International consensus on testosterone treatment for women

Jean Hailes, 2 September 2019

The first Global Position Statement on the use of testosterone in the treatment of women, led by the International Menopause Society (IMS), was published in four leading international medical journals today.

The statement has been authored by a diverse team of leading experts based around the world and has been endorsed by internationally-esteemed medical societies.

It follows years of debate regarding testosterone therapy for women and, for the first time, provides agreement among experts and medical societies about how testosterone could be prescribed for women.

Access the statement: 

Translation and implementation of the Australian-led PCOS guideline

Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Med J Aust 2018; 209 (7 Suppl): S3-S8. || doi: 10.5694/mja18.00656
Published online: 2018-10-01

Abstract

Introduction: We have developed the first international evidence-based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian-led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will diagnoenable practice benchmarking and feedback to further inform evidence-based practice. We propose that this methodology could be used in developing and implementing guidelines for other women’s health conditions and beyond.

Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non-fertility indications; and assessment and treatment of infertility.

Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as “at risk” and receive follow-up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple metapregnancies compared with clomiphene citrate.

Australia’s health 2018 (Report)

Australian Institute of Health and Welfare,  Release Date: 

 

Australia’s Health 2018 is the AIHW’s 16th biennial report on the health of Australians. It examines a wide range of contemporary topics in a series of analytical feature articles and short statistical snapshots.

The report also summarises the performance of the health system against an agreed set of indicators.

Australia’s health 2018: in brief is a companion report to Australia’s health 2018.

Table of contents:

Whole report:

PDF Report (17.3Mb)

Australia’s health 2018 in brief:

Companion ‘in brief’ booklet presents highlights in a compact easy-to-use format.

 

New standards of care for trans and gender diverse children and adolescents

The Royal Children’s Hospital Melbourne, 2017

The first Australian Standards of Care and Treatment Guidelines for trans and gender diverse children and adolescents, led Led by the Royal Children’s Hospital in Melbourne, have been released.

Dr Michelle Telfer, Head of Adolescent Medicine and Gender Services at the RCH, says health professionals, such as GPs, school counsellors and psychologists, from around the country often seek information from the RCH but until now only international guidelines had been available.

“With 1.2% of adolescents identifying as transgender, and referrals and requests for specialist support on the rise, there is definitely a need for Australia to have its own guidelines. Trans-medicine is a relatively new area of medical practise, and most doctors didn’t get taught how to manage the care of trans children and adolescents in medical school or in their later specialist training. These guidelines, developed by leaders in this field, will help to fill this knowledge gap,” she says.

The guidelines were developed using current evidence and the input of more than 50 specialists, and they have the endorsement of the Australian and New Zealand Professional Association for Transgender Health.

The guidelines include terminology, information about the unique clinical needs, treatment information, and the role of the various medical disciplines involved in the care.

Trans and gender diverse children and teenagers, and their parents, have also been consulted along the way.

“We frequently hear that many doctors, and other clinicians, don’t feel confident in what to do or say when they come across trans or gender diverse children or adolescents for the first time. With a guide to help them through all the stages of their care, our patients’ feel that they are likely to get better care and that others will also have a more positive experience when approaching doctors or psychologists,” she adds.

 

Broader definition of polycystic ovary syndrome is harming women: Australian experts

The Age, 

In an opinion article in the latest British Medical Journal, Australian researchers argue that an expanded definition had inadvertently led to overdiagnosis, and therefore too much treatment and even harm.

The widening of the definition (to include the sonographic presence of polycystic ovaries) in 2003 led to a dramatic increase in cases, from 5 to 21 per cent.

 

Mystery of the female orgasm may be solved

Guardian, Monday 1 August 2016

The purpose of the euphoric sensation of the female orgasm has long perplexed scientists, as it is not necessary for conception, and is often not experienced by women during sex itself. Now researchers in the US say they might have found its evolutionary roots. Human female orgasm, they say, might be a spin-off from our evolutionary past, when the hormonal surges that accompany it were crucial for reproduction.

  • Read more here
  • Access journal paper The Evolutionary Origin of Female Orgasm here