WORKSHOP: Revisiting Clinical Care of the "Hormonal" Patient
Presenting Author(s): Dr. Roger C. Rampling, MD, FRCPC
Date and time: 23 Mar 2024 from 14:10 to 14:40
Location: Hawthorn A
Learning Objectives
1. Detail several ways our medical institutions have failed to help these women;
2. Demonstrate the multiple improvements in psychiatric function achievable; and
3. Present longer term evidence of systemic health benefits and risk.
Literature References
1. Manson,J 2018 Managing Menopause: Are the WHI Findings Being Misunderstoodhttps://www.medscape.com/viewarticle/859512
2. Lega, I et al, CMAJ 2023 May 15;195:E677-82. A Pragmatic Approach to Menopause doi: 10.1503/cmaj.221438
3. Manson, J and Staunitz, N Engl J Med 2016; 374:803-806. Menopause Management: Getting Clinical Care Back on Track DOI: 10.1056/NEJMp1514242
4. Soares, C. N. Mood disorders in midlife women: understanding the critical window and its clinical implications. Menopause 21, 198–206 (2014. Menopause. 2014 Feb;21(2):198-206. doi: 10.1097/GME.0000000000000193
5. Pop AL, Nasui BA, Bors RG, Penes ON, Prada AG, Clotea E, Crisan S, Cobelschi C, Mehedintu C, Carstoiu MM, Varlas VN. The Current Strategy in Hormonal and Non-Hormonal Therapies in Menopause-A Comprehensive Review. Life (Basel). 2023 Feb 26;13(3):649. doi: 10.3390/life13030649.PMID: 36983805 Free PMC article.
Abstract
Females are well known to have greater risk of mood and anxiety disorders.Hormonal factors explain the largest biological differences between males and females. Neglecting these factors is not excusable when medicine and especially psychiatry are properly based on a bio-psycho-social model.
Scientific information on the effectiveness and risks of hormonal intervention has been developed over decades.In 2024, effective clinical management of hormonally distressed women is strikingly under-used, inappropriately discouraged, and even disparaged by physicians. This constitutes an enormous opportunity lost, and should be considered to be passive or active negligence in the effective medical care of half our population.
This presentation will detail several ways our medical institutions have failed to help these women.
This will lead to the real purpose of the presentation, which is to demonstrate the clinical improvements achievable. The approach recommended will combine medical first principles, careful patient assessment, and some of the strongest evidence in psychiatry.
Clinical preceptors, psychiatric residents, and treating psychiatrists will learn treatment principles to improve benefits and reduce side effects. An overview of evidence for long-term medical benefits and risks will be presented.