REPORT ABOUT THE CONGRESS

Women’s health care, especially in light of the aging population, has grown and changed significantly within the past few years. The field of medicine addressing the menopause is expanding rapidly and keeping pace with the new knowledge is difficult. Moreover, given the multifactorial approaches needed, the management of women’s health during the menopause is posing new challenges everyday to gynecologists as well as general practitioners.
The meeting was thus focused on updating the physicians and other health care professionals on the most recent research breakthroughs and innovative clinical applications, and discussing how to transfer these new data into everyday clinical practice from the perspective of treatment, prevention, and counseling.

“The highlights of the conference included the new findings on the biology of the estrogen receptors (ERs)”, said Pier Giorgio Crosignani, co-chairman of the meeting and professor of Obstetrics and Gynecology at the University of Milan, Italy. Today we know that the two known ER subtypes, alpha and beta, have a widespread distribution in mammalian tissues and may play an important role in a surprisingly large number of physiological processes, including hearing and immunity. “For instance, the new data in this field,” explained Crosignani, “are helping us to understand why the prevalence of some diseases, e.g. some autoimmune diseases, is higher in women than in men”.

Much discussion was devoted to the primary findings from the WHI (Women’s Health Initiative) trial of conjugated estrogen only (CEE), published just one week prior to the symposium (JAMA,2004;291:1701-12); www.jama.ama-assn.org/cgi/content/abstract/291/14/1701, and their implications on the use of hormone replacement therapy (HRT). While HRT has been confirmed as the best therapeutic option to treat climateric symptoms, with regard to prevention, however, “the study has shown that, with no benefit to heart disease, CEE should not be used for preventing coronary heart disease (CHD) and chronic disease in postmenopausal women,” said Marcia L. Stefanick, professor of Obstetrics and Gynecology at the Stanford University, Stanford, CA, USA.

Perhaps the most important moment of the meeting was the final round table “The future of menopause”, when a panel of experts from the major international scientific societies explained and compared the different and latest position statements on postmenopausal hormone usage, in light of the primary results of the WHI estrogen-alone trial. The result was a remarkable concordance of positions; however, several major differences were also highlighted. The lack of agreement indicates those areas in this field that need further research.

The main topics discussed during the symposium were:

1. New insights into the biology of the ERs
2. Primary findings from the WHI estrogen-alone trial and their implications for cardiovascular disease (CVD) prevention
3. Hormones and cancer risk
4. Metabolic syndrome, diabetes and lifestyle
5. Bone and joints
6. Quality of life
7. Round table “The future of menopause”

DOWNLOAD THE REPORT OF THE CONGRESS IN .pdf FORMAT

LIST OF ACRONYMS