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Chapter 28 - Gynecologic issues in the elderly

from Section III - Care of the elderly by organ system

Published online by Cambridge University Press:  05 June 2016

By
Michele Q. Zawora  and
Christine Hsieh
Edited by
Jan Busby-Whitehead ,
Christine Arenson ,
Samuel C. Durso ,
Daniel Swagerty ,
Laura Mosqueda ,
Maria Fiatarone Singh  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Samuel C. Durso
Affiliation:
The Johns Hopkins University School of Medicine
Daniel Swagerty
Affiliation:
University of Kansas
Laura Mosqueda
Affiliation:
University of Southern California
Maria Fiatarone Singh
Affiliation:
University of Sydney
William Reichel
Affiliation:
Georgetown University, Washington DC
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Summary

Gynecologic concerns remain common throughout the lifespan. The most common concerns of elderly females are vulvovaginitis and other vulvar conditions, gynecologic-specific cancers, pelvic floor prolapse, post-menopausal symptoms, and sexual dysfunction. Elderly patients are less likely to report concerns and may have special needs due to underlying comorbidities. Careful attention to risk factors with sensitive history taking is an important part of health and wellness in the aging female. Special adjustments can be made during the physical exam for patient comfort. The approach to the geriatric patient should be based individually on functional status and patient goals. Frail elders should be managed with quality of life and maintenance of function as the top priorities.
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 398 - 407
Publisher: Cambridge University Press
Print publication year: 2016

