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  1. 1
    010086

    Research on the menopause.

    World Health Organization. Scientific Group

    World Health Organization Technical Report Series. 1981; (670):1-120.

    This report includes the collective views of a World Health Organization (WHO) Scientific Group on Research on the Menopause that met in Geneva during December 1980. It includes information on the following: 1) the endocrinology of the menopause and the postmenopausal period (changes in gonadotropins and estrogens immediately prior to the menopause and changes in gonadotropin and steroid hormone levels after the menopause); 2) the age distribution of the menopause (determining the age at menopause, factors influencing the age at menopause, and the range of ages at menopause and the definition of premature and delayed menopause); 3) sociocultural significance of the menopause in different settings; 4) symptoms associated with the menopause (vasomotor symptoms, psychological symptoms, disturbances of sexuality, and insomnia); 5) disorders resulting from, or possibly accelerated by, the menopause (osteoporosis, atherosclerotic cardiovascular disease, and arthritic disorders); 6) risks, with particular reference to neoplasia, of therapeutic estrogens and progestins given to peri- and postmenopausal women (endometrial cancer, breast cancer, and gallbladder disease); 7) fertility regulating methods for women approaching the menopause (fertility and the need for family planning in women approaching the menopause, problems of family planning in perimenopausal women, and considerations with regard to individual methods of family planning in women approaching the menopause); and 8) estrogen and the health care management of perimenopausal and postmenopausal women. At this time some controversy exists as to whether there is a menopausal syndrome of somatic and psychological symptoms and illness. There are virtually no data on the age distribution of the menopause and no information on its sociocultural significance in the developing countries. The subject of risks and benefits of estrogen therapy in peri- and postmenopausal women is of much importance in view of the large number of prescriptions issued for this medication in developed countries, which indicates their frequrnt use, and the different interpretations and opinions among epidemiologists and clinicians on both past and current studies on this subject. Specific recommendations made by the Scientific Group appear at the end of each section of the report. The following were among the general recommendations made: WHO sponsored research should be undertaken to determine the impact on health service needs of the rapidly increasing numbers of postmenopausal women in developing countries; uniform terminology should be adopted by health care workers with regard to the menopause; uniform endocrine standards should be developed which can be applied to the description of peri- and postmenopausal conditions and diseases; and descriptive epidemiological studies of the age at menopause should be performed in a variety of settings.
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  2. 2
    044149
    Peer Reviewed

    Reduced risk of pelvic inflammatory disease with injectable contraceptives.

    Gray RH

    Lancet. 1985 May 4; 1(8436):1046.

    As part of a study on acute febrile pelvic inflammatory disease and IUDs, reported elsewhere, a significantly lower risk of PID was observed in women using injectable contraceptives. The World Health Organization coordinated the multinational case-control study in 1979-79. Diagnostic criteria were fever, suprapubic tenderness with guarding, cervical or adnexal tenderness or a pelvic mass. 319 cases and 639 matched controls were matched for age, parity, marital status and hospital status. Data were taken from questionnaires. 10 cases (3.1%) currently used injectable contraceptives, mainly Depo-Provera, compared to 38 controls (6.0%). Thus the risk of getting PID was half as great among injectable users, similar in magnitude to risks reported for women using oral contraceptives, barrier methods and sterilization in developing countries.
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  3. 3
    031956

    Thirteenth annual report.

    World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction

    Geneva, WHO, 1984 Dec. ix, 152 p.

    88 recommendations were formulated by the International Conference on Population held in Mexico City in 1984. 4 of these dealt specifically with research requirements in the population field and are reproduced in this report in their entirety. As a result of the changing perspectives and requirements of the scientific fields in which the Special Program of Research, Development and Research Training in Human Reproduction operates and taking into account the various suggestions resulting from recent reviews of the Program, several new developments have occurred. First is the attempt to distinguish more clearly between activities related to research and development and those related to resources for research. These 2 distinct but closely connected activities will be reorganized to interact in a complementary fashion. In the research and development component, the most notable changes relate to the creation of new Task Forces on the Safety and Efficacy of Fertility Regulating Methods and on Behavioral and Social Determinants of Fertility Regulation. The Program has been actively promoting coordination with other programs which support and conduct research in human reproduction. The research and development section of this report provides a technical review of the activities and plans of the various task forces, covering the following: new and improved methods of fertility regulation (long-acting systemic methods, oral contraceptives, post-ovulatory methods, IUDs, vaccines, plants, male methods, female sterilization, and natural methods), safety and efficacy of fertility regulating methods, infertility, and service and psychosocial research. The section devoted to resources for research describes some features of the network of centers, reviews the Program's institution strengthening activities in the different regions, and also considers research training and the program of standardization and quality control of laboratory procedures. The section covering special issues in drug development focuses on relations with industry, patents, and the role of the Special Program in the drug regulatory process.
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