh’, August 2018 <ods.od.nih.gov/factsheets/
BlackCohosh-HealthProfessional/>
Dietz, B.M., Hajirahimkhan, A., Dunlap, T.L., et al., ‘Botanicals and Their Bioactive
Phytochemicals for Women’s Health’, Pharmacological Reviews, October 2016
<www.ncbi.nlm.nih.gov/pmc/articles/PMC5050441/>
Neff, M.J., ‘NAMS Releases Position Statement’
Mulcahy, N., ‘“Surprising” Result in Flaxseed-for-Hot-Flashes Study’, Medscape,
June 2011 <www.medscape.com/viewarticle/743995>
Bommer, S., Klein, P. & Suter, A., ‘First time proof of sage’s tolerability and efficacy
in menopausal women with hot flushes’, Advances in Therapy, vol. 28, June 2011
<link.springer.com/article/10.1007/s12325-011-0027-z>
Rad, S., Forouhari, S., Dehaghani, A.S., et al., ‘The effect of salvia officinalis tablet on
hot flashes, night sweating, and estradiol hormone in postmenopausal women’,
International Journal of Medical Research & Health Sciences, 2016 <www.ijmrhs.com/
medical-research/the-effect-of-salvia-officinalis-tablet-on-hot-flashes-night-sweating-
and-estradiol-hormone-in-postmenopausal-women.pdf>
Neff, M.J., ‘NAMS Releases Position Statement’
The North American Menopause Society, ‘Nonhormonal management of menopause-
associated vasomotor symptoms’
Chichira, A., Willku, A., Andin, G., et al., ‘Maca’, MedlinePlus, January 2019
<medlineplus.gov/druginfo/natural/555.html>

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The North American Menopause Society, ‘Nonhormonal management of menopause-
associated vasomotor symptoms’
Neff, M.J., ‘NAMS Releases Position Statement’
The North American Menopause Society, ‘Nonhormonal management of menopause-
associated vasomotor symptoms’
Hirata, J.D., Swiersz, L.M., Zell, B., et al., ‘Does dong quai have estrogenic effects in
postmenopausal women? A double-blind, placebo-controlled trial’, Fertility and
Sterility, December 1997 <www.fertstert.org/article/S0015-0282(97)00397-X/
fulltext>
Liu, Y.R., Jiang, Y.L., Huang, R.Q., et al., ‘Hypericum perforatum L. preparations for
menopause: A meta-analysis of efficacy and safety’, Climacteric, vol. 17, November
2013 <www.tandfonline.com/doi/abs/10.3109/13697137.2013.861814>
Pachman, D.R., Jones, J.M. & Loprinzi, C.L., ‘Management of menopause-associated
vasomotor symptoms: Current treatment options, challenges and future directions’,
International Journal of Women’s Health, August 2010 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC2971731/>

Any other treatments out there?


Carpenter, J.S., Wells, N., Lambert, B., et al., ‘A Pilot Study of Magnetic Therapy for
Hot Flashes After Breast Cancer’, Cancer Nursing, April 2002 <journals.lww.com/
cancernursingonline/pages/articleviewer.aspx?year=2002&issue=04000&article=
00005&type=abstract> (paywall)
Thompson, E.A., ‘Alternative and complementary therapies for the menopause:
A homeopathic approach’, Maturitas: The European Menopause Journal, vol. 66,
August 2010 <www.sciencedirect.com/science/article/pii/S0378512210000538>
(paywall)
Royal College of Obstetricians and Gynaecologists, ‘Alternatives to HRT for the
Management of Symptoms of the Menopause’, Scientific Impact Paper No.6,
September 2010 <www.rcog.org.uk/globalassets/documents/guidelines/scientific-
impact-papers/sip_6.pdf>
Imperial College London, ‘New class of menopause drugs reduces number and severity
of hot flushes,’ ScienceDaily, 14 March 2018 <https://www.sciencedaily.com/
releases/2018/03/180314092319.htm>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’

CHAP T E R 4 : W H AT T H E H E L L H A PPE NED TO MY VAGINA?

Kim, H.K., Kang, S.Y., Chung, Y.J., et al., ‘The Recent Review of the Genitourinary
Syndrome of Menopause’, Journal of Menopausal Medicine, August 2015
<www.ncbi.nlm.nih.gov/pmc/articles/PMC4561742/>
Simon, J.A., Davis, S.R., Althof, S.E., et al., ‘Sexual well-being after menopause: An
International Menopause Society White Paper’, Climacteric, vol. 21, October 2018
<www.tandfonline.com/doi/full/10.1080/13697137.2018.1482647?scroll=
top&needAccess=true> (paywall)

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Faubion, S.S., Sood, R. & Kapoor, E., ‘Genitourinary Syndrome of Menopause:
Management Strategies for the Clinician’, Mayo Clinic Proceedings, vol. 92, December
2017 <www.mayoclinicproceedings.org/article/S0025-6196(17)30639-0/fulltext>
Kim, H.K., Kang, S.Y., Chung, Y.J., et al., ‘The Recent Review of the Genitourinary
Syndrome of Menopause’
Faubion, S.S., Sood, R. & Kapoor, E., ‘Genitourinary Syndrome of Menopause’

I thought it was just me?


Kim, H.K., Kang, S.Y., Chung, Y.J., et al., ‘The Recent Review of the Genitourinary
Syndrome of Menopause’
Simon, J.A., Davis, S.R., Althof, S.E., et al., ‘Sexual well-being after menopause’
Kao, A., Binik, Y.M., Kapuscinski, A., et al., ‘Dyspareunia in postmenopausal women:
A critical review’, Pain Research and Management, vol. 13, May/June 2008
<www.ncbi.nlm.nih.gov/pmc/articles/PMC2671314/>
Kim, H.K., Kang, S.Y., Chung, Y.J., et al., ‘The Recent Review of the Genitourinary
Syndrome of Menopause’
Faubion, S.S., Sood, R. & Kapoor, E., ‘Genitourinary Syndrome of Menopause’
Edwards, D. & Panay, N., ‘Treating vulvovaginal atrophy/genitourinary syndrome of
menopause: How important is vaginal lubricant and moisturizer composition?’,
Climacteric, March 2016 <www.ncbi.nlm.nih.gov/pmc/articles/PMC4819835/>

What happens to my body during sex?


Marthol, H. & Hilz, M.J., ‘[Female sexual dysfunction: A systematic overview of
classification, pathophysiology, diagnosis and treatment]’, Fortschritte der Neurologie:
Psychiatrie, March 2004 <www.thieme-connect.com/products/ejournals/abstract/
10.1055/s-2004-818357> (paywall)

How do I fix my sex life?


Panay, N., Palacios, S., Bruyniks, N., et al., ‘Symptom severity and quality of life
in the management of vulvovaginal atrophy in postmenopausal women’,
Maturitas: The European Menopause Journal, vol. 124, June 2019 <bit.ly/2UD7OMJ>
(paywall)

So, what treatments are available and work best?


The North American Menopause Society, ‘The 2017 hormone therapy position
statement of The North American Menopause Society’, Menopause: The Journal of
the North American Menopause Society, vol. 24, 2017 <www.menopause.org/docs/
default-source/2017/nams-2017-hormone-therapy-position-statement.pdf>
Primary Care Women’s Health Forum, ‘Guidance on diagnosis and management
of urogenital atrophy or genitourinary syndrome of the menopause (GSM)’,
Guidelines, September 2017 <www.guidelines.co.uk/womens-health/pcwhf-
management-of-urogenital-atrophy-or-gsm-guideline/453572.article>
Simon, J.A., Davis, S.R., Althof, S.E., et al., ‘Sexual well-being after menopause’

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Primary Care Women’s Health Forum, ‘Guidance on diagnosis and management of
urogenital atrophy’
Faubion, S.S., Sood, R. & Kapoor, E., ‘Genitourinary Syndrome of Menopause’
Australian Menopause Society, ‘Tibolone for Post-Menopausal Women’, July 2008
<www.imsociety.org/downloads/patient_information_sheets/tibolone_for_post_
menopausal_women.pdf>
Simon, J.A., Davis, S.R., Althof, S.E., et al., ‘Sexual well-being after menopause’
NPS Medicinewise, ‘Consumer medicine information: Androfeme 1’, NPS Medicinewise,
January 2014 <www.nps.org.au/medicine-finder/andro-feme-1-cream>
Jayasena, C.N., Alkaabi, F.M., Liebers, C.S., et al., ‘A Systematic Review of Randomized
Controlled Trials Investigating the Efficacy and Safety of Testosterone Therapy for
Female Sexual Dysfunction in Postmenopausal Women’, Clinical Endocrinol, 2019
<www.medscape.com/viewarticle/909278_8>
Glaser, R. & Dimitrakakis, C., ‘Testosterone therapy in women: Myths and
misconceptions’, Maturitas: The European Menopause Journal, March 2013
<www.maturitas.org/article/S0378-5122(13)00012-1/fulltext>
Shifren, J.L., ‘Testosterone for Midlife Women: The Hormone of Desire?’, NAMS
Practice Pearl, June 2015 <www.menopause.org/docs/default-source/professional/
practice-pear-testosterone.pdf/>
Simon, J.A., Davis, S.R., Althof, S.E., et al., ‘Sexual well-being after menopause’
International Society for Sexual Medicine, ‘Why is sleep important for sexual health?’,
Sexual Health Q&A <www.issm.info/sexual-health-qa/why-is-sleep-important-
for-sexual-health/>
SLUCare, ‘Guidelines for Vulvar Skin Care’, October 2016 <www.slucare.edu/ob-gyn/
female-pelvic-medicine-and-reconstructive-surgery/guidelines-for-vulvar-skin-care.
php>
Farrell, E., ‘Genitourinary syndrome of menopause’
Edwards, D. & Panay, N., ‘Treating vulvovaginal atrophy/genitourinary syndrome of
menopause’
Naumova, I. & Castelo-Branco, C., ‘Current treatment options for postmenopausal
vaginal atrophy’, International Journal of Women’s Health, July 2018 <www.ncbi.nlm.
nih.gov/pmc/articles/PMC6074805/>
Stanton, A.M., Handy, A.B. & Meston, C.M., ‘The Effects of Exercise on
Sexual Function in Women’, Sexual Medicine Reviews, vol. 6, October 2018
<www.sciencedirect.com/science/article/pii/S2050052118300180> (paywall)
Simon, J.A., Davis, S.R., Althof, S.E., et al., ‘Sexual well-being after menopause’
International Society for Sexual Medicine, ‘What medications might lower a person’s
libido?’, Sexual Health Q&A <www.issm.info/sexual-health-qa/what-medications-
might-lower-a-persons-libido/>
Farrell, E., ‘Genitourinary syndrome of menopause’, Australian Family Physician, July 2017
<https://www.racgp.org.au/afp/2017/july/genitourinary-syndrome-of-menopause/>
International Society for Sexual Medicine, ‘What medications might lower a person’s
libido?’

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The North American Menopause Society, ‘Yoga, Kegel Exercises, Pelvic Floor Physical
Therapy’ <www.menopause.org/for-women/sexual-health-menopause-online/
effective-treatments-for-sexual-problems/yoga-kegel-exercises-pelvic-floor-physical-
therapy>
Goliszek, A., ‘The Stress–Sex Connection’, Psychology Today, December 2014
<www.psychologytoday.com/us/blog/how-the-mind-heals-the-body/201412/
the-stress-sex-connection>

What about vaginal discharge?


Martino, J.L. & Vermund, S.H., ‘Vaginal Douching: Evidence for Risks or Benefits to
Women’s Health’, Epidemiol Review, October 2008 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC2567125/>
NHS Choices, ‘General Care of Vulval Skin’, NHS: Mid Cheshire Hospitals, March 2019
<www.mcht.nhs.uk/EasysiteWeb/getresource.axd?AssetID=11305&type=full>
Lamont, R.F., Sobel, J.D., Akins, R.A., et al., ‘The vaginal microbiome: New
information about genital tract flora using molecular based techniques’, BJOG: An
International Journal of Obstetrics and Gynaecology, vol. 118, April 2011 <www.ncbi.
nlm.nih.gov/pmc/articles/PMC3055920/>
Hoffmann, J., You, H.M., Hedberg, E.C., et al., ‘Prevalence of Bacterial Vaginosis and
Candida among Postmenopausal Women in the United States’, The Journal of
Gerontology Series B: Psychological Sciences and Social Sciences, November 2014
<www.ncbi.nlm.nih.gov/pmc/articles/PMC4303100/>
Brotman, R.M., Shardell, M.D., Gajer, P., et al., ‘Association between the vaginal
microbiota, menopause status and signs of vulvovaginal atrophy’, Menopause:
The Journal of the North American Menopause Society, vol. 21, May 2014
<www.ncbi.nlm.nih.gov/pmc/articles/PMC3994184/>
Hoffmann, J., You, H.M., Hedberg, E.C., et al., ‘Prevalence of Bacterial Vaginosis and
Candida’
Kim, J.M. & Park, Y.J., ‘Probiotics in the Prevention and Treatment of Postmenopausal
Vaginal Infections: Review Article’, Journal of Menopausal Medicine, December 2017
<www.ncbi.nlm.nih.gov/pmc/articles/PMC5770522/>
Hoffmann, J., You, H.M., Hedberg, E.C., et al., ‘Prevalence of Bacterial Vaginosis and
Candida’
Girerd, P.H. & Rivlin, M.E., ‘Bacterial Vaginosis Treatment & Management’, Medscape,
October 2018 <emedicine.medscape.com/article/254342-treatment#d6>

What is causing my itchy fanny?


Erekson, E.A., Martin, D.K., Brousseau, E.C., et al., ‘Over-the-counter treatments and
perineal hygiene in postmenopausal women’, Menopause: The Journal of the North
American Menopause Society, vol. 21, March 2014 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC3815513/>
Bachmann, G.A. & Nevadunsky, N.A., ‘Diagnosis and Treatment of Atrophic
Vaginitis’, American Family Physician, May 2000 <www.aafp.org/afp/2000/0515/
p3090.html>

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Kingston, A., ‘Review: The postmenopausal vulva’, The Obstetrician & Gynaecologist,
2009 <obgyn.onlinelibrary.wiley.com/doi/pdf/10.1576/toag.11.4.253.27528>
Bachmann, G.A. & Nevadunsky, N.A., ‘Diagnosis and Treatment of Atrophic
Vaginitis’
Kingston, A., ‘Review: The postmenopausal vulva’
Caro-Bruce, E. & Flaxman, G., ‘Vulvar pruritus in a postmenopausal woman’,
CMAJ JAMC, June 2014 <www.ncbi.nlm.nih.gov/pmc/articles/PMC4049992/>
Hoffmann, J., You, H.M., Hedberg, E.C., et al., ‘Prevalence of Bacterial Vaginosis and
Candida’
The American College of Obstetricians and Gynecologists, ‘Disorders of the
Vulva: Common Causes of Vulvar Pain, Burning, and Itching’, February 2019
<www.acog.org/Patients/FAQs/Disorders-of-the-Vulva-Common-Causes-of-Vulvar-
Pain-Burning-and-Itching?IsMobileSet=false#some>
‘Vulvovaginal health in post-menopausal women’, BPAC NZ, 2014 <bpac.org.nz/bpj/
2014/september/vulvovaginal.aspx>
Rapaport, L., ‘Vaginal Laser Treatment Tied to Complications Like Scarring’,
Medscape, March 2019 <www.medscape.com/viewarticle/909694?src=wnl_edit_
tpal&uac=117094MG&impID=1898298&faf=1>
Australasian Menopause Society, ‘Update on vaginal laser therapy’, November 2018
<www.menopause.org.au/hp/news/1266-update-on-vaginal-laser-therapy>
Song, S., Budden, A., Short, A., et al., ‘The evidence for laser treatments to the vulvo‐
vagina: Making sure we do not repeat past mistakes’, Australian and New Zealand
Journal of Obstetrics and Gynaecology, vol. 58, October 2017 <obgyn.onlinelibrary.
wiley.com/doi/10.1111/ajo.12735>

Now can we talk about my bladder?


