Book Review

The Abnormal Menstrual Cycle

N Engl J Med 2006; 354:2627-2628June 15, 2006

Article

The Abnormal Menstrual Cycle
Edited by Margaret Rees, Sally Hope, and Veronica Ravnikar. 244 pp., illustrated. Abingdon, England, Informa Healthcare/Taylor & Francis, 2005. $99.95. ISBN: 1-84214-212-7

Abnormalities of the menstrual cycle, whether of functional or anatomical origin, present a vexing array of clinical problems to the practitioner. The physician may be faced with the patient's psychological problems, social issues, many types of endocrine dysfunction, pelvic masses, or cancer. The Abnormal Menstrual Cycle presents a comprehensive overview of the diagnosis and treatment of these various conditions from the perspectives of editors who represent three disciplines of medicine: gynecology, family practice, and reproductive endocrinology.

One of the strengths of this book, which is aimed primarily at the generalist, is that it features an international cast of contributors. It leans heavily toward practices that are carried out in the United Kingdom, so references are made to some pharmaceutical products that are not available in the United States. The information presented in the book is supported by evidence-based medicine and is well referenced.

As I began to read the book, I expected to find it structured along traditional lines — either from pediatric problems to problems of menopause, or beginning with a discussion of how to identify and rule out anatomical problems and ending with a discussion of how to treat functional problems. However, throughout the book the authors emphasize the causes and natural history of diseases such as endometriosis, premenstrual dysphoric disorder, the polycystic ovary syndrome, and fibroids, and they present an overview of the diagnostic tools used to evaluate these problems and the limitations of these tools. Ample space is given to a discussion of the modern options for surgical treatment of menstrual dysfunction; this discussion includes an overview of all the newer instruments for endometrial ablation. Finally, the book is organized in terms of life transitions, including puberty, premature ovarian failure, perimenopause, and menopause.

Although its contents will be part of the armamentarium of every board-certified reproductive endocrinologist, the book also provides a concise overview of the evaluation of the abnormal menstrual cycle for the generalist. Thus, I recommend the book highly.

Richard E. Blackwell, M.D., Ph.D.
University of Alabama at Birmingham, Birmingham, AL 35233
rblackwe@uabmc.edu