Major & minor symptoms that need to be addressed at menopause.

/ T—Score?

No whispering, Pl express your valued opinion freely  Q.11 . Your views on multi-vitamin supplementation in otherwise health asymptomatic women? There are several drugs / brands of such nutritional supplements claimed as the ANTIOXIDANTS for post menopausal women? Does your Society approve such supplementation?

Q.12. what is  your stand / stand of your Society on estimation of serum Vit D & Homocysteine level  on four yearly basis and then supplementing such drugs as on demand basis or do you routinely prescribe such drugs on empirical basis.

Q. 13. What type of HRT will be most suitable for women whose father and mother has died in sixth decade of life due to M.I. and she herself is suffering from hyperlipidaemia?

Q. 14. Role of Biphosphonates in modern era:     Postmenopausal osteoporosis is a nightmare for orthopedic surgeons. Do all women who are on tibolone  Ry / CEE& MPA Ry    mandate Anti-resoprtive therapy concomitantly? Which HRT do not take care of bone health? It is our experience that most Indian women would not exercise or take milk or other healthy foods inspite of our advice. Such is the experience when we advocate attending Gym for PCOS girls.

Q. 15: If compliance is poor (which is true for most Indian women- who are less aware of consequences of bone loss) -   then question of antiresorptives  come in. Should you recommend routine calcium and vitamin D supplementation to all women after the attaining age of 35 yrs? Or wait till Lab evidence of osteoporosis is evident. What is the harm if we routinely prescribe Biphosphonates after certain age say, 35yrs? We are aware of its toxicity and side effects. But what else can be initiated to prevent bone loss if she is non compliant ion life style.  Do all HRT mandate co prescription of Biphosphonates (Alendronate/residronate) to ensure good bone health. Or else such antiresorptives  are prescribed in documented cases of osteopenia along with Tibolone/CEE/MPA Ry?  What is your recommendation? If so how long such Biphosphonates (Alendronate/residronate) are to be continued. Any monitoring during such long term Biphosphonates therapy?

Q. 16:--What about calcitonin & Isoflavones  in routine clinical practice? Isoflavones  have become popular in rural areas. As it is like soft protocol of stimulation in subfertility practice. What is your considered opinion on Isoflavones?

Q.17. Quite often elderly women suffer from Vulvar pain or vaginal soreness with no clinically demonstrable lesion. Is there any HRT locally or injectable which may benefit such women? What will be treatment of choice of Vulvar soreness in postmenopausal women?

The subject of the World Health Day in the year 2017  was “Let’s talk: Depression.”: Then why not menopause?? Members pl proceed for one day strike. However, Let’s see your skill on counseling to a menopausal women on following issues: How do you counsel & what advise U offer to a housewife, Executive, Political women-all at menopausal group. What your message to meno women as an imp person of the society at  large?? Treating physician experience on managing meno safely & comfort level (TREAT THE PATIENT &  Menopause (HRT or no HRT –decision is yours). Many Exciting developments in the recent past on Cardiac & bone health. Lets discuss in a truly Socratic manner . Discuss , debate on new developments on cardiac, endometrial, Breast and above all on muscular skeletal health  & finally analyze what we mean by

Menopausal: a) hypoactive sexual desire disorder (HSDD) b) Female sexual dysfunction (FSD)  c)

Menopause & depression d) Mood disorder e) Neuropsychological co-morbidities .f) Peri –menopausal mood disorders premenstrual syndrome g) Hot flashes nocturnal sweating and insomnia. Hurry up-pl express your views and disseminate your wisdom please