Heesakkers, J., Pons, M.E., Hobson, P.T., et al., ‘Dealing with complex overactive
bladder syndrome patient profiles with focus on fesoterodine: In or out of the EAU
guidelines?’, Research and Reports in Urology, October 2017 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC5673033/>
Alperin, M., Burnett, L., Lukacz, E., et al., ‘The Mysteries of Menopause and
Urogynecologic Health’, Menopause: The Journal of the North American Menopause
Society, 2019 <www.medscape.com/viewarticle/907155>

So, why have I started wetting myself?


Hillard, T., ‘The postmenopausal bladder’, Menopause International, June 2010
<journals.sagepub.com/doi/abs/10.1258/mi.2010.010020> (paywall)
Robinson, D. & Cardozo, L., ‘Oestrogens and the lower urinary tract’, BJOG: An
International Journal of Obstetrics and Gynaecology, vol. 111, December 2004
<obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-0528.2004.00459.x>
Preminger, G.M., ‘Effects of Aging on the Urinary Tract’, MSD Manual, June 2019
<www.msdmanuals.com/en-au/home/kidney-and-urinary-tract-disorders/biology-
of-the-kidneys-and-urinary-tract/effects-of-aging-on-the-urinary-tract>

16 THE M WORD
A.D.A.M., ‘Aging changes in the kidneys and bladder’, Medline Plus <medlineplus.gov/
ency/article/004010.htm>
Preminger, G.M., ‘Effects of Aging on the Urinary Tract’
Alperin, M., Burnett, L., Lukacz, E., et al., ‘The Mysteries of Menopause and
Urogynecologic Health’
Hillard, T., ‘The postmenopausal bladder’
Heesakkers, J., Pons, M.E., Hobson, P.T., et al., ‘Dealing with complex overactive
bladder syndrome’
Hillard, T., ‘The postmenopausal bladder’
Hersh, L. & Slazman, B., ‘Clinical Management of Urinary Incontinence in Women’,
American Family Physician, May 2013 <www.aafp.org/afp/2013/0501/p634.html>

What can I do about bladder leakage?


Qaseem, A., Dallas, P., Forciea, M.A., et al., ‘Nonsurgical Management of Urinary
Incontinence in Women: A Clinical Practice Guideline From The American College
of Physicians’, Annals of Internal Medicine, September 2014 <annals.org/aim/
fullarticle/1905131/nonsurgical-management-urinary-incontinence-women-
clinical-practice-guideline-from-american>
Heesakkers, J., Pons, M.E., Hobson, P.T., et al., ‘Dealing with complex overactive
bladder syndrome’
Orasanu, B. & Mahajan, S.T., ‘The use of botulinum toxin for the treatment of
overactive bladder syndrome’, Indian Journal of Urology, January/March 2013
<www.ncbi.nlm.nih.gov/pmc/articles/PMC3649594/>
Hersh, L. & Slazman, B., ‘Clinical Management of Urinary Incontinence in Women’
Qaseem, A., Dallas, P., Forciea, M.A., et al., ‘Nonsurgical Management of Urinary
Incontinence in Women’
Cody, J.D., Jacobs, M.L., Richardson, K., et al., ‘Oestrogens for urinary incontinence
in women’, Cochrane Database of Systematic Reviews, October 2012
<www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001405.pub3/full>
Tomaszewski, J., ‘Postmenopausal overactive bladder’, Przeglad Menopauzalny, vol. 13,
December 2014 <www.ncbi.nlm.nih.gov/pmc/articles/PMC4352916/>
Orasanu, B. & Mahajan, S.T., ‘The use of botulinum toxin for the treatment of
overactive bladder syndrome’
The American College of Obstetricians and Gynecologists, ‘Surgery for Stress Urinary
Incontinence’, January 2019 <www.acog.org/Patients/FAQs/Surgery-for-Stress-
Urinary-Incontinence?IsMobileSet=false>

How do you prevent UTIs after menopause?


Bergamin, P.A. & Kiosoglous, A.J., ‘Non-surgical management of recurrent urinary
tract infections in women’, Translational Andrology and Urology, vol. 6, July 2017
<www.ncbi.nlm.nih.gov/pmc/articles/PMC5522788/>
Kodner, C.M. & Gupton, E.K.T., ‘Recurrent Urinary Tract Infections in Women:
Diagnosis and Management’, American Family Physician, September 2010
<www.aafp.org/afp/2010/0915/p638.html>

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Raz, R., ‘Urinary Tract Infection in Postmenopausal Women’, Korean Journal of Urology,
December 2011 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3246510/>
Gupta, V., Nag, D. & Garg, P., ‘Recurrent urinary tract infections in women: How
promising is the use of probiotics?’, Indian Journal of Medical Microbiology,
July/September 2017 <www.ijmm.org/article.asp?issn=0255-0857;year=2017;
volume=35;issue=3;spage=347;epage=354;aulast=Gupta>
Nseir, W., Farah, R., Mahamid, M., et al., ‘Obesity and recurrent urinary tract infections
in premenopausal women: A retrospective study’, International Journal of Infectious
Diseases, December 2015 <www.ijidonline.com/article/S1201-9712(15)00248-9/
fulltext>
Kodner, C.M. & Gupton, E.K.T., ‘Recurrent Urinary Tract Infections in Women’
Alperin, M., Burnett, L., Lukacz, E., et al., ‘The Mysteries of Menopause and
Urogynecologic Health’
Forbes, R., Ali, A. & Abouhajar, A., ‘Alternatives to prophylactic antibiotics for the
treatment of recurrent urinary tract infection in women (ALTAR): Study protocol
for a multicentre, pragmatic, patient-randomised, non-inferiority trial’, Trials,
November 2018 <www.ncbi.nlm.nih.gov/pmc/articles/PMC6230276/>
Bushman, W. & Le, B.V., ‘How to manage recurrent UTIs in postmenopausal women’,
Urology Times, June 2016 <www.urologytimes.com/modern-medicine-feature-
articles/how-manage-recurrent-utis-postmenopausal-women>
Forbes, R., Ali, A. & Abouhajar, A., ‘Alternatives to prophylactic antibiotics’
Hickling, D.R. & Nitti, V.W., ‘Management of Recurrent Urinary Tract Infections in
Healthy Adult Women’, Reviews in Urology, vol. 15, 2013 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC3784967/>
Raz, R., ‘Urinary Tract Infection in Postmenopausal Women’
Bushman, W. & Le, B.V., ‘How to manage recurrent UTIs in postmenopausal
women’
Forbes, R., Ali, A. & Abouhajar, A., ‘Alternatives to prophylactic antibiotics’

What about complementary and home remedies?


Jepson, R.G., Williams, G. & Craig, J.C., ‘Cranberries for preventing urinary tract
infections’, Cochrane Database of Systematic Reviews, October 2012 <www.
cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001321.pub5/full>
Stapleton, A.E., Au-Yeung, M., Hooton, T.M., et al., ‘Randomized, placebo-controlled
phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention
of recurrent urinary tract infection’, Clinical Infectious Diseases, May 2011
<academic.oup.com/cid/article/52/10/1212/478332>
Hickling, D.R. & Nitti, V.W., ‘Management of Recurrent Urinary Tract Infections in
Healthy Adult Women’
Wellens, A., Garofalo, C., Nguyer, H., et al., ‘Intervening with Urinary Tract Infections
Using
Anti-Adhesives Based on the Crystal Structure of the FimH-Oligomannose-3
Complex’, PLOS One, April 2008 <https://doi.org/10.1371/journal.pone.0002040>

18 THE M WORD
What is prolapse?
National Association for Continence, ‘Kegel Exercises’ <www.nafc.org/kegel>
Iglesia, C.B. & Smithling, K.R., ‘Pelvic Organ Prolapse’, American Family Physician,
August 2017 <www.aafp.org/afp/2017/0801/p179.html>
Alperin, M., Burnett, L., Lukacz, E., et al., ‘The Mysteries of Menopause and
Urogynecologic Health’
Harvard Women’s Health Watch, ‘What to do about pelvic organ prolapse’, Harvard
Health Publishing, May 2014 <www.health.harvard.edu/womens-health/what-to-
do-about-pelvic-organ-prolapse>
Institute for Quality and Efficiency in Health Care, ‘Pelvic organ prolapse: Pelvic floor
exercises and vaginal pessaries’, Informed Health, August 2018 <www.ncbi.nlm.nih.
gov/books/NBK525762/>
Women’s Health Care Physicians, ‘Surgery for Pelvic Organ Prolapse’, The American
College of Obstetricians and Gynecologists, October 2018 <www.acog.org/Patients/
FAQs/Surgery-for-Pelvic-Organ-Prolapse?IsMobileSet=false#is>
Center for Women’s Pelvic Health at UCLA, ‘Pelvic Organ Prolapse’, UCLA Health
<obgyn.ucla.edu/treating-prolapse-with-surgery>

CHAP T E R 5 : S OM E B OD Y B U R N T D OWN MY H APPY PLAC E

Why do I feel like hormones rule my brain?


Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’, Medscape, January
2019 <emedicine.medscape.com/article/295382-overview#a4>
Brain Made Simple, ‘Hippocampus’, Brain Made Simple <brainmadesimple.com/
hippocampus.html>
Queensland Brain Institute, ‘The limbic system’ <qbi.uq.edu.au/brain/brain-anatomy/
limbic-system>
ter Horst, G.J., ‘Estrogen in the limbic system’, Vitamins and Hormones, 2010
<www.sciencedirect.com/science/article/pii/S0083672910820175?via%3Dihub>
(paywall)
Epperson, C.N., Amin, Z., Ruparel, K., et al., ‘Interactive Effects of Estrogen and
Serotonin On Brain Activation During Working Memory and Affective Processing
in Menopausal Women’, Psychoneuroendocrinology, March 2013 <www.ncbi.nlm.
nih.gov/pmc/articles/PMC3226892/>
Farber, N., ‘Estrogen and Progesterone: Beyond Reproduction’, Psychology Today,
March 2018 <www.psychologytoday.com/us/blog/the-blame-game/201803/
estrogen-and-progesterone-beyond-reproduction>
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’
Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’
Holschneider, D.P., Kumazawa, T., Chen K., et al., ‘Tissue-specific effects of estrogen
on monoamine oxidase A and B in the rat’, Life Sciences, 1998 <www.sciencedirect.
com/science/article/abs/pii/S0024320598002550?via%3Dihub> (paywall)
Robertson, S., ‘Estradiol and the Brain’, News-Medical, August 2018 <www.news-
medical.net/health/Estradiol-and-the-Brain.aspx>

19 THE M WORD
Bitran, D., Shiekh, M. & McLeod, M., ‘Anxiolytic effect of progesterone is mediated
by the neurosteroid allopregnanolone at brain GABAA receptors’, Journal of
Neuroendocrinology, March 1995 <onlinelibrary.wiley.com/doi/pdf/10.1111/
j.1365-2826.1995.tb00744.x> (paywall)
Stein, D.G., ‘Progesterone Exerts Neuroprotective Effects after Brain Injury’, Brain
Research Reviews, June 2009 <www.ncbi.nlm.nih.gov/pmc/articles/PMC2699575/>

I haven’t even reached menopause yet — so why do I feel depressed?


Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’
Worsley, R., ‘Menopause & Mood’, webinar, Jean Hailes for Women’s Health, July 2016
<jeanhailes.org.au/health-professionals/webinar-library/oestrogen-mood>
Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’

Can we blame our hormones then?


Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’

What happens after menopause?


Worsley, R., ‘Menopause & Mood’

Treating depression with lifestyle changes


Amnesty International, ‘Stop Torture Animation’, March 2015 <www.amnesty.org/en/
latest/education/2015/03/stop-torture-animation/>
Morgan, A.J. & Jorm, A.F., ‘Outcomes of Self-help Efforts in Anxiety Disorders’,
Expert Reviews Pharmacoeconomics & Outcomes Research, 2009 <www.medscape.
com/viewarticle/711635_7>
Knüppel, A., Shipley, M.J., Llewellyn, C.H., et al., ‘Sugar intake from sweet food and
beverages, common mental disorder and depression: Prospective findings from the
Whitehall II study’, Scientific Reports, July 2017 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC5532289/>
Selhub, E., ‘Nutritional psychiatry: Your brain on food’, Harvard Health Publishing,
November 2015 <www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-
on-food-201511168626>
Bousvaros, A., ‘Can probiotics help treat depression and anxiety?’, Harvard Health
Publishing, July 2017 <www.health.harvard.edu/blog/can-probiotics-help-treat-
depression-anxiety-2017072612085>
Allen, E.P. & Smith, A.P., ‘Chewing Gum: Cognitive Performance, Mood,
Well-Being, and Associated Physiology’, BioMed Research International, May 2015
<www.ncbi.nlm.nih.gov/pmc/articles/PMC4449949/>
Scholey, A., Hakell, C., Robertson, B., et al., ‘Chewing gum alleviates negative mood
and reduces cortisol during acute laboratory psychological stress’, Physiology &
Behavior, vol. 97, June 2009 <www.sciencedirect.com/science/article/abs/pii/
S0031938409000687> (paywall)
Wilkes, C., Kydd, R., Sagar, M., et al., ‘Upright posture improves affect and fatigue in
people with depressive symptoms’, Journal of Behavior Therapy and Experimental
Psychiatry, vol. 54, March 2017 <www.sciencedirect.com/science/article/pii/
S0005791616301719?via%3Dihub> (paywall)

20 THE M WORD
Nair, S., Sagar, M., Sollers, J., et al., ‘Do slumped and upright postures affect stress
responses? A randomized trial’, Health Psychology, June 2015 <psycnet.apa.org/
record/2014-37739-001> (paywall)

What are the psychological therapies?


Goyal, M., Singh, S., Sibinga, E.M.S., et al., ‘Meditation Programs for Psychological
Stress and Well-being’, JAMA Internal Medicine, March 2014 <jamanetwork.com/
journals/jamainternalmedicine/fullarticle/1809754>

Are there herbal, or other, remedies that might help me?