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References

Sultana, C. Geriatric gynecology. In: Arenson, C, Busby-Whitehead, J, Brummel-Smith, K, et al., editors. Reichel’s Care of the Elderly, Clinical Aspects of Aging. 6th ed. Cambridge: Cambridge University Press; 2009.Google Scholar
Letvak, S, Schoder, D. Sexually transmitted diseases in the elderly: what you need to know: the young aren’t the only ones at risk for STDs. Geriatric Nursing. 1996;17(4):156–160. doi:10.1016/S0197-4572(96)80063-2.Google Scholar
Centers for Disease Control and Prevention (CDC). Clinical prevention guidance. In: Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17;59(RR-12):2–8. Available at: www.guideline.gov/content.aspx?id=25577&search=sexually+transmitted+infections (accessed November 14, 2015).Google Scholar
Miller, KL, Baraldi, CA. Geriatric gynecology: promoting health and avoiding harm. Am J Obstet Gynecol. 2012 Nov;207(5):355–367. Available at: http://dx.doi.org/10.1016/j.ajog.2012.04.014 (accessed November 14, 2015).Google Scholar
Bachmann, GA, Nevadunsky, NS. Diagnosis and Treatment of Atrophic Vaginitis. Am Fam Physician. 2000 May 15;61(10):3090–3096.Google Scholar
Management of symptomatic vulvovaginal atrophy: 2013 position statement of the North American Menopause Society. Menopause. 2013 Sep;20(9):888–902.CrossRefGoogle Scholar
Urogenital health. In: Menopause and osteoporosis update 2009. J Obstet Gynaecol Can. 2009 Jan;31(1 Suppl 1):S27–S30. Available at: http://sogc.org/wp-content/uploads/2013/01/Menopause_JOGC-Jan_09.pdf (accessed November 14, 2015).Google Scholar
American College of Obstetricians and Gynecologists (ACOG). Management of Menopausal Symptoms. Washington, DC: American College of Obstetricians and Gynecologists (ACOG); 2014 Jan. 15 (ACOG Practice Bulletin No. 141). Available at: www.guideline.gov/content.aspx?id=47751&search=postmenopausal+symptoms (accessed November 14, 2015).Google Scholar
North American Menopause Society. The 2012 hormone therapy position statement of the North American Menopause Society. Menopause. 2012 Mar;19(3):257–271.Google Scholar
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2012. Atlanta: CDC. Available at: www.cdc.gov/std/stats12 (accessed November 14, 2015).Google Scholar
Perkins, KE, King, MC. Geriatric gynecology. Emerg Med Clin N Am. 2012;30(4):1007–1019.Google Scholar
Walter, LC, Covinsky, KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA 2001;285(21):2750–2756.Google Scholar
Canavan, TP, Cohen, D. Vulvar cancer. Am Fam Physician 2002;66(7):1269–1274.Google Scholar
Jemal, A, Siegel, R, Xu, J, Ward, E. Cancer statistics, 2010. CA Cancer J Clin 2010;60(5):277–300.Google Scholar
Johnson, TL, Kumar, NB, White, CD, Morley, GW. Prognostic features of vulvar melanoma: a clinicopathologic analysis. Int J Gynecol Pathol 1986;5(2):110–118.CrossRefGoogle ScholarPubMed
Creasman, WT, Phillips, JL, Menck, HR. The National Cancer Data Base report on cancer of the vagina. Cancer 1998;83(5):1033–1040.Google Scholar
Daling, JR, Madeleine, MM, Schwartz, SM, et al. A population-based study of squamous cell vaginal cancer: HPV and cofactors. Gynecol Oncol 2002;84(2):263–270.Google Scholar
Lee, LJ, Jhingran, A, Kidd, E, et al. ACR appropriateness criteria management of vaginal cancer. Oncology Journal, Gynecologic Cancers 2013. Available at: www.cancernetwork.com/oncology-journal/acr-appropriateness-criteria-management-vaginal-cancer/page/0/1 (accessed September 16, 2014).Google Scholar
Cervical cancer. NIH Consensus Statement. 1996;14:1–38. Available at: consensus.nih.gov/1996/1996CervicalCancer102PDF.pdf (accessed August 11, 2014).Google Scholar
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 131. Screening for cervical cancer. Obstet Gynecol. 2012;120(5):1222–1238.Google Scholar
Saslow, D, Solomon, D, Lawson, HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62(3):147–172.Google Scholar
US Preventive Services Task Force. Screening for Cervical Cancer: Recommendation Statement. Am Fam Physician. 2012;86(6):555–559.Google Scholar
Vesco, KK, Whitlock, EP, Eder, M, et al. Risk factors and other epidemiologic considerations for cervical cancer screening: a narrative review for the US Preventive Services Task Force. Ann Intern Med. 2011;155(10):698–705.CrossRefGoogle Scholar
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 35. Diagnosis and treatment of cervical carcinomas. Obstet Gynecol. 2002;78(1):79–91.Google Scholar
Sorosky, JI. Endometrial cancer. Obstet Gynecol 2012;120(2 Pt 1):383–397.Google Scholar
Swerdlow, AJ, Jones, ME. British Tamoxifen Second Cancer Study Group. Tamoxifen treatment for breast cancer and risk of endometrial cancer: a case-control study. J Natl Cancer Inst 2005;97(5)375–384.CrossRefGoogle ScholarPubMed
