1. Seminar 5 Eugene de Silva Ph.D. FRSA

2. Introduction Welcome Welcome SC300 AU Course – Unit 5 – week 5 SC300 AU Course – Unit 5 – week 5 Discussion points Discussion points Seminar Activity Seminar Activity Project Project

3. Unit 5 - Discussion What kinds of imbalances might affect your region (Note: Please do not discuss earthquakes, as they were discussed in last week's Discussion.) What kinds of imbalances might affect your region (Note: Please do not discuss earthquakes, as they were discussed in last week's Discussion.) What people in your area can do to prepare for them or prevent them. What people in your area can do to prepare for them or prevent them. Give some specific examples of weather incidents that occurred in your area in the past and discuss how those were handled. Give some specific examples of weather incidents that occurred in your area in the past and discuss how those were handled. What major natural disasters of the past are most similar to one that might affect your area? Explain. What major natural disasters of the past are most similar to one that might affect your area? Explain. Compare your own area's similarity to New Orleans—what similarities and differences exist between the areas? Compare your own area's similarity to New Orleans—what similarities and differences exist between the areas? Explain how you think a massive rescue and recovery effort might play out differently in your area, versus how it played out—and continues to—in post-Katrina New Orleans. Explain how you think a massive rescue and recovery effort might play out differently in your area, versus how it played out—and continues to—in post-Katrina New Orleans.

4. Discussion Q and A Q and A

5. Temperature and Equilibrium Virtual Lab Temperature and Equilibrium Virtual Lab Lab is followed by the quiz Lab is followed by the quiz

6. Seminar Discussion The case of your second cousin Tilly, a 53-year-old woman who comes to you concerned about menopause. What treatments exist for menopause and how safe and effective are they? What are some of the drawbacks to these treatments? If Tilly has been a smoker all her life, how might this alter her transition through menopause? Do some research on your own to learn about why, among Japanese women, hot flashes are very rare. Why do you think this might be the case?

7. Equilibrium Homeostasis - maintains stability in response to fluctuations Hormone balance

8. Puberty A process of physical changes Child to adult Hormone signals from brain to gonads

9. Menstrual Cycle

10. Menopause Natural stop in menstrual period and fertility Age 40 – 55 A year without a period

11. Menopause symptoms Changes in periods (they may be shorter or longer, heavier or lighter, or have more or less time in between) Hot flushes Night sweats Trouble sleeping through the night Vaginal dryness Mood changes Hair loss or thinning on the head, more hair growth on the face Physical and mental exhaustion Sleep problems Heart discomfort Joint/muscular problems

12. Issues Majority of women – no issues Longer life time 20% - Intolerable 6-7% - Symptoms up to five years

13. Testing and Treatments Diagnostic testing – FSH or Estrogens tests MRS scale - Menopause Rating Scale Health Related Quality of Life ( HRQoL) Menopause Treatments – Life style changes, prescriptions, non-prescription treatments

14. Menopause treatments HRT – Hormone Replacement Therapy Risks - Heart disease, stroke, blood clots, and breast cancer Prevention – Shortest time, lower doses

15. Seminar Discussion The case of your second cousin Tilly, a 53-year-old woman who comes to you concerned about menopause. What treatments exist for menopause and how safe and effective are they? What are some of the drawbacks to these treatments? If Tilly has been a smoker all her life, how might this alter her transition through menopause? Do some research on your own to learn about why, among Japanese women, hot flashes are very rare. Why do you think this might be the case?

16. What treatments exist for menopause and how safe and effective are they? Exercises Proper diet Ambient temperature changes Relaxations techniques Proper sleeping Effectiveness varies

17. Prescription treatments Activella and femhrt (PDR) Alora (PDR) Cenestin (PDR) Climara (PDR) CombiPatch (PDR) Conjugated estrogens (PDR) Esclim (PDR) Esterified estrogens and Methyltestosterone (PDR) Estraderm (PDR) Estradiol (PDR) Estradiol and Norethindrone acetate (PDR) Estradiol vaginal ring (PDR) Estradiol Vaginal Vagl Estradiol Vagl Estratest (PDR) Estring (PDR) Estrogen Patches (PDR) Estrogen with Progestin (PDR) femhrt (PDR) Premarin (PDR) Premphase (PDR) Prempro (PDR) Progesterone (PDR) Progesterone Micronized Oral Prometrium (PDR) Prometrium Oral Provera (PDR) Vagifem Vagl

18. Non-prescription treatments Placebo effect - Red clover (Trifolium pratense), Maca root (Lepidium peruvianum chacon), Vitamin E (Alpha tocopherol), Wild yam (Dioscorea villosa), Sarsaparilla (Smilax officinalis)

19. What are some of the drawbacks to these treatments? Breast cancer Cardiovascular problems Dementia Mood changes.

20. If Tilly has been a smoker all her life, how might this alter her transition through menopause? Increase early menopause. Reduces the number of ova.

21. Do some research on your own to learn about why, among Japanese women, hot flashes are very rare. Why do you think this might be the case? High fiber, low fat diet In take of soy products Exercise

22. Q and A