Liu, Y.R., Jiang, Y.L., Huang, R.Q., et al., ‘Hypericum perforatum L. preparations for
menopause: A meta-analysis of efficacy and safety’, Climacteric, vol. 17, November
2013 <www.tandfonline.com/doi/abs/10.3109/13697137.2013.861814>
Morgan, A.J. & Jorm, A.F., ‘Outcomes of Self-help Efforts in Anxiety Disorders’, Expert
Review of Pharmacoeconomics & Outcomes Research, 2009 <www.medscape.com/
viewarticle/711635_4>
National Institutes of Health, ‘Magnesium: Fact Sheet for Health Professionals’ <ods.
od.nih.gov/factsheets/Magnesium-HealthProfessional/>
Boyle, N.B., Lawton, C. & Dye, L., ‘The Effects of Magnesium Supplementation
on Subjective Anxiety and Stress: A Systematic Review’, Nutrients, April 2017
<www.ncbi.nlm.nih.gov/pmc/articles/PMC5452159/>
Lakhan, S.E. & Vieira, K.F., ‘Nutritional and herbal supplements for anxiety and
anxiety-related disorders: A systematic review’, Nutrition Journal, October 2010
<www.ncbi.nlm.nih.gov/pmc/articles/PMC2959081/>
Morgan, A.J. & Jorm, A.F., ‘Outcomes of Self-help Efforts in Anxiety Disorders’
Blue Pages, ‘Tryptophan’, December 2016 <bluepages.anu.edu.au/index.php?id=tryptophan>
Morgan, A.J. & Jorm, A.F., ‘Outcomes of Self-help Efforts in Anxiety Disorders’
Blue Pages, ‘Tryptophan’
Blue Pages, ‘Omega-3’ <bluepages.anu.edu.au/index.php?id=omega-3>
Morgan, A.J. & Jorm, A.F., ‘Outcomes of Self-help Efforts in Anxiety Disorders’
Lakhan, S.E. & Vieira, K.F., ‘Nutritional and herbal supplements for anxiety and
anxiety-related disorders’
Smriga, M., Ghosh, S., Mouneimne, Y., et al., ‘Lysine fortification reduces anxiety
and lessens stress in family members in economically weak communities in
Northwest Syria’, Proceedings of the National Academy of Sciences, June 2004
<www.pnas.org/content/101/22/8285>
Smriga, M., Ando, T., Akutsu, M., et al., ‘Oral treatment with L-lysine and L-arginine
reduces anxiety and basal cortisol levels in healthy humans’, Biomedical Research,
April 2007 <www.jstage.jst.go.jp/article/biomedres/28/2/28_2_85/_article>
Morgan, A.J. & Jorm, A.F., ‘Outcomes of Self-help Efforts in Anxiety Disorders’
Blue Pages, ‘Negative Air Ionisation’ <bluepages.anu.edu.au/index.php?id=negative-
air-ionisation>
Pittler, M.H. & Ernst, E., ‘Kava extract for treating anxiety’, Cochrane Database of
Systematic Reviews, January 2003 <www.cochranelibrary.com/cdsr/doi/10.1002/
14651858.CD003383/full>

21 THE M WORD
Alcohol and Drug Foundation, ‘Kava’, August 2019 <adf.org.au/drug-facts/kava/>
Amsterdam, J.D., Yao, Y., Mao, J.J., et al., ‘Randomized, Double-blind, Placebo-
controlled Trial of Cimicifuga racemosa (Black Cohosh) in Women with Anxiety
Disorder Due to Menopause’, Journal of Clinical Psychopharmacology, October 2009
<www.ncbi.nlm.nih.gov/pmc/articles/PMC3600411/>
National Institutes of Health, ‘Black Cohosh: Fact Sheet for Health Professionals’,
National Institutes of Health <ods.od.nih.gov/factsheets/BlackCohosh-
HealthProfessional/#h3>

What about antidepressant medication?


Cipriani, A., Furukawa, T.A., Salanti, G., et al., ‘The most effective antidepressants for
adults revealed in major review’, NIHR Signal, 2018 <discover.dc.nihr.ac.uk/
content/signal-00580/the-most-effective-antidepressants-for-adults-revealed-
in-major-review>
Ferguson, J.M., ‘SSRI Antidepressant Medications: Adverse Effects and Tolerability’,
The Primary Care Companion to the Journal of Clinical Psychiatry, February 2001
<www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/>
Harvard Women’s Health Watch, ‘Going off antidepressants’, Harvard Health Publishing,
November 2010 <www.health.harvard.edu/diseases-and-conditions/going-off-
antidepressants>

And can HRT help depression?


Worsley, R., Bell, R.J., Gartoulla, P., et al., ‘Moderate–Severe Vasomotor Symptoms
Are Associated with Moderate–Severe Depressive Symptoms’, Journal of Women’s
Health, vol. 26, July 2017 <www.liebertpub.com/doi/10.1089/jwh.2016.6142>
(paywall)
Worsley, R., ‘Menopause & Mood’

I’m not depressed; I’m just not that happy


Mills, P.J. & Redwine, L., ‘Can Gratitude Be Good for Your Heart?’, Greater Good
Magazine, October 2017 <greatergood.berkeley.edu/article/item/can_gratitude_
be_good_for_your_heart>
Karns, C.M., Moore, W.E. & Mayr, U., ‘The Cultivation of Pure Altruism via Gratitude:
A Functional MRI Study of Change with Gratitude Practice’, Frontiers in Human
Neuroscience, December 2017 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC5770643/>
Wong, J. & Brown, J., ‘How Gratitude Changes You and Your Brain’, Greater Good
Magazine, June 2017 <greatergood.berkeley.edu/article/item/how_gratitude_
changes_you_and_your_brain>
Shpancer, N., ‘Action Creates Emotion’, Psychology Today, October 2010
<www.psychologytoday.com/us/blog/insight-therapy/201010/action-creates-emotion>
Riggio, R.E., ‘There’s Magic in Your Smile’, Psychology Today, June 2012
<www.psychologytoday.com/us/blog/cutting-edge-leadership/201206/
there-s-magic-in-your-smile>

22 THE M WORD
Tolle, E., A New Earth: Awakening to Your Life’s Purpose, New York, NY: Penguin
Random House, 2005
Fox, M., ‘Happiness is contagious: Study’, Reuters, December 2008 <www.reuters.com/
article/us-happiness/happiness-is-contagious-study-idUSTRE4B400H20081205>
Thoma, M.V., Marca, R.L., Brönnimann, R., et al., ‘The Effect of Music on the Human
Stress Response’, PLOS One, August 2013 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC3734071/>
Lee, M., Lee, J., Park, B.J., et al., ‘Interaction with indoor plants may reduce
psychological and physiological stress by suppressing autonomic nervous system
activity in young adults: A randomized crossover study’, Journal of Physiological
Anthropology, April 2015 <www.ncbi.nlm.nih.gov/pmc/articles/PMC4419447/>
Bryner, J., ‘Houseplants Make Air Healthier’, Live Science, September 2009
<www.livescience.com/5681-houseplants-air-healthier.html>
Qin, J., Sun, C., Zhou, X., et al., ‘The effect of indoor plants on human comfort’,
Indoor and Built Environment, September 2013 <www.researchgate.net/
publication/274476416_The_effect_of_indoor_plants_on_human_comfort>
Babar, A., Al-Wabel, N.A., Shams, S., et al., ‘Essential oils used in aromatherapy: A
systemic review’, Asian Pacific Journal of Tropical Biomedicine, vol. 5, August 2015
<www.sciencedirect.com/science/article/pii/S2221169115001033>
Beetz, A., Uvnäs-Moberg, K., Julius, H., et al., ‘Psychosocial and Psychophysiological
Effects of Human–Animal Interactions: The Possible Role of Oxytocin’, Frontiers in
Psychology, July 2012 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3408111/>
Human Animal Bond Research Institute, ‘Survey: Pet Owners and the Human–Animal
Bond’, 2016 Pet Owners Survey, 2016 <habri.org/2016-pet-owners-survey>

CH A PT E R 6 : T I R E D , B L OAT E D AND ITC H Y:


T H E GI R L B A N D N OB OD Y WA N TS TO S IGN

Why am I tired all the time?


Everitt, H., McDermott, L., Leydon, G., et al., ‘GPs’ management strategies for patients
with insomnia: A survey and qualitative interview study’, British Journal of General
Practice, February 2014 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3905408/>
Cintron, D., Lipford, M., Larrea-Mantilla, L., et al., ‘Efficacy of menopausal hormone
therapy on sleep quality: Systematic review and meta-analysis’, Endocrine, July 2017
<www.ncbi.nlm.nih.gov/pmc/articles/PMC5509066/>
Panneerselvam, S., ‘Effectiveness of Aromatherapy in Insomnia’, International
Journal of Innovative Pharmaceutical Sciences and Research, November 2017
<www.researchgate.net/publication/321431103_EFFECTIVENESS_OF_
AROMATHERAPY_IN_INSOMNIA>
Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’, Medscape, January
2019 <emedicine.medscape.com/article/295382-overview#a4>
The North American Menopause Society, ‘The 2017 hormone therapy position
statement of The North American Menopause Society’, Menopause: The Journal of
the North American Menopause Society, vol. 24, 2017 <www.menopause.org/docs/
default-source/2017/nams-2017-hormone-therapy-position-statement.pdf>

23 THE M WORD
Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’
Jehan, S., Jean-Louis, G., Zizi, F., et al., ‘Sleep, Melatonin, and the Menopausal
Transition: What Are the Links?’, Sleep Science, January/March 2017 <www.ncbi.
nlm.nih.gov/pmc/articles/PMC5611767/>
Bhatt, N.V. & Hategan, A.H., ‘Menopause and Mood Disorders’
Jehan, S., Jean-Louis, G., Zizi, F., et al., ‘Sleep, Melatonin, and the Menopausal
Transition’
National Sleep Foundation, ‘Orexin receptor antagonists: A new class of sleeping pill’
<www.sleepfoundation.org/articles/orexin-receptor-antagonists-new-class-
sleeping-pill>
Messina, G., Viggiano, A., De Luca, V., et al., ‘Hormonal Changes in Menopause
and Orexin-A Action’, Obstetrics and Gynecology International, January 2013
<www.hindawi.com/journals/ogi/2013/209812/>
Australian Prescriber, ‘Suvorexant for insomnia’, NPS Medicinewise, May 2017
<www.nps.org.au/australian-prescriber/articles/suvorexant-for-insomnia>
Chan, S. & Debono, M., ‘Replication of cortisol circadian rhythm: New advances in
hydrocortisone replacement therapy’, Therapeutic Advances in Endocrinology and
Metabolism, June 2010 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3475279/>
Eichling, P.S. & Sahni, J., ‘Menopause Related Sleep Disorders’, Journal of Clinical
Sleep Medicine, 2005 <jcsm.aasm.org/articles/010312.pdf>
Balbo, M., Leproult, R. & Van Cauter, E.V., ‘Impact of Sleep and Its Disturbances
on Hypothalamo-Pituitary-Adrenal Axis Activity’, International Journal of
Endocrinology, March 2010 <www.hindawi.com/journals/ije/2010/759234/>

How can I fix my sleep?


Lewis, J.G., ‘Can wearing orange-tinted glasses before bed help you sleep? Only one
way to find out …’, The Conversation, April 2015 <theconversation.com/can-
wearing-orange-tinted-glasses-before-bed-help-you-sleep-only-one-way-to-find-
out-40684>
Maness, D.L. & Khan, M., ‘Nonpharmacologic Management of Chronic Insomnia’,
American Family Physician, December 2015 <www.aafp.org/afp/2015/1215/p1058.
html#afp20151215p1058-t5>
Jacobson, B.H., Boolani, A. & Smith, D.B., ‘Changes in back pain, sleep quality, and
perceived stress after introduction of new bedding systems’, Journal of Chiropractic
Medicine, March 2008 <www.ncbi.nlm.nih.gov/pmc/articles/PMC2697581/>
National Sleep Foundation, ‘How does exercise help those with chronic insomnia?’
<www.sleepfoundation.org/articles/how-does-exercise-help-those-chronic-
insomnia>
Gooneratne, N.S., ‘Complimentary [sic] and Alternative Medicine for Sleep
Disturbances in Older Adults’, Clinics in Geriatric Medicine, vol. 24, February 2008
<www.ncbi.nlm.nih.gov/pmc/articles/PMC2276624/>
National Sleep Foundation, ‘How Alcohol Affects the Quality — and Quantity — of
Sleep’ <www.sleepfoundation.org/articles/how-alcohol-affects-quality-and-
quantity-sleep>

24 THE M WORD
I still can’t sleep. What about medications?
Cintron, D., Lipford, M., Larrea-Mantilla, L., et al., ‘Efficacy of menopausal hormone
therapy on sleep quality’
Medscape Internal Medicine, ‘Hormonal Changes and Insomnia in Perimenopause and
Postmenopause: Management of Insomnia’, Medscape, 2005 <www.medscape.org/
viewarticle/503078_4>
Haefely, W., ‘Benzodiazepine interactions with GABA receptors’, Neuroscience
Letters, vol. 47, June 1984 <www.sciencedirect.com/science/article/abs/pii/
0304394084905147?via%3Dihub> (paywall)
Script Wise, ‘Prescription Benzodiazepines’ <www.scriptwise.org.au/benzodiazepines/>
Jehan, S., Jean-Louis, G., Zizi, F., et al., ‘Sleep, Melatonin, and the Menopausal Transition’

And what about complementary therapies and home remedies?


Gooneratne, N.S., ‘Complimentary [sic] and Alternative Medicine for Sleep
Disturbances in Older Adults’
Panneerselvam, S., ‘Effectiveness of Aromatherapy in Insomnia’
Gooneratne, N.S., ‘Complimentary [sic] and Alternative Medicine for Sleep
Disturbances in Older Adults’
Taavoni, S., Ekbatani, N.N. & Haghani, H., ‘Valerian/lemon balm use for sleep
disorders during menopause’, Complementary Therapies in Clinical Practice,
vol. 19, November 2013 <www.sciencedirect.com/science/article/pii/
S1744388113000601?via%3Dihub> (paywall)
Gooneratne, N.S., ‘Complimentary [sic] and Alternative Medicine for Sleep
Disturbances in Older Adults’
Bezerra, A.G., Pires, G.N., Andersen, M.L., et al., ‘Acupuncture to Treat Sleep Disorders
in Postmenopausal Women: A Systematic Review’, Evidence-Based Complementary
and Alternative Medicine, August 2015 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC4561166/>
Matires, J. & Zeidler, M., ‘The value of mindfulness meditation in the treatment of
insomnia’, Current Opinion in Pulmonary Medicine, November 2015 <journals.lww.
com/co-pulmonarymedicine/Abstract/2015/11000/The_value_of_mindfulness_
meditation_in_the.2.aspx> (paywall)
Garcia, M.C., Kozasa, E.H., Tufik, S., et al., ‘The effects of mindfulness and relaxation
training for insomnia (MRTI) on postmenopausal women’, Menopause: The Journal
of The North American Menopause Society, vol. 25, September 2018 <journals.lww.
com/menopausejournal/Citation/2018/09000/The_effects_of_mindfulness_and_
relaxation_training.7.aspx> (paywall)
National Institutes of Health, ‘Magnesium: Fact Sheet for Health Professionals’
The National Sleep Foundation, ‘Power (Down) Vitamins: Promote Better Sleep
With Magnesium’, Sleep <www.sleep.org/articles/power-vitamins-promote-better-
sleep-magnesium/>
National Institutes of Health, ‘Magnesium: Fact Sheet for Health Professionals’ <ods.
od.nih.gov/factsheets/Magnesium-HealthProfessional/>
Riley, P.T., ‘Magnesium’, UMW, July 2011 <students.umw.edu/healthcenter/
files/2011/08/Magnesium2.pdf>

25 THE M WORD
Might I have sleep apnoea?
National Heart, Lung, and Blood Institute, ‘Sleep Apnea’, US Department of Health
& Human Services <www.nhlbi.nih.gov/health-topics/sleep-apnea>
Eichling, P.S. & Sahni, J., ‘Menopause Related Sleep Disorders’
National Heart, Lung, and Blood Institute, ‘Sleep Apnea’

Could it be a thyroid problem that’s making me tired?


Gietka-Czernel, M., ‘The thyroid gland in postmenopausal women: Physiology and diseases’,
Menopause Review, June 2017 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5509968/>
Hershman, J.M., ‘Overview of Thyroid Function’, MSD Manual, May 2019
<www.msdmanuals.com/professional/endocrine-and-metabolic-disorders/thyroid-
disorders/overview-of-thyroid-function>
Gietka-Czernel, M., ‘The thyroid gland in postmenopausal women’
Terrie, Y.C., ‘Hypothyroidism: What Every Patient Needs to Know’, Pharmacy Times,
January 2011 <www.pharmacytimes.com/publications/issue/2011/january2011/
patiented-0111>

Might my iron be too low?


Killip, S., Bennett, J.M. & Chambers, M.D., ‘Iron Deficiency Anemia’, American Family
Physician, March 2007 <www.aafp.org/afp/2007/0301/p671.html>
Harper, J.L., ‘Iron Deficiency Anemia’, Medscape, September 2019 <emedicine.
medscape.com/article/202333-overview>

So what’s a normal period?


