T he clinical presentation of dyspareunia is often perplexing; patients may be difficult to assess, and positive clinical findings are not always observed on standard gynecologic examination. Adding to the confusion, the American Psychiatric Association’s Diagnostic and Statistical Manual defines dyspareunia as a sexual condition rather than a pain disorder, implying a psychogenic origin.1,2 Pa...

Several comprehensive accounts of postmenopausal hormone replacement treatment have been published in the United Kingdom in the past year`so in this review we concentrate on areas which, while often controversial, are of concern to the practising physician. We discuss the effects of postmenopausal hormone replacement therapy on the risks of developing coronary heart disease, osteoporosis, and c...

It is estimated that 75% of women are in an acute estrogen deficiency state within a few years after the onset of the menopause. Every woman inevitably reaches this phase except for a fortunate few who have some source of endogenous estrogens available to them. We believe it would be prudent to offer hormone replacement therapy to every woman with symptoms of the menopause, and to those in whom...

Journal of Family Planning and Reproductive Health Care 2004: 30(1) Introduction “I’m confused, anxious, wary. The press coverage on hormone replacement therapy (HRT) has left me feeling concerned and, frankly, troubled. Is HRT a good thing or isn’t it? Should I be taking it or shouldn’t I? I’ve even become doubtful about taking medical advice on all this. To be frank, I’m going to gather infor...