1. UNIT 5 SEMINAR

2. SC 300 UNIT 5 Ajit T. Joseph, Ph.D., P.E. AJoseph@kaplan.edu AIM: ATJoseph3

3. Agenda 1.Menopause -History -Symptoms -Treatments a)Lifestyle changes b)Prescription c)Nonprescription 2.Soy 3.Smoking 4.Discussion Board 5.Quiz 6.Q&A

4. Seminar Preparation Please remember that the “pre-seminar” assignment should be done before we meet for the seminar For example tonight you should have prepared the following: Come to Seminar prepared to discuss 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?

5. History “Menopause is not a dangerous time or experience for the majority of women, any more than puberty is….” ~Dr. Andrew F. Currier, 1897 “…a large proportion of women go through menopause with scarcely a ripple and need no medical treatment whatsoever.” ~Dr. Emil Novak, 1922

6. Symptoms and evaluation Episodes of sweating or hot flushes Heart discomfort Sleep problems Depressive mood, irritability, or anxiety Physical or mental exhaustion Sexual problems Bladder problems Dryness of vagina, skin, or hair Joint or muscular discomfort

7. Treatments: lifestyle changes Image credit: Microsoft Clip Art

8. Treatments: Prescription ProCon Hormone therapy (local or systemic): estrogen, progestogen, or combinations Decrease hot flashes Relieve vaginal dryness Relieve some urinary symptoms Prevent osteoporosis Increased risk of developing breast and uterine cancers; heart disease, stroke, and pulmonary embolism; and dementia Low-dose antidepressants Decrease hot flashes Relieve some mood symptoms Side effects may include sexual dysfunction, anxiety, headache, nausea, insomnia or drowsiness, dry mouth, decreased appetite, or constipation Anti-seizure medicationsDecrease hot flashes Side effects may include fatigue, dizziness, rash, heart palpitations, swelling, and drowsiness, but generally decrease over time (weeks) Anti-hypertensive (blood pressure) medications Decrease hot flashes Unpleasant side effects including dry mouth, drowsiness, or insomnia are common BisphosphenatesPrevent or treat osteoporosis Side effects may include damage to the esophagus and muscle pain; long-term use can lead to brittle bones (quantity over quality) Selective estrogen receptor modulators Prevent or treat osteoporosisIncreased risk of blood clots, hot flashes, nausea, and leg cramps

9. Treatments: Nonprescription ProCon Black cohosh (Actaea racemosa, Cimicifuga racemosa, Remifemin) Decrease hot flashes Relieve some mood symptoms Relieve vaginal dryness Reduce sleep disturbances Increased risk of liver problems Dong Quai (Angelica sinensis) Decrease hot flashes Relieve some mood symptoms Relieve vaginal dryness Increased risk of bleeding complications Ginseng or Ginkgo (Panax ginseng or Panax quinquefolius) Relieve some mood symptoms Reduce sleep disturbances Appears to be nontoxic, both in the short- and long-term, except in highly excessive doses Chaste Berry (Vitex agnus castus) Decrease hot flashes Relieve some mood symptoms Appears to be nontoxic, both in the short- and long-term, except in highly excessive doses. Passion flower (Passiflora incarnata) Relieve some mood symptoms Reduce sleep disturbances Appears to be nontoxic, both in the short- and long-term, except in highly excessive doses.

10. Smoking Image credit: Microsoft Clip Art

11. Soy

12. Unit Five - Q uiz Please be sure to complete the Unit 5 Quiz; You will only be able to take your Quiz one time. Click the "Save Answers" button often; If you lose your internet connection during your Quiz, sign on again and try to access your Quiz. If you are unable to enter, contact your instructor; You will be able to see the time remaining at the top left of the page. When you are finished, click the "Submit for Grading" button. After this, you will not be able to change answers.

13. Discussion Board – Unit Five Discussion at Natural Disasters, particularly Hurricane Katrina I’ve posted three websites under the Discussion and in the Webliography 1. Government site that gives history of Katrina 2. Government site that explains recovery efforts 3. Government site on Disaster Preparedness (particularly hurricanes)

14. Discussion Board – Unit Five Please note there are 6 parts to the Discussion Question in Unit Five. It’s all one thread but 6 questions to consider. Make sure your posts address the complete assignment…not just one or two of the questions for consideration. Remember, the unit started on Wednesday so you should be working on Unit Five Discussion already.

15. Discussion Board - Content Discussion Questions provide a forum for students to ask questions and answer important questions about the course material. The Discussion Questions also allow students to receive feedback from the instructor and other students in the class. A Discussion Question grade will be posted to the grade sheet for each Unit. Content: 1. Answer the discussion question(s) completely 2. Responses must make some informed reference(s) to the lesson material (properly cited and referenced, of course) 3. Writing is clear with only minor mistakes in grammar, style, or punctuation that do not affect readability

16. Discussion Board - Participation 1. Contribute meaningfully (substantially) on at least three days 2. Respond to at least two other people, in addition to answering the discussion question(s) completely 3. Responses must advance the discussion (If you wait to participate on the last day of the week, there is no way to advance the discussion as it is over!)

17. Image credits: Microsoft Clip Art