Mayo Clinic, ‘Menstrual cycle: What’s normal, what’s not’, June 2019 <www.mayoclinic.
org/healthy-lifestyle/womens-health/in-depth/menstrual-cycle/art-20047186>
Gokyildiz, S., Aslan, E., Kizilkaya Beji, N., et al., ‘The Effects of Menorrhagia on
Women’s Quality of Life: A Case-Control Study’, ISRN Obstetrics and
Gynecology, July 2013 <www.researchgate.net/publication/256086220_The_
Effects_of_Menorrhagia_on_Women’s_Quality_of_Life_A_Case-Control_Study>
Thomas, L., ‘Prolonged and heavy bleeding during menopause is common’, Michigan
News, April 2014 <news.umich.edu/prolonged-and-heavy-bleeding-during-
menopause-is-common/>
Hernandez-Rey, A.E., ‘Anovulation’, Medscape, August 2018 <emedicine.medscape.com/
article/253190-overview>

What are the options for treating my very heavy periods?


Maybin, J.A. & Critchley, H.O.D., ‘Medical management of heavy menstrual
bleeding’, Women’s Health, January 2016 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC4728737/>
Marret, H., Fauconnier, A., Chabbert-Buffet, N., et al., ‘Clinical practice guidelines on
menorrhagia: Management of abnormal uterine bleeding before menopause’,
European Journal of Obstetrics & Gynecology and Reproductive Biology, May 2010
<jeanhailes.org.au/contents/documents/Health_Professionals/Webinars/Clinical_
practice_menorrhagia_guideline_2010.pdf>

26 THE M WORD
Kost, A. & Pitney, C., ‘Tranexamic Acid (Lysteda) for Cyclic Heavy Menstrual
Bleeding’, American Family Physician, October 2011 <www.aafp.org/afp/2011/
1015/p883.html>
Lethaby, A., Augood, C. & Duckitt, K., ‘Nonsteroidal anti-inflammatory drugs
for heavy menstrual bleeding’, Cochrane Database of Systematic Reviews, 2000
<www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000400/full>
Maybin, J.A. & Critchley, H.O.D., ‘Medical management of heavy menstrual
bleeding’
Shaw, J.A., ‘Menorrhagia Treatment & Management’, Medscape, December 2018
<emedicine.medscape.com/article/255540-treatment#d9>
Fisher, B.R., ‘Global Endometrial Ablation Manufacturer FDA Approval’, Department
of Health & Human Services, October 2015 <www.fda.gov/downloads/
MedicalDevices/ResourcesforYou/Industry/UCM470246.pdf>
Rodriguez, M.B., Lethaby, A., Grigore, M., et al., ‘Are newer methods for destroying the
lining of the uterus (endometrial ablation) more effective and safer compared to
established methods?’, Cochrane Database of Systematic Reviews, January 2019
<www.cochrane.org/CD001501/MENSTR_are-newer-methods-destroying-
lining-uterus-endometrial-ablation-more-effective-and-safer-compared>
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists,
‘Heavy Menstrual Bleeding’, Women’s Health <www.ranzcog.edu.au/Womens-
Health/Patient-Information-Resources/Heavy-Menstrual-Bleeding>
The American College of Obstetricians and Gynecologists, ‘Heavy Menstrual Bleeding’,
June 2016 <www.acog.org/Patients/FAQs/Heavy-Menstrual-Bleeding?
IsMobileSet=false>

Why else might I be bleeding?


La Cruc, M.S.D. & Buchanan, E.M., ‘Uterine Fibroids: Diagnosis and Treatment’,
American Family Physician, January 2017 <www.aafp.org/afp/2017/0115/p100.
html>
Stewart, E.A., Cookson, C.L., Gandolfo, R.A., et al., ‘Epidemiology of uterine
fibroids: A systematic review’, BJOG: An International Journal of Obstetrics
and Gynaecology, May 2017 <obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/
1471-0528.14640>
La Cruc, M.S.D. & Buchanan, E.M., ‘Uterine Fibroids:’
Zimmermann, A., Beruit, D., Gerlinger, C., et al., ‘Prevalence, symptoms and
management of uterine fibroids: An international internet-based survey of 21,746
women’, BMC Women’s Health, March 2012 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC3342149/>
La Cruc, M.S.D. & Buchanan, E.M., ‘Uterine Fibroids’
Clark, J., ‘Outpatient versus inpatient uterine polyp treatment for abnormal uterine
bleeding: Randomised controlled non-inferiority study’, BMJ, March 2015
<www.bmj.com/content/350/bmj.h1398>
Hill, D.A., ‘Endometrial Polyps’, Modern Medicine Network, June 2011 <www.obgyn.
net/laparoscopy/endometrial-polyps>

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AAGL Practice Committee, ‘AAGL Practice Report: Practice Guidelines for the
Diagnosis and Management of Endometrial Polyps’, The Journal of Minimally
Invasive Gynecology, vol. 19, January/February 2012 <www.aagl.org/wp-content/
uploads/2013/03/aagl-Practice-Guidelines-for-the-Diagnosis-and-Management-
of-Endometrial-Polyps.pdf>
Jean Hailes for Women’s Health, ‘Adenomyosis’ <jeanhailes.org.au/health-a-z/vulva-
vagina-ovaries-uterus/adenomyosis>
Taran, F.A., Steward, E.A. & Brucker, S., ‘Adenomyosis: Epidemiology, Risk Factors,
Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy’,
Geburtshilfe und Frauenheilkunde, September 2013 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC3859152/>
Tosti, C., Troia, L., Vannuccini, S., et al., ‘Current and future medical treatment of
adenomyosis’, Journal of Endometriosis, December 2016
<www.researchgate.net/publication/312249653_Current_and_future_medical_
treatment_of_adenomyosis>

Tell me about hysterectomy then!


The American Cancer Society, ‘Can Ovarian Cancer Be Prevented?’, April 2018
<www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/prevention.html>
The American College of Obstetricians and Gynecologists, ‘Hysterectomy’, October
2018 <www.acog.org/Patients/FAQs/Hysterectomy?IsMobileSet=false#risks>

What if my low iron is nothing to do with my periods?


Sabook, M., Zehra, A., Qamar, K., et al., ‘Disorders associated with malabsorption of
iron: A critical review’, Pakistan Journal of Medical Sciences, November/December
2015 <www.ncbi.nlm.nih.gov/pmc/articles/PMC4744319/>
Killip, S., Bennett, J.M. & Chambers, M.D., ‘Iron Deficiency Anemia’, American Family
Physician, March 2007 <www.aafp.org/afp/2007/0301/p671.html#sec-2>

How do I fix my low iron?


The British Dietetic Association, ‘Iron’, Food Fact Sheet, September 2017 <www.bda.
uk.com/foodfacts/iron_food_fact_sheet.pdf>
Killip, S., Bennett, J.M., Chambers, M.D., ‘Iron Deficiency Anemia’
Hematol, A.J., ‘Iron overload and prolonged ingestion of iron supplements: Clinical
features and mutation analysis of hemochromatosis-associated genes in four
cases’, American Journal of Hematology, October 2006 <www.ncbi.nlm.nih.gov/
pubmed/16838333>
Qi, L., Meigs, J., Manson, J.E., et al., ‘HFE genetic variability, body iron stores,
and the risk of type 2 diabetes in U.S. women’, Diabetes, December 2005
<diabetes.diabetesjournals.org/content/54/12/3567.long>
Richi, A.B., Baumer, B., Conrad, B., et al., ‘Health Risks Associated with Meat
Consumption: A Review of Epidemiological Studies’, International Journal for
Vitamin and Nutrition Research, 2015 <econtent.hogrefe.com/doi/pdf/10.1024/
0300-9831/a000224>

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If it’s not my iron, my thyroid or lack of sleep, then why am I still tired?
National Health and Medical Research Council, ‘Water’, Nutrient Reference Values, April
2014 <www.nrv.gov.au/nutrients/water>
Thayer, R.E., ‘Energy, tiredness, and tension effects of a sugar snack versus moderate
exercise’, Journal of Personality and Social Psychology, vol. 52, January 1987 <psycnet.
apa.org/buy/1987-14916-001>
Peper, E. & Lin, I.M., ‘Increase or Decrease Depression: How Body Postures Influence
Your Energy Level’, Biofeedback, vol. 40, 2012 <www.aapb-biofeedback.com/
doi/10.5298/1081-5937-40.3.01>
Healthbeat, ‘9 tips to boost your energy — naturally’, Harvard Health Publishing
<www.health.harvard.edu/energy-and-fatigue/9-tips-to-boost-your-energy-
naturally>
Shmerling, R.H., ‘The latest scoop on the health benefits of coffee’, Harvard Health
Publishing, September 2017 <www.health.harvard.edu/blog/the-latest-scoop-on-
the-health-benefits-of-coffee-2017092512429>

What about some long-term strategies to boost my energy?


Warner, J., ‘Exercise Fights Fatigue, Boosts Energy’, WebMD.com, November 2006
<www.webmd.com/diet/news/20061103/exercise-fights-fatigue-boosts-energy>
Marshall, P.S., O’Hara, C. & Steinberg, P., ‘Effects of seasonal allergic rhinitis on fatigue
levels and mood’, Psychosomatic Medicine, July/August 2002 <www.ncbi.nlm.nih.
gov/pubmed/12140359>
American College of Allergy, Asthma & Immunology, ‘Fatigue’, Allergist <acaai.org/
allergies/allergy-symptoms/fatigue>

Why am I so bloated?
Seo, A.Y., Kim, N. & Oh, D.H., ‘Abdominal Bloating: Pathophysiology and Treatment’,
Journal of Neurogastroenterology and Motility, October 2013 <www.ncbi.nlm.nih.
gov/pmc/articles/PMC3816178/>
Heitkemper, M.M. & Chang, L., ‘Do Fluctuations in Ovarian Hormones Affect
Gastrointestinal Symptoms in Women With Irritable Bowel Syndrome?’, Gender
Medicine, vol. 6, 2009 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3322543/>
Seo, A.Y., Kim, N. & Oh, D.H., ‘Abdominal Bloating’
International Foundation for Gastrointestinal Disorders, ‘IBS Treatment Options’,
July 2017 <aboutibs.org/treatment-main.html>
US National Library of Medicine, ‘Irritable Bowel Syndrome’, Medline Plus,
<medlineplus.gov/irritablebowelsyndrome.html#summary>

Is the bloating because of my hormones?


Heitkemper, M.M. & Chang, L., ‘Do Fluctuations in Ovarian Hormones Affect
Gastrointestinal Symptoms in Women With Irritable Bowel Syndrome?’
Palsson, O.S. & Whitehead, W.E., ‘Hormones and IBS’, UNC Center for Functional
GI & Motility Disorders, 2017 <www.med.unc.edu/ibs/files/2017/10/IBS-and-
Hormones.pdf>

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Heitkemper, M.M. & Chang, L., ‘Do Fluctuations in Ovarian Hormones Affect
Gastrointestinal Symptoms in Women With Irritable Bowel Syndrome?’
Monash University, ‘FODMAPs and Irritable Bowel Syndrome’ <www.monashfodmap.
com/about-fodmap-and-ibs/>
Monash University, ‘Treating IBS’ <www.monashfodmap.com/i-am-a-health-professional/>
International Foundation for Gastrointestinal Disorders, ‘IBS Treatment Options’
National Center for Complementary and Integrative Health, ‘6 Tips: IBS and
Complementary Health Practices’ <nccih.nih.gov/health/tips/IBS>

Can we talk about constipation?


Cleveland Clinic, ‘Stool changes and what they mean’, April 2019 <my.clevelandclinic.
org/health/articles/9663-stool-changes-what-do-they-mean-when-should-i-see-
a-doctor>

And now that we’re on a roll, can we talk about farting?


Seo, A.Y., Kim, N. & Oh, D.H., ‘Abdominal Bloating: Pathophysiology and
Treatment’
Williams, S.R., Laughlin, P.D., O’Connor, O.J., et al., ‘Computed Tomography
Assessment of Intestinal Gas Volumes in Functional Gastrointestinal Disorders’,
Journal of Neurogastroenterology and Motility, October 2012 <www.ncbi.nlm.nih.
gov/pmc/articles/PMC3479256/>
Canadian Society of Intestinal Research, ‘Intestinal Gas Overview’, GI Society
<www.badgut.org/information-centre/a-z-digestive-topics/intestinal-gas/>
Cormier, R.E. in Clinical Methods: The History, Physical, and Laboratory Examinations,
3rd ed., Boston, MA: Butterworths, 1990
Canadian Society of Intestinal Research, ‘Intestinal Gas Overview’
Bolin, T., ‘Wind: Problems with intestinal gas’, Australian Family Physician, vol. 42,
May 2013 <www.racgp.org.au/afp/2013/may/wind/>
Bowen, R., ‘Intestinal Gas Production’, VIVO Pathophysiology <www.vivo.colostate.edu/
hbooks/pathphys/digestion/largegut/flatus.html>
Canadian Society of Intestinal Research, ‘Intestinal Gas Overview’

Why have I got so many aches and pains? I feel like an 80-year-old
Cleveland Clinic, ‘Osteoporosis: Prevention With Calcium Treatment’, October 2015
<my.clevelandclinic.org/health/articles/15049-osteoporosis-prevention-with-
calcium-treatment>
Avis, N.E., Brockwell, S. & Colvin, A., ‘A universal menopausal syndrome?’,
The American Journal of Medicine, vol. 118, December 2005 <www.amjmed.com/
article/S0002-9343(05)00917-4/fulltext#section.0030>
Watt, F.E., ‘Musculoskeletal pain and menopause’, Post Reproductive Health, vol. 24,
2018 <journals.sagepub.com/doi/pdf/10.1177/2053369118757537>
Booth, J., Moseley, G.L., Schiltenwolf, M., et al., ‘Exercise for chronic musculoskeletal
pain: A biopsychosocial approach’, Musculoskeletal Care, December 2017
<onlinelibrary.wiley.com/doi/full/10.1002/msc.1191> (paywall)

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Smith B.E., Hendrick, P., Bateman, M., et al., ‘Musculoskeletal pain and exercise —
challenging existing paradigms and introducing new’, British Journal of Sports Medicine,
vol. 53, 2019 <bjsm.bmj.com/content/early/2018/06/20/bjsports-2017-098983>
LA Biomed, ‘Estrogen may relieve post-menopausal joint pain’, American Association
for the Advancement of Science, 20 March 2013 <www.eurekalert.org/pub_
releases/2013-03/labr-emr031813.php>

Is there anything I can do to help my bone health?


Villa-Forte, A., ‘Effects of Aging on the Musculoskeletal System’, Merck Manual,
September 2017 <www.merckmanuals.com/home/bone,-joint,-and-muscle-
disorders/biology-of-the-musculoskeletal-system/effects-of-aging-on-the-
musculoskeletal-system>
Moses, S., ‘Osteoporosis Management’, Family Practice Notebook, February 2019
<fpnotebook.com/rheum/Bone/OstprsMngmnt.htm>
Jeremiah, M.P., Unwin, B.K., Greenawald, M.H., et al., ‘Diagnosis and Management
of Osteoporosis’, American Family Physician, August 2015 <www.aafp.org/afp/
2015/0815/p261.html>
Moses, S., ‘Osteoporosis Management’
Jeremiah, M.P., Unwin, B.K., Greenawald, M.H., et al., ‘Diagnosis and Management
of Osteoporosis’
Cleveland Clinic, ‘Osteoporosis: Prevention With Calcium Treatment’
National Institutes of Health, ‘Vitamin D’, August 2019 <ods.od.nih.gov/factsheets/
VitaminD-HealthProfessional/>
Moukayed, M. & Grant, W.B., ‘The roles of UVB and vitamin D in reducing risk of
cancer incidence and mortality: A review of the epidemiology, clinical trials, and
mechanisms’, Reviews in Endocrine & Metabolic Disorders, June 2017 <link.springer.
com/article/10.1007%2Fs11154-017-9415-2> (paywall)
Cancer Council, ‘Vitamin D’, August 2019 <www.cancer.org.au/preventing-cancer/
sun-protection/vitamin-d/>
National Institutes of Health, ‘Vitamin D’
Jeremiah, M.P., Unwin, B.K., Greenawald, M.H., et al., ‘Diagnosis and Management
of Osteoporosis’
Sharma, S., Tandon, V.R., Mahajan, S., et al., ‘Obesity: Friend or foe for osteoporosis’,
Journal of Mid-Life Health, January/March 2014 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC3955049/>

Why are my breasts aching?