Brinton, LA, Berman, ML, Mortel, R, et al. Reproductive, menstrual and medical risk factors for endometrial cancer: results from a case control study. Am J Obstet Gynecol 1992;167(5):1317–1325.Google Scholar
Lancaster, JM, Powell, CM, Kauff, ND, et al. Society of Gynecologic Oncologists Education Committee statement on risk assessment for inherited gynecologic cancer predispositions. Gynecol Oncol 2007;107(2):159–162.Google Scholar
Mueck, AO, Seeger, H, Rabe, T. Hormonal contraception and risk of endometrial cancer: a systematic review. Endocr Relat Cancer 2010;17(4):R263–R271.Google Scholar
Zhou, B, Yang, L, Sun, Q, et al. Cigarette smoking and the risk of endometrial cancer: a meta-analysis. Am J Med 2008:121(6):501–508.Google Scholar
Moore, SC, Gierach, GL, Schatzkin, A, Matthews, CE. Physical activity, sedentary behaviours, and the prevention of endometrial cancer. Br J Cancer 2010; 103(7):933–938.Google Scholar
Yu, X, Bao, Z, Zou, J, Dong, J. Coffee consumption and risk of cancers: a meta-analysis of cohort studies. BMC Cancer 2011;11:96.CrossRefGoogle ScholarPubMed
Tang, NP, Li, H, Qiu, YL, et al. Tea consumption and risk of endometrial cancer: a metaanalysis. Am J Obstet Gynecol 2009;201(6):605.Google Scholar
Von Greunigen, VE, Karlen, JR. Carcinoma of the endometrium. Am Fam Phys 1995;51(6):1531–1536.Google Scholar
Buchanan, EM, Weinstein, LC, Hillson, C. Endometrial Cancer. Am Fam Phys 2009;80(10):1075–1080.Google Scholar
American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 280. The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer. Obstet Gynecol. 2002;100(6):1413–1416.Google Scholar
US Preventive Services Task Force. Screening for ovarian cancer: reaffirmation recommendation statement. Ann Intern Med 2012;157(12):900–904.Google Scholar
Tortolero-Luna, G, Mitchell, MF, Rhodes-Morris, HE. Epidemiology and screening for ovarian cancer. Obstet Gynecol Clin North Am 1994;21(1):1–23.Google Scholar
Teneriello, MG, Park, RC. Early detection of ovarian cancer. CA Cancer J Clin 1995;45(2):71–87.Google Scholar
McDonald, JM, Modesitt, SC. The incidental postmenopausal adnexal mass. Clin Obstet Gynecol 2006;49(3):506–516.Google Scholar
Roett, M, Evans, P. Ovarian cancer: an overview. Am Fam Physician 2009;361:170–177.Google Scholar
Modesitt, SC, Pavlik, EJ, Ueland, FR, et al. Risk of malignancy in unilocular ovarian cystic tumors less than 10 centimeters in diameter. Obstet Gynecol 2003;102(3):594–599.Google Scholar
Komatsu, T, Konisha, I, Mandai, M, et al. Adnexal masses: transvaginal US and gadolinium-enhanced MR imaging assessment of intratumoral structure. Radiology 1996;198(1):109–115.CrossRefGoogle ScholarPubMed
van Nagell, JR Jr, Hoff, JT. Transvaginal ultrasonagraphy in ovarian cancer screening: current perspectives. Int J Womens Health 2013;6: 25–33.Google Scholar
NIH consensus conference. Ovarian cancer: screening, treatment, and follow-up. Development Panel on Ovarian Cancer. JAMA 1995;273(6):491–497.Google Scholar
Lowder, JL, Ghetti, C, Nikolajski, C, et al. Body image perceptions in women with pelvic organ prolapse: a qualitative study. Am J Obstet Gynecol 2011;204(5):411.e1–5.Google Scholar
Jelovsek, JE, Maher, C, Barber, MD. Pelvic organ prolapse. Lancet 2007;369(9566):1027–1038.CrossRefGoogle ScholarPubMed
Bump, RC, Mattiasson, A, Bo, K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–17.Google Scholar
Culligan, PJ. Nonsurgical management of pelvic organ prolapse. Obstet Gynecol 2012;119(4):852–860.Google Scholar
Vasomotor symptoms. In: Menopause and osteoporosis update 2009. J Obstet Gynaecol Can. 2009 Jan;31(1 Suppl 1):S9–S10.Google Scholar
North American Menopause Society. The 2012 hormone therapy position statement of the North American Menopause Society. Menopause. 2012 Mar;19(3):257–271. doi:10.1097/gme.0b013e31824b970a.Google Scholar
American College of Obstetricians and Gynecologists (ACOG). Female Sexual Dysfunction. Washington, DC: American College of Obstetricians and Gynecologists (ACOG); 2011 Apr: 12 p. (ACOG Practice Bulletin No. 119). Available at: www.guideline.gov/content.aspx?id=32672&search=postmenopausal+symptoms (accessed November 14, 2015).Google Scholar
Wallace Kazer, M. Issues regarding sexuality. In: Boltz, M, Capezuti, E, Fulmer, T, Zwicker, D, editors. Evidence-based Geriatric Nursing Protocols for Best Practice. 4th ed. New York, NY: Springer Publishing Company; 2012: 500–515. Available at: www.guideline.gov/content.aspx?id=43928&search=sexual+dysfunction (accessed November 14, 2015).Google Scholar
Health Care Guideline: Diagnosis of Breast Disease, 14th ed. January 2012. Available at: www.icsi.org/_asset/v9l91q/DxBrDis.pdf (accessed November 14, 2015).Google Scholar

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