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Now and Then - A Gynaecologist' Journey

Dr Margaret Smith AM

Now & Then - A Gynaecologist’s Journey is the autobiography of Dr Margaret Smith, a Perth based Obstetrician and Gynaecologist. She is one of the foundation members of the Australasian Menopause Society, and was the President from 1995 to 1997.

Margaret is now in her late 70’s, and this book, published only last year, follows her life journey through her childhood, University years, early and late careers to now. She shares the experiences in her life that set her path, or were the turning points that got her through, not just in terms of shaping her career but also the making of herself as a person. She does this through story telling, giving opinions and analysis, and describing the people she met along the way.

She recounts many varied and interesting clinical scenarios - especially from her years in the Papua New Guinea Highlands where she had to deal with situations one could not dream of, including the delivery of premature, undiagnosed triplets, with no paediatric support! This and many other stories make light and entertaining reading. She also recounts stories of the non medical, and non clinical aspects of her life - her teaching, and her near death experiences in 2002 and her eventual recovery.

Margaret was one of the pioneering women who studied medicine at a time when it was the domain of men. It was fascinating to read that there were only 4 women graduating in her class from the University of Adelaide in 1955 and they were all denied a resident position at a hospital after graduation purely on gender and the assumption they would not need a hospital post as they would not be specialising. It is therefore thanks to women like Margaret and her supporters that have made the career paths for we later generations of women doctors so much smoother and give us broader options.

Times have changed dramatically since Margaret was born and embarked on her career. She is still an active member of the medical community and therefore is very qualified to compare the “Now and Then”. As the blurb on her back cover states this may seem judgmental but after so many years and so many experiences it is only fair she is allowed to do this.

This book is an interesting read of one woman’s journey through the era in which she grew up, an era where Margaret made many sacrifices and choices that we modern medico’s did not have to make. Margaret’s generation paved the way and it is enlightening to read her story!

http://www.caringforwomen.com.au/books.html

Reviewed by Dr Elizabeth Gallagher
Content updated 5 July 2011

Menopause Matters

Dr Julia Schlam Edelman MD FACOG, 2010,Johns Hopkins Press Health Book, Johns Hopkins University Press. www.press.jhu.edu

"Menopause Matters" by Dr. Julia Edelman, an American gynaecologist, is a comprehensive, scientifically based and well written guide providing information and practical advice to the woman approaching or arrived at the menopausal years. Topics addressed include lifestyle issues, menopausal symptoms, contraception for the perimenopausal women, psychological issues, heart and bone health, consideration of HRT, sexual function and more.The use of illustrative case stories, ability to convey complicated scientific findings in an accurate but simplified manner and the provision of lists for further reference at the end of each chapter enhances the consumer friendly nature of this book. I particularly like the emphasis on preventative health measures for midlife women and the "team approach" recommended for a woman and her doctor.This book is designed for the American audience which causes difficulties and possibly some confusion for the non-USA reader in regard to use of non-metric measurements and units (for example weight and cholesterol levels), reference to certain medications (micronised progesterone is not available in Australia but tibolone is) and the difference in healthcare organisation. However, the non-USA reader will still find much to inform and consider.

Reviewed by Dr Amanda Vincent MBBS, B Med Sci, PhD, FRACP
Consultant Endocrinologist, Menopause Unit, Southern Health, Victoria, Australia
Chair of the Australasian Menopause Society Education Sub-committee.

Good oil or snake oil?

Treatment regimens for postmenopausal women’
Dr Barry G Wren AM,
MD, MBBS, MHPEd., FRANZCOG, FRCOG

This book is a wonderfully concise summary of the available treatments for the management of menopausal symptoms. It also takes a fascinating look at menopause itself, in terms of how our understanding of menopause evolved over time, and how treatments were developed by various cultures for treatment of menopause-related symptoms. Dr Wren takes the reader through the development of exogenous oestrogens and progestogens and puts HRT use into context, especially given the recent controversies surrounding HRT. In the course of history synthetically produced sex steroid HRT has only really existed over the last 75 years or so, remarkable when we consider the controversy its use has been associated with over the past 10 years. Dr Wren looks at the development of breast, ovarian and endometrial cancer, and the relationship of all of these to HRT. He also looks at the effects of HRT on the cardiovascular system. The book summarises the roles of HRT, lists and describes currently available HRT treatments and summarises current guidelines from peak menopause bodies as to their recommendations for HRT use. Osteoporosis management is discussed, including non-HRT options for treatment, and the risks and benefits associated with these. Non-HRT therapies, both medical and alternative, for the treatment of menopausal symptoms are discussed. Dr Wren also takes the reader through a concise analysis of the WHI study, including the various issues surrounding the publication of results from the study.

All up the book makes for fascinating reading, even for those who are well versed in menopausal management. At less than 100 pages, it is also highly recommended for those who wish to be updated about the options for menopausal symptom relief, yet don’t have the time or resources to look at a variety of different guidelines or references.

Dr Sonia Davison, MBBS FRACP PhD, Senior Postdoctoral Research Fellow, Women’s Health Research Program, Monash University

Where did my libido go?

This book is geared to be read by any woman with a libido problem interfering with their relationship.

By Dr Rosie King MB BS FAChSHM

Dr Rosie King has assessed the different possible issues for women in this regard and managed to normalise the sexual difficulties which may be found in any relationship. She gives clear guidelines as to ways that women may take control of the situation and work to make improvements with the assistance of the willing partner.

It is 309 pages long however she has condensed the information into a few pages of “key points” related to each chapter. This allows the reader to be directed to read the information relevant to them, more easily and then progress to the full chapter details if desired. The writing style is lucid, logical and humorous at times. She includes some relevant anatomy, physiology and behavioural information. She usefully includes anecdotal male and female libido stories to illustrate important points.

Life Begins at Menopause?

A guide to the changes at midlife and menopause for women and their partners

Life Begins at Menopause? A guide to the changes at midlife and menopause for women and their partners By Dr Mandy Deeks PhD Psychologist

There are significant stages that a woman passes through in her life and menopause is a time when, by its very definition, the biological and reproductive function of a woman comes to an end. This ending brings with it consequences, in the context of a dynamic life journey, which can be either welcomed on the one hand or on the other, experienced with negative feelings. An acknowledgement and scrutiny of the complexity of the aspects of the menopause is welcomed as is consideration about how to understand and negotiate this journey with some success. This applies both physically and emotionally.