Leinster S.J., Whitehouse, G.H. & Walsh, P.V., ‘Cyclical mastalgia: Clinical and
mammographic observations in a screened population’, BJS, vol. 74, March 1987
<onlinelibrary.wiley.com/doi/abs/10.1002/bjs.1800740324> (paywall)
Murtagh, J., Murtagh’s General Practice, 6th ed., Sydney: McGraw-Hill Australia, 2015
Hadi, M.S., ‘Sports Brassiere: Is It a Solution for Mastalgia?’, The Breast Journal,
November 2000 <www.researchgate.net/publication/11989924_Sports_Brassiere_
Is_It_a_Solution_for_Mastalgia>

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Zafar, A. & Rehman, A., ‘Topical diclofenac versus oral diclofenac in the treatment
of mastalgia — a randomized clinical trial’, Rawal Medical Journal, 2013
<www.bibliomed.org/?mno=38969>
Jean Hailes for Women’s Health, ‘How to tackle mastalgia’, Medical Observer, October
2017 <jeanhailes.org.au/news/how-to-tackle-mastalgia-medical-observer>
Westmead Breast Cancer Institute, ‘Mastalgia’, April 2018 <www.bci.org.au/breast-
cancer-information/fact-sheets/mastalgia/>
Bundred, N.J., ‘Breast Pain’, BJM Clinical Evidence, April 2007 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC2943772/>

Why am I so itchy?
Bundred, N.J., ‘Breast Pain’
American Academy of Dermatology, ‘Caring for your skin in menopause’ <www.aad.
org/public/skin-hair-nails/skin-care/skin-care-during-menopause>
Nair, P.A., ‘Dermatosis associated with menopause’, Journal of Mid-Life Health,
October–December 2014 <www.ncbi.nlm.nih.gov/pmc/articles/PMC4264279/>

C HA PT E R 7 : W H E R E D I D M Y WA IS TLINE GO?

Pinkerton, J.A., ‘Midlife Weight Gain — Sound Familiar? You’re Not Alone’, NAMS:
The North American Menopause Society, January 2018 <www.menopause.org/
for-women/menopause-take-time-to-think-about-it/consumers/2018/01/23/
midlife-weight-gain-sound-familiar-you-re-not-alone>

The case against disappearing oestrogen


Monda, V., Salerno, M., Fiorenzo, M., et al., ‘Role of Sex Hormones in the
Control of Vegetative and Metabolic Functions of Middle-Aged Women’,
Frontiers in Physiology, October 2017 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC5632804/>
Espeland, M.A., Stefanick, M.L., Kritz-Silverstein, D., et al., ‘Effect of postmenopausal
hormone therapy on body weight and waist and hip girths’, JCEM: The Journal of
Clinical Endocrinology and Metabolism, May 1997 <academic.oup.com/jcem/
article/82/5/1549/2823430>
Messina, G., Viggiano, A., De Luca, V., et al., ‘Hormonal Changes in Menopause
and Orexin-A Action’, Obstetrics and Gynecology International, January 2013
<www.hindawi.com/journals/ogi/2013/209812/>
Monda, V., Salerno, M., Fiorenzo, M., et al., ‘Role of Sex Hormones in the Control
of Vegetative and Metabolic Functions of Middle-Aged Women’

The case against hunger hormones


Soni, A.C., Conroy, M.B., Mackey, R.H., et al., ‘Ghrelin, Leptin, Adiponectin, and
Insulin Levels and Concurrent and Future Weight Change in Overweight
Postmenopausal Women’, Menopause: The Journal of the North American Menopause
Society, March 2012 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3069721/>

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Makris, C.M., Alexandrou, A., Papatsoutsos, G.E., et al., ‘Ghrelin and Obesity:
Identifying Gaps and Dispelling Myths. A Reappraisal’, In Vivo, November/
December 2017 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5756630/>
Paracchini, V., Pedotti, P. & Taioli, E., ‘Genetics of Leptin and Obesity: A HuGE
Review’, American Journal of Epidemiology, vol. 162, July 2005 <academic.oup.com/
aje/article/162/2/101/139354>
Lihn, A.S., Pedersen, S.B. & Richelsen, B., ‘Adiponectin: Action, regulation and
association to insulin sensitivity’, Obesity Reviews, February 2005 <www.ncbi.nlm.
nih.gov/pubmed/15655035>

The case against getting older


Lobo, R.A., Davis, S.R., De Villiers, T.J., et al., ‘Prevention of diseases after menopause’,
Climacteric, October 2014 <www.imsociety.org/manage/images/pdf/
bfd997dcdc32ccfe595f8fbf092abe3e.pdf>
Pinkerton, J.A., ‘Midlife Weight Gain — Sound Familiar? You’re Not Alone’

The case against sleep deprivation


Zeratsky, K., ‘Is too little sleep a cause of weight gain?’, Mayo Clinic, May 2018
<www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sleep-and-
weight-gain/faq-20058198>

The case against insulin


Dumas, M.A., ‘How Does Metformin Affect Insulin Resistance?’, Medscape, August
2001 <www.medscape.com/viewarticle/412474>
Onyango, A.N., ‘Cellular Stresses and Stress Responses in the Pathogenesis of Insulin
Resistance’, Oxidative Medicine and Cellular Longevity, July 2018 <www.ncbi.nlm.
nih.gov/pmc/articles/PMC6079365/>
Noakes, T.D., ‘So What Comes First: The Obesity or the Insulin Resistance? And Which
Is More Important?’ Clinical Chemistry, January 2018 <clinchem.aaccjnls.org/
content/64/1/7>
Zhou, J., Massey, S., Story, D., et al., ‘Metformin: An Old Drug with New Applications’,
International Journal of Molecular Sciences, September 2018 <www.ncbi.nlm.nih.
gov/pmc/articles/PMC6213209/>

The case against being a couch potato


Messina, G., Viggiano, A., De Luca, V., et al., ‘Hormonal Changes in Menopause and
Orexin-A Action’

The case against anxiety and depression


Brumpton, B., Langhammer, A., Romundstad, P., et al., ‘The associations of anxiety
and depression symptoms with weight change and incident obesity: The HUNT
Study’, International Journal of Obesity, December 2012 <www.nature.com/articles/
ijo2012204>
Singh, M., ‘Mood, food, and obesity’, Frontiers in Psychology, September 2014
<www.ncbi.nlm.nih.gov/pmc/articles/PMC4150387/>

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Why has my shape changed?
Lobo, R.A., Davis, S.R., De Villiers, T.J., et al., ‘Prevention of diseases after
menopause’

But I’m fat and happy


Lobo, R.A., Davis, S.R., De Villiers, T.J., et al., ‘Prevention of diseases after
menopause’

How can I budge the menopause weight?


Lichtman, S.W., Pisarska, K., Berman, E.R., et al., ‘Discrepancy between Self-Reported
and Actual Caloric Intake and Exercise in Obese Subjects’, The New England
Journal of Medicine, December 1992 <www.nejm.org/doi/10.1056/
NEJM199212313272701?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org
&rfr_dat=cr_pub%3dwww.ncbi.nlm.nih.gov>
Burke, L.E., Wang, J. & Sevick, M.A., ‘Self-Monitoring in Weight Loss: A Systematic
Review of the Literature’, Journal of the Academy of Nutrition and Dietetics, January
2011 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3268700/>
Harrison, P., ‘Docs Call Attention to Women Piling on Pounds in Midlife’, Medscape,
October 2017 <www.medscape.com/viewarticle/886795>
Mearns T. McCaskie, ‘Guide to Meat Weights’ <www.mccaskiebutcher.co.uk/about-us/
guide-to-meat-sizes>
Weight Loss Resources, ‘How Many Calories in Potato Baked’ <www.weightlossresources.
co.uk/calories-in-food/veg/potato-baked.htm>
Stookey, J.J.D., ‘Negative, Null and Beneficial Effects of Drinking Water on Energy
Intake, Energy Expenditure, Fat Oxidation and Weight Change in Randomized
Trials: A Qualitative Review’, Nutrients, January 2016 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC4728633/>
Nutrition Australia, ‘Australian Dietary Guidelines: Recommended daily intakes’
<www.nutritionaustralia.org/national/resource/australian-dietary-guidelines-
recommended-daily-intakes>
Nutrition Australia, ‘Australian Dietary Guidelines: Standard serves’
<www.nutritionaustralia.org/national/resource/australian-dietary-guidelines-
standard-serves>
Nutrition Australia, ‘Nutrition Australia urges Australians to eat more! (Vegetables that
is)’ <www.nutritionaustralia.org/national/news/2018/02/nutrition-australia-urges-
australians-eat-more-vegetables>
The Department of Health, ‘Fact Sheet: How much sugar is in what we drink?’,
Healthy Bodies Need Healthy Drinks Resource Package, September 2014
<www.health.gov.au/internet/publications/publishing.nsf/Content/sugar-drinks-
toc~sugar-drinks-3-fact-sheets~sugar-drinks-factsheet-3-3-sugar-what-drink>
Gardener, H., Moon, Y.P., Rundek, T., et al., ‘Diet Soda and Sugar-Sweetened Soda
Consumption in Relation to Incident Diabetes in the Northern Manhattan Study’,
Current Developments in Nutrition, January 2018 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC5998368/>

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Chia, C.W., Shardell, M., Tanaka, T., et al., ‘Chronic Low-Calorie Sweetener Use and
Risk of Abdominal Obesity among Older Adults: A Cohort Study’, PLOS One,
November 2016 <journals.plos.org/plosone/article?id=10.1371/journal.pone.
0167241>
Saplakoglu, Y., ‘No, Drinking Diet Soda Won’t Poison Your Gut Bacteria, but It Could
Do Harm’, Live Science, October 2018 <www.livescience.com/63743-artificial-
sweeteners-gut-health.html>
Green, E. & Murphy, C., ‘Altered processing of sweet taste in the brain of diet soda
drinker’, Physiology & Behavior, vol. 107, November 2012 <linkinghub.elsevier.com/
retrieve/pii/S003193841200193X>
CalorieKing.com, ‘Pinot Noir Red Wine’ <www.calorieking.com/foods/calories-in-
wines-pinot-noir-red-wine-10-alc_f-ZmlkPTIxMDcxOQ.html>
CalorieKing.com, ‘Gin & Tonic, no lime wedge’ <www.calorieking.com/foods/calories-
in-cocktails-gin-tonic-no-lime-wedge_f-ZmlkPTE1ODIyOA.html>
Kase, C.A., Piers, A.D., Schaumberg, K., et al., ‘The relationship of alcohol use to
weight loss in the context of behavioral weight loss treatment’, Appetite, April 2017
<www.ncbi.nlm.nih.gov/pmc/articles/PMC4768732/>
Blundell, J.E. & King, N.A., ‘Effects of exercise on appetite control: Loose coupling
between energy expenditure and energy intake’, International Journal of Obesity
and Related Metabolic Disorders, August 1998 <www.ncbi.nlm.nih.gov/pubmed/
9778093>
Harrison, P., ‘Docs Call Attention to Women Piling on Pounds in Midlife’

What about medications to give my belly a nudge?


Harrison, P., ‘Docs Call Attention to Women Piling on Pounds in Midlife’
Scott, A.G., ‘Is Metformin Effective for Weight Loss?’, Medscape, December 2014
<www.medscape.com/viewarticle/836254>
Doheny, K., Escobar, J.S. & Apovian, C., ‘Metformin Alters Microbiota, Improving
Insulin Sensitivity’, endocrineweb.com, July 2019 <www.endocrineweb.com/
professional/type-2-diabetes/metformin-alters-microbiota-improving-insulin-
sensitivity>
Lobo, R.A., Davis, S.R., De Villiers, T.J., et al., ‘Prevention of diseases after menopause’
Levri, K.M., Slaymaker, E., Last, A., et al., ‘Metformin as Treatment for Overweight and
Obese Adults: A systematic review’, Annals of Family Medicine, September 2005
<www.ncbi.nlm.nih.gov/pmc/articles/PMC1466911/>
Scott, A.G., ‘Is Metformin Effective for Weight Loss?’
van der Aa, M.P., Elst, M.A.J., van de Garde, E.M.W., et al., ‘Long-term treatment
with metformin in obese, insulin-resistant adolescents: Results of a randomized
double-blinded placebo-controlled trial’, Nutrition & Diabetes, 2016
<www.nature.com/articles/nutd201637>
National Institute of Diabetes and Digestive and Kidney Diseases, ‘Prescription
Medications to Treat Overweight and Obesity’, US Department of Health and
Human Services, July 2016 <www.niddk.nih.gov/health-information/weight-
management/prescription-medications-treat-overweight-obesity>

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Harrison, P., ‘Docs Call Attention to Women Piling on Pounds in Midlife’
Lobo, R.A., Davis, S.R., De Villiers, T.J., et al., ‘Prevention of diseases after menopause’
Jain, A.B., ‘Dispelling the Myths About Obesity’, Medscape, September 2018
<www.medscape.com/viewarticle/902133#vp_2>

What about weight-loss supplements and home remedies?


National Institutes of Health, ‘Carnitine’, Fact Sheet for Health Professionals <ods.od.nih.
gov/factsheets/Carnitine-HealthProfessional/>
Pooyandjoo, M., Nouhi, M., Shab-Bidar, S., et al., ‘The effect of (L-)carnitine on weight
loss in adults: A systematic review and meta-analysis of randomized controlled
trials’, Obesity Reviews, October 2016 <onlinelibrary.wiley.com/doi/full/10.1111/
obr.12436> (paywall)
National Institutes of Health, ‘Chromium’, Dietary Supplement Fact Sheet <ods.od.nih.
gov/factsheets/Chromium-HealthProfessional/>
Shmerling, R.H., ‘Apple cider vinegar diet: Does it really work?’, Harvard Health
Publishing, April 2018 <www.health.harvard.edu/blog/apple-cider-vinegar-diet-
does-it-really-work-2018042513703>
Jurgens, T. & Whelan, A.M., ‘Can green tea preparations help with weight loss?’,
Canadian Pharmacists Journal, May 2014 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC4025876/>
Mayo Clinic, ‘Coconut oil for weight loss: Does it work?’, May 2019 <www.mayoclinic.
org/healthy-lifestyle/weight-loss/in-depth/coconut-oil-and-weight-loss/art-20450177>
Leech, J., ‘How green coffee been [sic] extract works’, Medical News Today, June 2017
<www.medicalnewstoday.com/articles/318611.php>
National Institutes of Health, ‘Dietary Supplements for Weight Loss’, Fact Sheet for
Consumers, June 2019 <ods.od.nih.gov/factsheets/weightloss-consumer/>
Mayo Clinic, ‘Over-the-counter weight-loss pills’, February 2018 <www.mayoclinic.org/
healthy-lifestyle/weight-loss/in-depth/weight-loss/art-20046409>

Isn’t there anything new being researched for weight loss?


Kobyliak, N., Conte, C., Cammarota, G., et al., ‘Probiotics in prevention and treatment
of obesity: A critical view’, Nutrition & Metabolism, February 2016 <www.ncbi.nlm.
nih.gov/pmc/articles/PMC4761174/#!po=14.1026>
Gille, D., Schmid, A., Walther, B., et al., ‘Fermented Food and Non-Communicable
Chronic Diseases: A Review’, Nutrients, April 2018 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC5946233/>

And what about weight-loss surgery?


