Lissa Zala, BA, Andrea Swan, BScN, and Jerilynn Prior, MD
Victoria, Canada: Trafford Publishing; 2005
This book is an attempt to meld factual information with personal experiences of women transitioning from reproductive life to the menopause years. In that attempt, there are discussions of ovarian function, basic reproductive anatomy, and a glossary of terms that should provide a basis for understanding not only the contents of the book but also medical jargon, which will help readers translate the “medicalese” often used by their healthcare providers.
The life expectancy of women, especially in developed nations, has increased enough to allow the majority to live 30 years beyond menopause (80 years old or older). To this end, the book discusses three forms of care for women: lifestyle choices, alternative therapies, and traditional treatments. There are appropriate notations that most alternative therapies are not tested or government approved, and potential risks of complementary and alternative therapies are explained, including prolongation of bleeding with some, and drug-to-drug interactions with others. There are extensive references to the use of FDA-approved drugs for treatment of menopausal symptoms (although the lack of information about off-label might send some readers to other sources for the complete story).
One strength of this book is a very lucid explanation of the importance of taking personal responsibility for making lifestyle changes, such as smoking cessation, sensible diet, and exercise. The discussion of heart disease, diabetes, hypertension, and other common causes of high medical cost, illness, and death is welcome. Appropriate screening tests for colorectal cancer, breast cancer, and cervical cancer are explained, but North American readers need to recognize that some of the Canadian and United States protocols differ.
This 213-page book elaborates the phases of the perimenopausal transition by age and phase, in cookbook fashion, so the reader must be careful to realize that each woman experiences symptoms differently or not at all. There are templates for charting symptoms and signs, which are useful for understanding one’s own personal experiences and may also serve as a foundation for asking appropriate questions of one’s healthcare professionals. The authors should also be applauded for acknowledging the influences of emotional health, social contexts, interpersonal relationships, and sexuality. There is a lot of substance in this small book.
Transitions is well footnoted and concludes with references and websites where the curious reader can find additional information. As a physician, I always appreciate when patients come to appointments with lists of questions that can direct discussion to important points.
However, the book does contain some bias. It is written as a commercial venture in addition to being a heartfelt effort to educate and share experiences. It is a venue to sell tapes, DVDs, and videos produced by the authors. Like any other book or article, there is a message not only in what is said, but what is left unsaid.
I think the majority of readers will find this book valuable.
Paul D. Burstein, MD, FACOG
Department of Obstetrics and Gynecology
University of Wisconsin Medical School, Milwaukee Clinical Campus, and the Medical College of Wisconsin
NAMS Menopause Practitioner