Foreword

For the past 12 years, the topic of menopause has been the subject of much controversy – fueled by the initial announcement, by way of a press conference in July 2002, that the US Women's Health Initiative randomized controlled trial of continuous combined hormone replacement had shown a 26% increase in breast cancer risk after 5.6 years of follow-up. Not emphasized was the fact that the results were barely statistically significant and were equivalent to an annual risk of <1 extra case of breast cancer per 1000 women treated per year – and then only in women who had previously taken hormone replacement. Much time and effort have been expended in the past 12 years to analyze this initial result in much greater detail – including the documentation that estrogen-only treatment actually reduced breast cancer risk overall. This in turn has led the International Menopause Society and various national societies to publish guidelines summarizing current practice in menopause management. The guidelines are generally directed to a discussion of benefits and risks of hormone therapy with recommendations regarding standard management of women in their late 40s and 50s. The present volume is much broader in its scope and deals with many aspects not readily available to the general practitioner, gynecologist or endocrinologist involved in the care of mid-life women. The last chapter is a somewhat surprising addition to the book – andrologists in general do not accept the concept of the male menopause and many of the opinions expressed by Carruthers would be strongly disputed by them. This is an interesting book with many contributions in areas not generally covered. It is recommended for both a general and a specialist readership and will be a very useful reference source in a number of areas.