Harrison, P., ‘Docs Call Attention to Women Piling on Pounds in Midlife’

And once I’ve lost the weight, how can I stop it coming back?
Harrison, P., ‘Docs Call Attention to Women Piling on Pounds in Midlife’

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CHA PT E R 8 : T H E S H A R PE ST T OO L IN TH E S H ED

Alzheimer’s Association, ‘Mild Cognitive Impairment (MCI)’ <www.alz.org/alzheimers-


dementia/what-is-dementia/related_conditions/mild-cognitive-impairment>
Dementia Australia, ‘Mild Cognitive Impairment (MCI)’, Dementia Q&A, 2006
<www.dementia.org.au/files/helpsheets/Helpsheet-DementiaQandA13-
MildCognitiveImpairment_english.pdf>

Does my brainpower really decline around menopause?


Greendale, D.A., Wight, R.G., Huang, M.-H., et al., ‘Menopause-associated Symptoms
and Cognitive Performance: Results From the Study of Women’s Health Across
the Nation’, American Journal of Epidemiology, June 2010 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC2915492/>
Maki, P., ‘Cognitive changes in perimenopause’, IMS: 16th World Congress on
Menopause <www.imsvancouver2018.com/wp-content/app/abs/links/text.
php?id=7835>
Henderson, V.W., ‘Cognitive Changes After Menopause: Influence of Estrogen’,
Clinical Obstetrics and Gynecology, September 2008 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC2637911/>
Henderson, V.W., ‘Cognitive Changes After Menopause: Influence of Estrogen’
Greendale, D.A., Wight, R.G., Huang, M.-H., et al., ‘Menopause-associated Symptoms
and Cognitive Performance’
University of California at San Francisco Weill Institute for Neurosciences, ‘Executive
Functions’ <memory.ucsf.edu/executive-functions>
Henderson, V.W., ‘Cognitive Changes After Menopause’
Maki, P., ‘Cognitive changes in perimenopause’
Greendale, D.A., Wight, R.G., Huang, M.-H., et al., ‘Menopause-associated Symptoms
and Cognitive Performance’
Sturdee, D.W., Hunter, M.S. & Maki, P.M., ‘The menopausal hot flush: A review’,
Climacteric, April 2017 <www.researchgate.net/publication/315801438_The_
menopausal_hot_flush_a_review/download>

So is it a combination of hormones and just getting older?


Krikorian, R., Shidler, M.D., Nash, T.A., et al., ‘Blueberry Supplementation Improves
Memory in Older Adults’, Journal of Agricultural and Food Chemistry, January 2010
<www.ncbi.nlm.nih.gov/pmc/articles/PMC2850944/>
Santoro, N., MD & Randolph, J.F. Jr., MD, ‘Reproductive Hormones and the
Menopause Transition’, Obstetrics and Gynecology Clinics of North America,
September 2011 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197715/>
National Institute on Aging, ‘How the Aging Brain Affects Thinking’, Cognitive Health,
May 2017 <www.nia.nih.gov/health/how-aging-brain-affects-thinking>
Kim, B., Hong, V.M., Yang, J., et al., ‘A Review of Fermented Foods with Beneficial
Effects on Brain and Cognitive Function’, Preventive Nutrition and Food Science,
vol. 21, December 2016 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5216880/>

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What lifestyle and diet changes can I make to prevent cognitive decline?
Ruthirakuhan, M., Luedke, A.C., Tam, A., et al., ‘Use of Physical and Intellectual
Activities and Socialization in the Management of Cognitive Decline of Aging
and in Dementia: A Review’, Journal of Aging Research, December 2012
<www.ncbi.nlm.nih.gov/pmc/articles/PMC3549347/>
Maki, P.M., Rubin, L.H., Savarese, A., et al., ‘Stellate ganglion blockade and verbal
memory in midlife women: Evidence from a randomized trial’, Maturitas: The
European Menopause Journal, vol. 92, October 2016 <www.maturitas.org/article/
S0378-5122(16)30163-3/abstract>
Ruthirakuhan, M., Luedke, A.C., Tam, A., et al., ‘Use of Physical and Intellectual
Activities and Socialization’
Mayo Clinic, ‘Nutrition and healthy eating’, June 2019 <www.mayoclinic.org/healthy-
lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801>
Graff-Radford, J., ‘Alzheimer’s: Can a Mediterranean diet lower my risk?’, Mayo Clinic,
April 2019 <www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-
answers/alzheimers-disease/faq-20058062>
Ozawa, M., Ohara, T., Ninomiya, T., et al., ‘Milk and dairy consumption and risk of
dementia in an elderly Japanese population: The Hisayama Study’, Journal of the
American Geriatrics Society, July 2014 <onlinelibrary.wiley.com/doi/full/10.1111/
jgs.12887> (paywall)
Bazian, ‘Milk and dairy “good for the brain” claim unproven’, NHS, March 2015
<www.nhs.uk/news/food-and-diet/milk-and-dairy-good-for-the-brain-claim-
unproven/>
Saharan, S. & Mandal, P.K., ‘The Emerging Role of Glutathione in Alzheimer’s Disease’,
Journal of Alzheimer’s Disease, vol. 40, April 2014 <content.iospress.com/articles/
journal-of-alzheimers-disease/jad132483> (paywall)
Grant, W.B., ‘Modifiable pathways in Alzheimer’s disease: Mendelian randomisation
analysis’, BJM, December 2017 <www.bmj.com/content/359/bmj.j5375/rr>
Dementia Australia, ‘What you eat and drink and your brain’, 2006 <www.dementia.
org.au/files/helpsheets/Helpsheet-DementiaQandA07-WhatYouEatAndDrinkAnd
YourBrain_english.pdf>
Breastcancer.org, ‘Drinking Alcohol’ <www.breastcancer.org/risk/factors/alcohol>
Kim, B., Hong, V.M., Yang, J., et al., ‘A Review of Fermented Foods with Beneficial
Effects on Brain and Cognitive Function’, Preventive Nutrition and Food Science,
vol. 21, December 2016 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5216880/>
Krikorian, R., Shidler, M.D., Nash, T.A., et al., ‘Blueberry Supplementation Improves
Memory in Older Adults’, Journal of Agricultural and Food Chemistry, January 2010
<www.ncbi.nlm.nih.gov/pmc/articles/PMC2850944/>
Torborg, L., ‘Mayo Clinic Q & A: Impaired sleep and risk of dementia’, Mayo Clinic,
December 2017 <newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-
impaired-sleep-and-risk-of-dementia/>
Wein, H., ‘Sleep deprivation increases Alzheimer’s protein’, National Institutes of
Health, April 2018 <www.nih.gov/news-events/nih-research-matters/sleep-
deprivation-increases-alzheimers-protein>

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Washington University School of Medicine, ‘Sleep deprivation accelerates Alzheimer’s
brain damage’, ScienceDaily, January 2019 <www.sciencedaily.com/releases/2019/
01/190124141536.htm>
Marquie, J.C., Tucker, P., Folkard, S., et al., ‘Chronic effects of shift work on cognition:
Findings from the VISAT longitudinal study’, Occupational & Environmental
Medicine, vol. 72 <oem.bmj.com/content/72/4/258.abstract>
Duman, J.A., ‘Strategies for Preventing Cognitive Decline in Healthy Older Adults’,
Canadian Journal of Psychiatry, November 2017 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC5697626/>
Vance, D.A., Webb, N.M., Marceaux, J.C., et al., ‘Mental Stimulation, Neural Plasticity,
and Aging: Directions for Nursing Research and Practice’, The Journal of
Neuroscience Nursing, 2008 <www.medscape.com/viewarticle/580273_2>
Vance, D.A., Webb, N.M., Marceaux, J.C., et al., ‘Mental Stimulation, Neural Plasticity,
and Aging’
Hudson, S. & Tabet, N., ‘Acetyl-L-carnitine for dementia’, Cochrane Database of
Systematic Reviews, 2003 <www.ncbi.nlm.nih.gov/pubmed/12804452>
Allen, E.P. & Smith, A.P., ‘Chewing Gum’

What medications and supplements are available?


Henderson, V.W., ‘Cognitive Changes After Menopause’
Nappi, R.E., ‘Cognitive aging in midlife women: Is it real?’, Australasian Menopause
Society, March 2017 <www.menopause.org.au/members/ims-menopause-live/
935-cognitive-aging-in-midlife-women-is-it-real>
Henderson, V.W., ‘Cognitive Changes After Menopause’
Manson, J.E., ‘Estrogen and Cognition: An Enigma in Postmenopausal Women’,
Medscape, April 2019 <www.medscape.com/viewarticle/911065?src=wnl_edit_
tpal&uac=117094MG&impID=1929038&faf=1>
‘Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland:
Nationwide case-control study’, BMJ, March 2019 <www.bmj.com/content/364/
bmj.l665/rapid-responses>
Manson, J.E., ‘Estrogen and Cognition’
‘Use of postmenopausal hormone therapy and risk of Alzheimer’s disease in Finland’,
BMJ
National Institutes of Health, ‘Carnitine’, Fact Sheet for Health Professionals <ods.od.nih.
gov/factsheets/Carnitine-HealthProfessional/>
Chen, N., Yang, M., Zhou, M., et al., ‘L-carnitine for cognitive enhancement in people
without cognitive impairment’, Cochrane Database of Systematic Reviews, March
2017 <www.cochrane.org/CD009374/DEMENTIA_l-carnitine-cognitive-
enhancement-people-without-cognitive-impairment>
Hudson, S. & Tabet, N., ‘Acetyl-L-carnitine for dementia’
National Institutes of Health, ‘Carnitine’
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’,
Actas Españolas de Psiquiatría, 2017 <www.actaspsiquiatria.es/repositorio//
suplements/19/ENG/19-ENG-219614.pdf>

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National Institutes of Health, ‘Vitamin E’, Fact Sheet for Health Professionals, July 2019
<ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/#h7>
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
Laird, E.J., O’Halloran, A.M., Carey, D., et al., ‘Voluntary fortification is ineffective to
maintain the vitamin B12 and folate status of older Irish adults: Evidence from the
Irish Longitudinal Study on Ageing (TILDA)’, British Journal of Nutrition, vol. 120,
July 2018 <www.cambridge.org/core/journals/british-journal-of-nutrition/article/
voluntary-fortification-is-ineffective-to-maintain-the-vitamin-b12-and-folate-status-
of-older-irish-adults-evidence-from-the-irish-longitudinal-study-on-ageing-tilda/
DE9009BE6F7218ACA51E0B67941CCD22>
McCleery, J., Abraham, R.P., Denton, D.A., et al., ‘Vitamin and mineral
supplementation for preventing dementia or delaying cognitive decline in people
with mild cognitive impairment’, Cochrane Database of Systematic Reviews,
November 2018 <www.cochrane.org/CD011905/DEMENTIA_vitamin-and-
mineral-supplementation-preventing-dementia-or-delaying-cognitive-decline-
people-mild>
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
Graff-Radford, J., ‘Vitamin D: Can it prevent Alzheimer’s & dementia?’, Mayo Clinic,
April 2019 <www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-
answers/vitamin-d-alzheimers/faq-20111272>
University of Adelaide, ‘Vitamin D no defense against dementia’, ScienceDaily, July 2018
<www.sciencedaily.com/releases/2018/07/180710101659.htm>
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
Birks, J. & Evans, G.J., ‘There is no convincing evidence that Ginkgo biloba is
efficacious for dementia and cognitive impairment’, Cochrane Database of Systematic
Reviews, January 2009 <www.cochrane.org/CD003120/DEMENTIA_there-is-no-
convincing-evidence-that-ginkgo-biloba-is-efficacious-for-dementia-and-cognitive-
impairment>
Graff-Radford, J., ‘Ginkgo biloba: Can it prevent memory loss?’, Mayo Clinic, April
2019 <www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/
ginkgo-biloba-memory-loss/faq-20058119>
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
Birks, J. & Evans, G.J., ‘There is no convincing evidence that Ginkgo biloba is
efficacious for dementia and cognitive impairment’
American Society for Nutrition, ‘Coconut Oil’, July 2009 <nutrition.org/coconut-oil/>
Reger, M.A., Henderson, S.T., Hale, C., et al., ‘Effects of beta-hydroxybutyrate on
cognition in memory-impaired adults’, Neurobiology of Aging, vol. 25, March 2004
<www.sciencedirect.com/science/article/abs/pii/S0197458003000873?via%3Dihub>
(paywall)
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
Wang, Y., Yang, G., Gong, J., et al., ‘Ginseng for Alzheimer’s Disease: A Systematic
Review and Meta-Analysis of Randomized Controlled Trials’, Current Topics in
Medicinal Chemistry, vol. 16, 2016 <www.eurekaselect.com/133968/article>
(paywall)

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Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
Hanson, A., ‘Fish Oil and Seafood for Brain Health: What’s the Evidence?’, UW
Medicine: Memory & Brain Wellness Center, April 2018 <depts.washington.edu/
mbwc/news/article/fish-oil-and-seafood-for-brain-health-whats-the-evidence>
Yurko-Mauro, K., McCarthy, D., Bailey-Hall, E., et al., ‘Results of the MIDAS trial:
Effects of docosahexaenoic acid on physiological and safety parameters in
age-related cognitive decline’, Alzheimer’s & Dementia, vol. 5, July 2009
<www.alzheimersanddementia.com/article/S1552-5260(09)01564-7/abstract>
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
Burckhardt, M., Herke, M., Wustmann, T., et al., ‘Omega-3 fatty acids for the
treatment of dementia’, Cochrane Database of Systematic Reviews, April 2016 <www.
cochrane.org/CD009002/DEMENTIA_omega-3-fatty-acids-treatment-dementia>
National Institutes of Health, ‘Omega-3 Fatty Acids’, Fact Sheet for Consumers,
November 2018 <ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/>
Olivera-Pueyo, J. & Pelegrin-Valero, C., ‘Dietary supplements for cognitive impairment’
National Institutes of Health, ‘Omega-3 Fatty Acids’

C HAPT E R 9 : M A KE M E L OOK L I KE H ELEN MIR R EN

What’s happening to my face and skin as I age?


Hartstein, M.E., Wulc, A.E. & Holck, D.E.E. (eds), Midfacial Rejuvenation, Springer-
Verlag, 2012
Luebberding, S., Krueger, N. & Kerscher, M., ‘Age-related changes in skin barrier
function — quantitative evaluation of 150 female subjects’, International Journal of
Cosmetic Science, April 2013 <onlinelibrary.wiley.com/doi/full/10.1111/ics.12024>
(paywall)
Farage, M.A., Miller, K.W., Elsner, P., et al., ‘Characteristics of the Aging Skin’, Advances in
Wound Care, February 2013 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3840548/>
American Academy of Dermatology, ‘Caring for your skin in menopause’ <www.aad.org/
public/skin-hair-nails/skin-care/skin-care-during-menopause>
Luebberding, S., Krueger, N. & Kerscher, M., ‘Age-related changes in skin barrier function’
American Academy of Dermatology, ‘What causes our skin to age?’, 2018 <www.aad.
org/public/skin-hair-nails/anti-aging-skin-care/causes-of-aging-skin>
Papakonstantinou, E., Roth, M. & Karakiulakis, G., ‘Hyaluronic acid: A key molecule
in skin aging’, Dermato Endocrinology, vol. 4, July 2012 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC3583886/>
Luebberding, S., Krueger, N. & Kerscher, M., ‘Age-related changes in skin barrier function’
Levakov, A., Vuckovic, N., Dolai, M., et al., ‘Age-related skin changes’, Medicinski
Pregled, May/June 2012 <www.ncbi.nlm.nih.gov/pubmed/22730701>
Minikis, K., ‘Microdermabrasion’, Medscape, March 2018 <emedicine.medscape.com/
article/843957-overview#a9>
Levakov, A., Vuckovic, N., Dolai, M., et al., ‘Age-related skin changes’
Farage, M.A., Miller, K.W., Elsner, P., et al., ‘Characteristics of the Aging Skin’

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Can sunscreen help prevent my skin from aging?
Papakonstantinou, E., Roth, M. & Karakiulakis, G., ‘Hyaluronic acid: A key molecule
in skin aging’
Chein, A. & Jacobe, H., ‘UV Radiation & Your Skin’, Skin Cancer Foundation, June
2019 <www.skincancer.org/prevention/uva-and-uvb>
Goh, C.L., Noppakun, N., Micali, G., et al., ‘Meeting the challenges of acne treatment
in Asian patients: A review of the role of dermocosmetics as adjunctive therapy’,
Journal of Cutaneous and Aesthetic Surgery, vol. 9, 2016 <www.ncbi.nlm.nih.gov/
pmc/articles/PMC4924420/>
Beasley, D.G. & Meye, T.A., ‘Characterization of the UVA protection provided by
avobenzone, zinc oxide, and titanium dioxide in broad-spectrum sunscreen
products’, American Journal of Clinical Dermatology, vol. 11, 2010 <www.ncbi.nlm.
nih.gov/pubmed/20806994>
Skin Reference, ‘Comedogenic ratings (causes acne)’, March 2016 <skinreference.com/
comedogenic-ratings-causes-acne/>
EWG, ‘The trouble with ingredients in sunscreens’ <www.ewg.org/sunscreen/report/
the-trouble-with-sunscreen-chemicals/>

How should I clean my skin?


