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Case #828
Council on Menopause Management

A 55-year-old Caucasian woman with multiple symptoms that are affecting her daily activities

Release Date: October 28, 2009
Expiration Date: October 27, 2010

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Chief Complaint

“I can’t sleep. I am gaining weight. I am moody. I don’t like the person that I am turning into.”

History of Present Illness

Ingrid is a 55-year-old Caucasian woman who presents with multiple symptoms. She states that she wakes up several times each night drenched in sweat and has been experiencing dramatic mood swings. During the day, she has what she describes as “spells” of sweating and heart palpitation, sometimes with a headache. In addition, she is depressed on a regular basis for no apparent reason. She also reports several other problems, including pain on urination and occasional pain during sexual activity.
   
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Disclosures and Important Information


Sponsored by the Duke University School of Medicine


In collaboration with MedCases, LLC

Supported by an educational grant from Wyeth Pharmaceuticals, Inc.

Release Date: October 28, 2009

Expiration Date: October 27, 2010

Estimated time to complete this activity:1.0 hour

Accreditation Statement

The Duke University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

The Duke University School of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

"The Council on Menopause Management" educational activities have been reviewed and are acceptable for up to 4.0 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins September 15, 2009. Term of approval is for one year from this date. (Each case study is approved for 1.0 Prescribed credit; the newsletter is approved for 1.0 prescribed credit; and the video is approved for 1.0 prescribed credit. Credit may be claimed for 1 year from the date of this case study).

Faculty

Michelle P. Warren, MD
Medical Director, Center for Menopause, Hormonal Disorders and Women’s Health
Department of Obstetrics and Gynecology
Columbia University Medical Center
New York, NY

Faculty Reviewer

Charles B. Hammond, MD
E. C. Hamblen Professor
Chair Emeritus, Department of Obstetrics and Gynecology
Reproductive Endocrinology and Fertility
Duke University Medical Center
Durham, NC

Target Audience

This activity is intended for gynecologists, family practitioners, internists, and other practitioners who care for menopausal women.

Prerequisites

There are no prerequisites.

Statement of Need

Menopause-related vasomotor symptoms can diminish menopausal women’s quality of life. With so many different types of interventions available for the treatment of vasomotor symptoms, women should be active participants in the treatment decision-making process. This educational activity has been designed to facilitate application of the latest research and guidelines to help clinicians improve counseling, management, treatment, and care of menopausal women with the ultimate goal of increasing their longevity and quality of life.

Objectives

Upon completion of this case, you should be able to:

  • Describe the impact of menopause on life functions and quality of life
  • Discuss the effects of hormone therapy (HT) on menopause symptoms
  • Identify the effects of SSRIs, SSNRIs, and gabapentin on hot flushes, mood, and depression
  • Consider the impact of a family history of breast cancer on treatment
  • Review cardiac considerations and impact on treatment

Method of Participation

This Internet-based activity takes approximately 1 hour to complete. You should review the objectives and case, answer the multiple-choice post-test and complete an evaluation form online. Once completed, you will be able to save your certificate to your own computer and print it on your own printer.

Staff and Content Validation Reviewer Disclosure

The staff involved with this activity and any content validation reviewers of this activity have reported no relevant financial relationships with commercial interests.

Policy on Speaker and Provider Disclosure

In accordance with the ACCME Standards for Commercial Support of CME, the Duke University School of Medicine implemented mechanisms, prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity.

Planning Committee/Faculty Disclosure

The following planning committee members have indicated they have no relationship(s) with industry to disclose relative to the content of this CME activity: Brian McDonough, MD; Raja Sekhar, MD; Lillie Chen; Carolyn Darrow, MPH; and Daryl Ehrentreu, RPh, MBA.

The following speakers and/or planning committee members have indicated that they have relationship(s) with industry to disclose:

David Archer, MD Consultant: Bayer, Schering Plough Organon, Agile Therapeutics, Radius Pharmaceuticals Inc, Xanodyne
PI: Wyeth, Bayer, Schering Plough Organon, Zanodyne
Speaker: Wyeth, Schering Plough Organon
Charles B. Hammond, MD Board Member and Scholar Award: Bayer Pharmaceuticals
Michelle P. Warren, MD Consultant: Barr Laboratories (Duramed), Bradley Pharmaceuticals, Ferring, QuatRx, Warner Chilcott, National Cattlemans Beef Association
Speaker: Novartis, Novo Nordisk, Upsher Smith, Warner Chilcott, Wyeth Pharmaceuticals Inc.
PI: Novartis, Solvay, Wyeth Pharmaceuticals, Inc., Ferring
Solicited Manuscript: Up to Date
Advisory Board Member: Yoplait
Wyeth-Ayerst Professor of Woman's Health: Wyeth Pharmaceuticals, Inc.

Off-label Statement/Unapproved Uses

Duke School of Medicine requires CME faculty (speakers) to disclose to attendees when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved); and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty may discuss information about pharmaceutical agents that is outside of U.S. Food and Drug Administration approved labeling. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

No faculty member has indicated that their presentation will include information on off-label products.

Disclaimer

The information provided in this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own.

The MedCases Web site does not define a standard of care, nor is it intended to dictate an exclusive course of management. Cases are provided for informational and educational purposes only and are not intended as medical advice. This information should not substitute for a visit or consultation with a health care provider.

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Copyright Information

© 2009 MedCases, LLC and Duke University School of Medicine

For Further Information

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For Questions/Information Regarding CME Credits:

Duke University School of Medicine Office of CME
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Durham, NC 27707
Phone (919) 401-1200
Fax (919) 401-1213
cme@mc.duke.edu
http://cme.mc.duke.edu

Hardware/Software Requirements and Technical Assistance

This Web-based CME activity is best experienced using a current generation browser, such as Internet Explorer 5.5 or higher. This Web site requires that JavaScript and session cookies be enabled. In addition, you will require the Adobe Flash Player plugin to view the case simulation.

Detailed Requirements:

  • 128 MB RAM
  • Windows 98 or newer
  • Adobe Flash Player 8 minimum needed
  • Audio playback with speakers for programs that have video content
  • Internet Explorer 5.5 or higher or Mozilla Firefox 1.0 or higher or Apple Safari
  • 1024 x 768 resolution
  • Broadband connection highly recommended

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