Book Review

Management of the Perimenopause

N Engl J Med 2007; 356:2010-2011May 10, 2007

Article

Management of the Perimenopause
(Practical Pathways in Obstetrics and Gynecology.) Edited by James H. Liu and Margery L.S. Gass. 531 pp., illustrated. New York, McGraw-Hill, 2006. $62.95. ISBN: 978-0-07-142281-9

With the myriad of medical textbooks that are available, it is rare to find one that covers a novel topic. Perimenopause is a topic that has largely been met with indifference, and for this reason Management of the Perimenopause is a welcome addition to the library of any physician who cares for female patients at this stage of life. There has been a lack of rigorous research on perimenopause, but an important exception is the Study of Women across the Nation. This study, funded by the National Institutes of Health, provides longitudinal data on women from diverse backgrounds. Other cohort studies have made major contributions and provide a global viewpoint of this time in a woman's life.

One of the major challenges in producing a textbook on perimenopause is to define its time frame. Some guidance is provided by the Stages of Reproductive Aging Workshop, developed under the auspices of the American Society for Reproductive Medicine, but this resource is difficult to use in a clinical setting. Management of the Perimenopause acknowledges that additional information will be required before a time frame for menopause can be clearly defined. With that caveat, the text covers a wide range of problems, some specific to the menopausal transition and some found throughout the lifespan.

The book is easy to use, with key points highlighted in the margins, clear and concise headings, and diagrams to guide diagnosis and treatment. The case studies are excellent teaching tools and can be modified for use in training settings. The chapters are short but comprehensive. For nonsurgeons, medical alternatives are often provided, and a working knowledge of the types of procedures available can be helpful. Despite the number of detailed drawings of surgical procedures, however, the book lacks sufficient rigor to be used as a surgical textbook. Overall, referencing is uneven; some chapters provide adequate evidence for their recommendations, and in others, the evidence is sparse.

These faults notwithstanding, this book is a welcome addition to the literature that brings together topics as diverse as migraines, pelvic pain, and thyroid disorders in the context of perimenopause. It will be particularly useful as a teaching tool, and the information is well organized and functional.

Lorraine A. Fitzpatrick, M.D.
GlaxoSmithKline, Collegeville, PA 19426
lorraine.a.fitzpatrick@gsk.com