Mukhopadhyay, P., ‘Cleansers and their role in various dermatological disorders’,
Indian Journal of Dermatology, vol. 56, 2011 <www.ncbi.nlm.nih.gov/pubmed/
21572782>
Gfatter, R., Hackl, P. & Braun, F., ‘Effects of soap and detergents on skin surface pH,
stratum corneum hydration and fat content in infants’, Dermatology, vol. 195, 1997
<www.ncbi.nlm.nih.gov/pubmed/9407174>
Ananthapadmanabhan, K.P., Moore, D.J., Subramanyan, K., et al., ‘Cleansing without
compromise: The impact of cleansers on the skin barrier and the technology of mild
cleansing’, Dermatological Therapy, vol. 17, 2004 <www.ncbi.nlm.nih.gov/
pubmed/14728695>

What can I put on my skin to combat aging?


Levin, J. & Momin, S.B., ‘How much do we really know about our favorite
cosmeceutical ingredients?’, The Journal of Clinical and Aesthetic Dermatology, vol. 3,
2010 <www.ncbi.nlm.nih.gov/pmc/articles/PMC2921764/>
Thomas, J.R., Dixon, T.K. & Bhattacharyya, T.K., ‘Effects of topicals on the aging skin
process’, Facial Plastic Surgery Clinics of North America, vol. 21, 2013 <www.ncbi.
nlm.nih.gov/pubmed/23369589/>
Fox, L., Csongradi, C., Aucamp, M., et al., ‘Treatment modalities for acne’, Molecules,
vol. 21, 2016 <www.ncbi.nlm.nih.gov/pmc/articles/PMC6273829/>
Abokwidir, M. & Feldman, S.R., ‘Rosacea management’, Skin Appendage Disorders,
vol. 2, 2016 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5096126/>
Mukherjee, S., Date, A., Patravale, V., et al., ‘Retinoids in the treatment of skin aging:
An overview of clinical efficacy and safety’, Clinical Interventions in Aging, vol. 1,
2006 <www.ncbi.nlm.nih.gov/pubmed/18046911>

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Sorg, O., Antille, C., Kaya, G., et al. ‘Retinoids in cosmeceuticals’, Dermatology Therapy,
vol. 19, 2006 <www.ncbi.nlm.nih.gov/pubmed/17014484>
Thomas, J.R., Dixon, T.K. & Bhattacharyya, T.K., ‘Effects of topicals on the aging skin
process’
Babamiri, K. & Nassab, R., ‘Cosmeceuticals: The evidence behind the retinoids’,
Aesthetic Surgery Journal, vol. 30, 2010 <www.ncbi.nlm.nih.gov/
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Sorg, O., Antille, C., Kaya, G., et al. ‘Retinoids in cosmeceuticals’
Diridollou, S., Vienne, M.P., Alibert, M., et al., ‘Efficacy of topical 0.05% retinaldehyde
in skin aging by ultrasound and rheological techniques’, Dermatology, vol. 199,
1999 <www.ncbi.nlm.nih.gov/pubmed/10473959>
Vienne, M.P., Ochando, N., Borrel, M.T., et al., ‘Retinaldehyde alleviates rosacea’,
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Dréno, B., Nocera, T., Verrière F., et al., ‘Topical retinalehyde with glycolic acid: Study
of tolerance and acceptability in association with anti-acne treatments in 1,709
patients’, Dermatology, vol. 210, 2005, <www.ncbi.nlm.nih.gov/pubmed/15724104>
Humbert, P.G., Haftek, M., Creidi, P., et al., ‘Topical ascorbic acid on photoaged skin.
Clinical, topographical and ultrastructural evaluation: Double-blind study vs.
placebo’, Experimental Dermatology, vol. 12, 2003 <www.ncbi.nlm.nih.gov/
pubmed/12823436>
Aguilera, J., de Gálvez, M.V., Sánchez, C., et al., ‘Changes in photoinduced cutaneous
erythema with topical application of a combination of vitamins C and E before and
after UV exposure’, Journal of Dermatological Science, vol. 66, 2012 <www.ncbi.nlm.
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Farris, P.K., ‘Topical vitamin C: A useful agent for treating photoaging and other
dermatologic conditions’, Dermatologic Surgery, vol. 31, 2005 <www.ncbi.nlm.nih.
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old/VITCTEXT.htm>
Al-Niaimi, F. & Change, N.Y.Z., ‘Topical vitamin C and the skin: Mechanisms of action
and clinical applications’, The Journal of Clinical and Aesthetic Dermatology, vol. 10,
2017 <www.ncbi.nlm.nih.gov/pubmed/29104718>
Telang, A.S., ‘Vitamin C in dermatology’, Indian Dermatology Online Journal, vol. 4,
2013 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3673383/?report=classic>
Pullar, J.M., Carr, A.C. & Vissers, M.C.M., ‘The Roles of Vitamin C in Skin Health’,
Nutrients, August 2017 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579659/>
Al-Niaimi, F. & Change, N.Y.Z., ‘Topical vitamin C and the skin’
Maia Campos, P.M.B.G., Gonçalves, G.M.S. & Gaspar, L.R., ‘In vitro antioxidant
activity and in vivo efficacy of topical formulations containing vitamin C and its
derivatives studied by non-invasive methods’, Skin Research and Technology, vol. 14,
2008 <onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0846.2008.00288.x>

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Al-Niaimi, F. & Change, N.Y.Z., ‘Topical vitamin C and the skin’
National Institutes of Health, ‘Niacin’, July 2019 <ods.od.nih.gov/factsheets/
Niacin-HealthProfessional/>
Hakozaki, T., Minwalla, L., Zhuang, J., et al., ‘The effect of niacinamide on reducing
cutaneous pigmentation and suppression of melanosome transfer’, British Journal
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Bissett, D.L., Miyamoto, K., Sun, P., et al., ‘Topical niacinamide reduces yellowing,
wrinkling, red blotchiness, and hyperpigmented spots in aging facial skin’,
International Journal of Cosmetic Science, vol. 26, 2004 <www.ncbi.nlm.nih.gov/
pubmed/18492135/>
Flament, F., Bazin, R., Laquieze, S., et al., ‘Effect of the sun and visible clinical signs of
aging in Caucasian skin’, Clinical, Cosmetic and Investigational Dermatology, vol. 6,
2013 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3790843/pdf/ccid-6-221.pdf>
Choi, W., Yin, L., Smuda, C., et al., ‘Molecular and historical characterisation of
age spots’, Experimental Dermatology, vol. 26, 2016 <www.ncbi.nlm.nih.gov/
pubmed/27621222>
Bissett, D.L., Miyamoto, K., Sun, P., et al., ‘Topical niacinamide reduces yellowing,
wrinkling, red blotchiness, and hyperpigmented spots in aging facial skin’
Shin, J.W. & Park, K.C., ‘Current clinical use of depigmenting agents’, Dermatologic
Sinica, vol. 32, December 2014 <www.sciencedirect.com/science/article/pii/
S1027811714000445#article-footnote->
Wohlrab, J. & Kreft, D., ‘Niacinamide: Mechanisms of action and its topical use in
dermatology’, Skin Pharmacology and Physiology, vol. 27, 2014 <www.ncbi.nlm.nih.
gov/pubmed/24993939>
Rivers, J.K., ‘The role of cosmeceuticals in anti-aging therapy’, Skin Therapy Letter,
vol. 4, 2008 <www.skintherapyletter.com/family-practice/cosmeceuticals-
anti-aging-fp/>
Kawada, A., Konishi, N., Oiso, N., et al., ‘Evaluation of anti-wrinkle effects of a novel
cosmetic containing niacinamide’, The Journal of Dermatology, vol. 35, 2008
<onlinelibrary.wiley.com/doi/full/10.1111/j.1346-8138.2008.00537.x>
Gehring, W., ‘Nicotinic acid/niacinamide and the skin’, Journal of Cosmetic Dermatology,
vol. 3, 2004 <www.ncbi.nlm.nih.gov/pubmed/17147561>
Bissett, D.L., Oblong, J.E. & Berge, C.A., ‘Niacinamide: A B vitamin that improves
aging facial skin appearance’, Dermatologic Surgery, vol. 31, 2006 <onlinelibrary.
wiley.com/doi/abs/10.1111/j.1524-4725.2005.31732>
Walocko, F.M., Eber, A.E., Keri, J.E., et al., ‘The role of nicotinamide in acne
treatment’, Dermatologic Therapy, vol. 30, 2017 <www.ncbi.nlm.nih.gov/
pubmed/28220628>
Gehring, W., ‘Nicotinic acid/niacinamide and the skin’
Draelos, Z.D., Ertel, K. & Berge, C., ‘Niacinamide-containing facial moisturizer
improves skin barrier and benefits subjects with rosacea’, Curtis, vol. 76, 2005
<www.ncbi.nlm.nih.gov/pubmed/16209160/>
Chen, A.C. & Damian, D.L., ‘Nicotinamide and the skin’, Australian Journal of
Dermatology, vol. 55, 2014 <www.ncbi.nlm.nih.gov/pubmed/24635573>

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Bains, P., Kaur, M., Kaur, J., et al., ‘Nicotinamide: Mechanism of action and indications
in dermatology’, Indian Journal of Dermatology, Venereology and Leprology, vol. 84,
2018 <www.ncbi.nlm.nih.gov/pubmed/29405129>
Fox, L., Csongradi, C., Aucamp, M., et al., ‘Treatment modalities for acne’
Khodaeiani, E., Fouladi, R.F., Amirnia, M., et al., ‘Topical 4% nicotinamide vs. 1%
clindamycin in moderate inflammatory acne vulgaris’, International Journal of
Dermatology, vol. 52, 2013 <www.ncbi.nlm.nih.gov/pubmed/23786503>
Nazarali, S. & Kuzel, P., ‘Vitamin B derivative (nicotinamide) appears to reduce skin
cancer risk’, Skin Therapy Letter, vol. 22, 2017 <www.ncbi.nlm.nih.gov/pubmed/
28888216>
Chen, A.C. & Damian, D.L., ‘Nicotinamide and the skin’
Cancer Council, ‘Non-melanoma cancer’, March 2019 <www.cancer.org.au/about-
cancer/types-of-cancer/skin-cancer/non-melanoma.html>
Knip, M., Douek, I.F., Moor, W.P., et al., ‘Safety of high-dose nicotinamide: A review’,
Diabetologia, vol. 43, 2000 <www.ncbi.nlm.nih.gov/pubmed/11126400>
Kornhauser, A., Coelho, S.G. & Herring, V.J., ‘Applications of hydroxy acids:
Classification, mechanisms, and photoactivity’, Clinical, Cosmetic and
Investigational Dermatology, vol. 3, 2010 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC3047947/>
Kornhauser, A., Coelho, S.G. & Herring, V.J., ‘Applications of hydroxy acids’
Katsambas, A.D., ‘RALGA (Diacneal), a retinaldehyde and glycolic acid association and
postinflammatory hyperpigmentation in acne — A review’, Dermatology, vol. 210,
2005 <www.ncbi.nlm.nih.gov/pubmed/15724107>
Newman, N., Newman, A., Moy, L.S., et al., ‘Clinical improvement of photoaged skin
with 50% glycolic acid a double-blind vehicle-controlled study’, Dermatologic
Surgery, vol. 22, 1996 <onlinelibrary.wiley.com/doi/abs/10.1111/j.1524-4725.1996.
tb00347.x>
Stiller, M.J., Bartolone, J., Stern, R., et al., ‘Topical 8% glycolic and 8% L-lactic acid
creams for the treatment of photodamaged skin. A double-blind vehicle-controlled
clinical trial’, Archives of Dermatology, vol. 132, 1996 <www.ncbi.nlm.nih.gov/
pubmed/8651713>
Tran, C. & Kasraee, B., ‘Pharmacology of ALGA, a mixture of retinaldehyde and
glycolic acid’, Dermatology, vol. 1, 2005 <www.researchgate.net/publication/
8009726_Pharmacology_of_RALGA_a_Mixture_of_Retinaldehyde_and_
Glycolic_Acid>
Tsai, T. & Hantash, B., ‘Cosmeceutical agents: A comprehensive review of the
literature’, Clinical Medicine Insights: Dermatology, 2008 <www.researchgate.net/
publication/49620409_Cosmeceutical_Agents_A_Comprehensive_Review_of_
the_Literature>
EWG, ‘Sodium hydroxide’ <www.ewg.org/skindeep/ingredient/706075/
SODIUM_HYDROXIDE/>
Sarkar, R., Bansal, S. & Garg, V.K., ‘Chemical peels for melasma in dark-skinned
patients’, Journal of Cutaneous and Aesthetic Surgery, vol. 5, 2012 <www.ncbi.nlm.
nih.gov/pmc/articles/PMC3560164/>

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US Food and Drug Administration, ‘Alpha Hydroxy Acids’, July 2019 <www.fda.gov/
Cosmetics/ProductsIngredients/Ingredients/ucm107940.htm>

Can I do anything about age spots?


