Highlights of the American Society of Reproductive Medicine 63rd Annual Meeting

October 13-17, 2007; Washington, DC

Peter Kovacs, MD

Disclosures

January 09, 2008

In This Article

Introduction

The 63rd annual meeting of the American Society for Reproductive Medicine (ASRM) was held in Washington, DC in October 2007. Hundreds of presentations covered the latest developments in assisted reproduction; however, this year 1 day was dedicated entirely to special sessions covering menopause including plenary sessions, and oral and poster presentations.

Menopause affects millions of women worldwide, and given improved life expectancy, at least one third of a woman's life is spent in menopause. Menopause is accompanied by typical hormonal changes and characteristic symptoms. As the ovaries cease their regular activity, estradiol and androgen levels decrease, while gonadotropin levels rise.

Most women who enter menopause will complain of some degree of:

  • Hot flushes;

  • Vaginal dryness;

  • Dyspareniua;

  • Mood changes; and

  • Sleeping difficulty.

The incidence of cardiovascular disease and osteoporosis also increases with age, but these medical problems are rarely associated with warning symptoms and often first present in the form of a severe complication such as a heart attack or fracture.

For decades, the replacement of the "missing" hormones was considered the standard treatment. Numerous observational studies supported the use of estrogen-only or estrogen-progesterone hormone replacement therapy (HRT). As estrogen induces favorable lipid changes, lowers inflammatory cytokine levels, has vasodilatatory effects and improves cardiac output, basic science lent scientific support to the clinical observations. Therefore, the recent findings of randomized clinical trials (RCTs) evaluating hormone replacement came as a surprise, since according to these studies HRT not only did not show primary or secondary cardiovascular (CV) protective effects, but also even increased CV risk and other medical diseases under certain conditions.

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