Position of the Spanish Menopause Society regarding vaginal health care in postmenopausal women.

Vaginal health, defined as the vaginal state in which the physiological condition remains stable, being protected from the onset of symptoms and facilitating a satisfying sex life, is one of the most common and less valued concerns in postmenopausal women. Many of the conditions that affect the vagina are related to its trophism and susceptibility to infection by unusual germs, which are phenomena strongly influenced by estrogen impregnation and the microbiota composition, ultimately affecting sexuality and the quality of life. An expert panel of the Spanish Menopause Society met to establish criteria for diagnosing and treating the processes that affect overall vaginal health and to decide the optimal timing and methods based on the best evidence available.

Position of the Spanish Menopause Society regarding the management of menopausal symptoms in breast cancer patients.

Breast cancer is the most common female cancer in Spain. Its high prevalence, its high survival rate, and its incidence are the reasons treatment is increasingly sought for common problems by young women who have survived it. Besides the contraception and fertility issues, many breast cancer survivors develop sexual disorders and menopausal symptoms, whether as a consequence of treatment-induced menopause or side effects of treatment. For such reasons, a panel of experts from the Spanish Menopause Society has met to develop usage recommendations for the relief of vasomotor symptoms and for sexual and reproductive health in patients with breast cancer based on the best evidence available.

Unintended pregnancy after gonadal failure chemoprevention with gonadotropin-releasing hormone agonist in women with hematologic malignancies.

Many patients who receive co-treatment with GnRH agonists (GnRH-a) during chemotherapy treatment preserve their ovarian function and are at risk of unintended pregnancies. Therefore, it is important to offer them effective contraception. Also, pregnancies occurring after cancer therapy in women who received GnRH-a are not associated with adverse neonatal outcomes.

Follicle-stimulating hormone does not directly regulate bone mass in human beings: evidence from nature.

OBJECTIVE: To evaluate the effect of FSH levels in the development of human osteoporosis. DESIGN: Case-series study. SETTING: Gynecology department in a teaching hospital. PATIENT(S): A total of 8 women diagnosed with Kallman syndrome (KS) were compared with 11 with Turner syndrome and 11 with pure gonadal dysgenesia (GD, karyotype 46,XX). INTERVENTION(S): We assessed the pituitary-gonadal axis, bone turnover markers, bone mass, and patient characteristics. MAIN OUTCOME MEASURE(S): Bone mineral density as assessed by dual-energy X-ray absorptiometry, plasma FSH, LH, E(2), osteocalcin (BGP), and urinary type I collagen cross-linked N-telopeptide. Other biochemical markers included 25-hydroxyvitamin D, as well as parathyroid hormone and urine concentration of calcium and creatinine. RESULT(S): In girls with Turner syndrome and GD, FSH (64.03 +/- 29.2 and 90.08 +/- 22.41 mIU/mL, respectively) and LH (45.29 +/- 11.90 and 48.83 +/- 12.44 mIU/mL, respectively) levels were significantly higher compared with those observed in girls with KS (FSH: 1.87 +/- 0.64 and LH: 1.02 +/- 0.57), whereas no differences were detected in E(2) or bone marker levels. Bone mineral density correlated positively with FSH levels but not with E(2); however, after adjusting for previous growth-hormone therapy, these differences were not found. In addition, bone mineral density in spine and total hip was significantly lower in patients with KS. CONCLUSION(S): Follicle-stimulating hormone does not appear to have a major role in the development of bone loss in young women with primary amenorrhea.