Flament, F., Bazin, R., Laquieze, S., et al., ‘Effect of the sun and visible clinical signs of
aging in Caucasian skin’
Choi, W., Smuda, C., Batzer, J., et al., ‘Molecular and historical characterization of age
spots’, Experimental Dermatology, vol. 26, 2016 <www.ncbi.nlm.nih.gov/
pubmed/27621222>
Sarkar, R., Arora, P. & Garg, K.V., ‘Cosmeceuticals for hyperpigmentation: What is
available?’, Journal of Cutaneous and Aesthetic Surgery, vol. 6, 2013 <www.ncbi.nlm.
nih.gov/pmc/articles/PMC3663177/>
Ortonne, J.P., Pandya, A.G., Lui, H., et al., ‘Treatment of solar lentigines’, Journal of the
American Academy of Dermatology, vol. 54, 2006 <www.ncbi.nlm.nih.gov/
pubmed/16631967>
Sofen, B., Prado, G. & Emer, J., ‘Melasma and post inflammatory hyperpigmentation:
Management update and expert opinion’, Skin Therapy Letter, vol. 21, 2016
<www.skintherapyletter.com/melasma/melasma-post-inflammatory-
hyperpigmentation-treatment/>
Shokeen, D., ‘Postinflammatory hyperpigmentation in patients with skin of colour’,
Cutis, vol. 97, 2016 <www.ncbi.nlm.nih.gov/pubmed/26919365>
Sofen, B., Prado, G. & Emer, J., ‘Melasma and post inflammatory hyperpigmentation’
Rivas, S. & Pandya, A.G., ‘Treatment of melasma with topical agents, peels and lasers:
An evidence-based review’, American Journal of Clinical Dermatology, vol. 14, 2013
<www.ncbi.nlm.nih.gov/pubmed/23881551>
Zolghadri, S., Bahrami, A., Khan, M.T.H., et al., ‘A comprehensive review on tyrosinase
inhibitors’, Journal of Enzyme Inhibition and Medicinal Chemistry, 2019 <https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC6327992/>
Shin, J.W. & Park, K.C., ‘Current clinical use of depigmenting agents’
Ebanks, J.P., Wickett, R.R. & Boissy, R.E., ‘Mechanisms regulating skin pigmentation:
The rise and fall of complexion coloration’, International Journal of Molecular
Sciences, vol. 10, 2009 <www.ncbi.nlm.nih.gov/pmc/articles/PMC2769151/>
Garcia, S.E., ‘In Rwanda, the government has banned skin bleaching products’, SBS.
com.au, November 2018 <www.sbs.com.au/news/in-rwanda-the-government-has-
banned-skin-bleaching-products>
Kolbe, L., Mann, T., Gerwat, W., et al., ‘4-n-butylresorcinol, a highly effective tyrosinase
inhibitor for the topical treatment of hyperpigmentation’, Journal of the European
Academy of Dermatology and Venereology, vol. 27, 2012 <www.ncbi.nlm.nih.gov/
pubmed/23205541>
Shin, J.W. & Park, K.C., ‘Current clinical use of depigmenting agents’
Ebanks, J.P., Wickett, R.R. & Boissy, R.E., ‘Mechanisms regulating skin pigmentation’
Kim, H., Choi, H.-R., Kim, D.-S., et al., ‘Topical hypopigmenting agents for
pigmentary disorders and their mechanisms of actions’, Annals of Dermatology, vol.
24, 2012 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3283838/>

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Levin, J. & Momin, S.B., ‘How much do we really know about our favorite
cosmeceutical ingredients?’
Shin, J.W. & Park, K.C., ‘Current clinical use of depigmenting agents’
Ebanks, J.P., Wickett, R.R. & Boissy, R.E., ‘Mechanisms regulating skin pigmentation’

What anti-aging procedures are available?


Small, R., ‘Botulinum toxin injection for facial wrinkles’, American Family Physician,
vol. 90, August 2014 <www.aafp.org/afp/2014/0801/p168.html>
American Society of Plastic Surgeons, ‘Microdermabrasion’ <www.plasticsurgery.org/
cosmetic-procedures/microdermabrasion>
Minkis, K., ‘Microdermabrasion’, Medscape, March 2018 <emedicine.medscape.com/
article/843957-overview#a11>
Kaushik, S.B. & Alexis, A.F., ‘Nonablative fractional laser resurfacing in skin colour:
Evidence-based review’, The Journal of Clinical and Aesthetic Dermatology, vol. 10,
2017 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5605208/>
American Society of Plastic Surgeons, ‘Laser skin resurfacing’ <www.plasticsurgery.org/
cosmetic-procedures/laser-skin-resurfacing>
Funt, D. & Pavicic, T., ‘Dermal fillers in aesthetics: An overview of adverse events and
treatment approaches’, Clinical, Cosmetic and Investigational Dermatology, vol. 6,
2013 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3865975/>
American Society for Dermatologic Surgery, ‘Chemical Peels’ <www.asds.net/skin-
experts/skin-treatments/chemical-peels>
Lei, X., Xu, P. & Cheng, B., ‘Problems and solutions for platelet-rich plasma in
facial rejuvenation: A systematic review’, Aesthetic Plastic Surgery, vol. 43, 2019
<link.springer.com/article/10.1007%2Fs00266-018-1256-1>
Charles-de-Sá, L., Gontijo-de-Amorim, N.F., Takiya, C.M., et al. ‘Effect of use of
platelet-rich plasma (PRP) in skin with intrinsic aging process’, Aesthetic Surgery
Journal, vol. 38, 2018 <www.ncbi.nlm.nih.gov/pubmed/29040421>
Ranaweera, A., ‘Skin needling’, DermNet NZ, Oct 2018 <www.dermnetnz.org/topics/
skin-needling/>
The North American Menopause Society, ‘The 2017 hormone therapy position
statement of The North American Menopause Society’, Menopause: The Journal of
the North American Menopause Society, vol. 24, 2017 <www.menopause.org/docs/
default-source/2017/nams-2017-hormone-therapy-position-statement.pdf>
Farage, M.A., Miller, K.W., Elsner, P., et al., ‘Characteristics of the Aging Skin’

Are there any lifestyle changes I can make to combat aging?


Rinnerthaler, M., Bischof, J., Streubel, M.K., et al., ‘Oxidative stress in aging human skin’,
Biomolecules, vol. 5, 2015 <www.ncbi.nlm.nih.gov/pmc/articles/PMC4496685/>
American Academy of Dermatology, ‘What causes our skin to age?’
Cosgrove, M.C., Franco, O.H., Granger, S.P., et al., ‘Dietary nutrient intakes and
skin-aging appearance among middle-aged American women’, The American
Journal of Clinical Nutrition, vol. 86, 2007 <www.ncbi.nlm.nih.gov/pubmed/
17921406>

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American Academy of Dermatology, ‘What causes our skin to age?’
Cosgrove, M.C., Franco, O.H., Granger, S.P., et al., ‘Dietary nutrient intakes and
skin-aging appearance among middle-aged American women’
National Institutes of Health, ‘Vitamin A fact sheet for health professionals’, 2019
<ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/>
American Academy of Dermatology, ‘What causes our skin to age?’
Oyetakin-White, P., Suggs, A., Koo, B., et al., ‘Does poor sleep quality affect skin ageing?’,
Clinical Dermatology, vol. 40, 2014 <www.ncbi.nlm.nih.gov/pubmed/25266053>

Can I get beauty from supplements?


Cosgrove, M.C., Franco, O.H., Granger, S.P., et al., ‘Dietary nutrient intakes and
skin-aging appearance among middle-aged American women’
Choi, F.D., Sung, C.T., Juhasz, M.L.W., et al., ‘Oral collagen supplementation: A
systematic review of dermatological applications’, Journal of Drugs in Dermatology,
vol. 18, 2019 <jddonline.com/articles/dermatology/S1545961619P0009X>
Pérez-Sánchez, A., Barrajón-Catalán, E., Herranz-López, M., et al., ‘Nutraceuticals for
skin care: A comprehensive review of human clinical studies’, Nutrients, vol. 10,
2018 <www.ncbi.nlm.nih.gov/pmc/articles/PMC5946188/>
Cosgrove, M.C., Franco, O.H., Granger, S.P., et al., ‘Dietary nutrient intakes and
skin-aging appearance among middle-aged American women’
Pérez-Sánchez, A., Barrajón-Catalán, E., Herranz-López, M., et al., ‘Nutraceuticals for
skin care’
Cosgrove, M.C., Franco, O.H., Granger, S.P., et al., ‘Dietary nutrient intakes and
skin-aging appearance among middle-aged American women’

What skincare ingredients should I not waste my money on?


Rinnerthaler, M., Bischof, J., Streubel, M.K., et al., ‘Oxidative stress in aging human
skin’
Narurkarm V.A., Fabi, S.G., Bucay, V.W., et al., ‘A new approach in topical hyaluronic
acid: Going beyond instant benefits to restore epidermal HA homeostasis’, Journal
of Drugs in Dermatology, vol. 15, 2016 <jddonline.com/articles/dermatology/
S1545961616S0021X>

Why am I getting acne and breakouts at menopause?


American Academy of Dermatology, ‘Skin condition by the numbers’, 2018
<www.aad.org/media/stats/conditions/skin-conditions-by-the-numbers>
Collier, C.N., Harper, J.C., Cantrell, W.C., et al., ‘The prevalence of acne in adults
20 years and older’, Journal of the American Academy of Dermatology, vol. 58, 2008
<www.sciencedirect.com/science/article/pii/S019096220701081X>

Have I got acne, or rosacea?


American Academy of Dermatology, ‘Is that acne or rosacea on your skin?’, 2018
<www.aad.org/public/diseases/acne-and-rosacea/is-that-acne-or-rosacea>
Abokwidir, M. & Feldman, S.R., ‘Rosacea management’

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Blount, B.W. & Pelletier, A.L., ‘Rosacea: A common, yet commonly overlooked, condition’,
American Family Physician, vol. 66, 2002 <www.aafp.org/afp/2002/0801/p435.html>
Chosidow, O. & Cribier, B., ‘Epidemiology of rosacea: Updated data’, Annales
Dematologie et de Vènèrèologie, vol. 138, 2011 <www.ncbi.nlm.nih.gov/pubmed/
22183096>
Blount, B.W. & Pelletier, A.L., ‘Rosacea: A common, yet commonly overlooked, condition’
Do, J.L. & Do, R.M., ‘A guide to the ingredients and potential benefits of over-the-
counter cleansers and moisturizers for rosacea patients’, The Journal of Clinical and
Aesthetic Dermatology, vol. 4, 2011 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC3168246/pdf/jcad_4_8_31.pdf>
Blount, B.W. & Pelletier, A.L., ‘Rosacea’
Zeichner, J.A., Baldwin, H.E., Cook-Bolden, F.E., et al., ‘Emerging issues in adult
female acne’, The Journal of Clinical and Aesthetic Dermatology, vol. 10, 2017
<www.ncbi.nlm.nih.gov/pmc/articles/PMC5300732/>
Li, S., Cho, E., Drucker, A.M., et al., ‘Cigarette smoking and risk of incident rosacea in
women’, American Journal of Epidemiology, vol. 186, 2017 <academic.oup.com/aje/
article/186/1/38/3791463>
Zeichner, J.A., Baldwin, H.E., Cook-Bolden, F.E., et al., ‘Emerging issues in adult
female acne’
Weiss, E. & Katta, R., ‘Diet and rosacea: The role of dietary change in the management
of rosacea’, Dermatology Practical & Conceptual, vol. 7, 2017 <www.ncbi.nlm.nih.
gov/pmc/articles/PMC5718124/>
Mansouri, Y. & Goldenberg, G., ‘Devices and topical agents for rosacea management’,
Custis, vol. 94, 2014 <www.ncbi.nlm.nih.gov/pubmed/25101340>
Rolfe, H.M., ‘A review of nicotinamide: Treatment of skin diseases and potential side
effects’, Journal of Cosmetic Dermatology, vol. 13, 2014 <www.ncbi.nlm.nih.gov/
pubmed/25399625>
Abokwidir, M. & Feldman, S.R., ‘Rosacea management’
Sorg, O., Antille, C., Kaya, G., et al., ‘Retinoids in cosmeceuticals’
Do, J.L. & Do, R.M., ‘A guide to the ingredients and potential benefits of over-the-
counter cleansers and moisturizers for rosacea patients’

Why am I growing chin hair?


Piérard-Franchimont, C. & Piérard, G.E., ‘Alterations in hair follicle dynamics in
women’, BioMed Research International, 2013 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC3884776/>
Dinh, Q.Q. & Sinclair, R., ‘Female pattern hair loss: Current treatment concepts’,
Clinical Interventions in Aging, vol. 2, 2007 <www.ncbi.nlm.nih.gov/pmc/articles/
PMC2684510/>
Miranda, B.H., Charlesworth, M.R., Tobin, D.J., et al., ‘Androgens trigger different
growth responses in genetically identical human hair follicles in organ culture that
reflect their epigenetic diversity in life’, The Journal of the Federation of American
Societies for Experimental Biology, vol. 32, 2018 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC5928870/>

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Pasquali, R., Vicennati, V., Bertazzo, D., et al., ‘Determinants of sex hormone-binding
globulin blood concentration in premenopausal and postmenopausal women with
different estrogen status’, Metabolism — Clinical and Experimental, vol. 46, 1997
<www.ncbi.nlm.nih.gov/pubmed/9005961>

How can I get rid of my facial hair?


Agrawal, N.K., ‘Management of hirsutism’, Indian Journal of Endocrinology and
Metabolism, vol. 17, 2013 <www.ncbi.nlm.nih.gov/pmc/articles/PMC3830374/>
American Society of Health-System Pharmacists, ‘Eflornithine’, Medline Plus, May 2016
<medlineplus.gov/druginfo/meds/a604031.html>
Agrawal, N.K., ‘Management of hirsutism’

I’ve got hair on my chin, but the hair on my head is thinning! Help!
Dinh, Q.Q. & Sinclair, R., ‘Female pattern hair loss’
Alwaleedi, S.A., ‘The involvement of androgens in human hair growth’, American Journal
of Biomedical Sciences, vol. 7, 2015 <www.nwpii.com/ajbms/papers/AJBMS_2015_
2_05.pdf>
Dinh, Q.Q. & Sinclair, R., ‘Female pattern hair loss’
The North American Menopause Society, ‘The 2017 hormone therapy position
statement of The North American Menopause Society’
Alwaleedi, S.A., ‘The involvement of androgens in human hair growth’

Is it an illusion, or is my nose getting bigger as I age?


Lee, J.W., McHugh, J., Kim, J.C., et al., ‘Age-related historical changes in human nasal
cartilage’, JAMA Facial Plastic Surgery, vol. 15, 2013 <jamanetwork.com/journals/
jamafacialplasticsurgery/fullarticle/1673466>

Why have my boobs got so saggy?


Machida, Y. & Nakadate, M., ‘Breast shape change associated with aging: A study using
prone breast magnetic resonance imaging’, International Open Access Journal of the
American Society of Plastic Surgeons, vol. 3, 2015 <www.ncbi.nlm.nih.gov/pmc/
articles/PMC4494483/>
Ross, A., ‘Most women satisfied with breast reduction cosmetic results’, American
Society of Plastic Surgeons, 2012 <www.plasticsurgery.org/news/press-releases/
most-women-satisfied-with-breast-reduction-cosmetic-results>

What’s happened to my labia?


Kreklau, A., Vâz, I., Oehme, F., et al., ‘Measurements of a “normal vulva” in women
aged 15–84: A cross‐sectional prospective single‐centre study’, BJOG: An
International Journal of Obstetrics and Gynaecology, vol. 125, 2018 <obgyn.
onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15387>
Gunter, J., ‘Your vulva doesn’t need a facial it needs pubic hair’, Dr. Jen Gunter, 2015
<drjengunter.wordpress.com/2015/01/29/your-vulva-doesnt-need-a-facial-it-
needs-pubic-hair/>

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Veale, D., Eshkevari, E., Ellison, N., et al., ‘A comparison of risk factors for women
seeking labiaplasty compared to those not seeking labiaplasty’, Body Image, January
2014 <https://www.ncbi.nlm.nih.gov/pubmed/24239491>

And — I’ve got a double chin and jowls!


Reece, E.M. & Rohrich, R.J., ‘The aesthetic jaw line: Management of the aging jowl’,
Aesthetic Surgery Journal, vol. 28, 2008 <academic.oup.com/asj/article-pdf/
28/6/668/605815/28-6-668.pdf>
Deeks, E.D., ‘Deoxycholic acid: A review in submental fat contouring’, American Journal
of Clinical Dermatology, vol. 17, 2016 <www.ncbi.nlm.nih.gov/pubmed/27785706>
Reece, E.M. & Rohrich, R.J., ‘The aesthetic jaw line’
Hunsaker, D.H., ‘Jowl sculpting by buccal fat removal and rhytidectomy’, Archives of
Otolaryngology: Head and Neck Surgery, vol. 115, 1989 <jamanetwork.com/journals/
jamaotolaryngology/article-abstract/617489>

Why have I got droopy eyelids and eye bags?


Gilliland, G.D., ‘Dermatochalasis’, Medscape, 22 February 2017 <emedicine.medscape.
com/article/1212294-overview>
Neal Handel MD.com, ‘Blephoraplasty: Eyelid Rejuvenation Photo Gallery’, 2019
<drhandel.com/blephoraplasty-eyelid-rejuvenation-photo-gallery/>
Gilliland, G.D., ‘Dermatochalasis’

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