The Role of Energy Availability in the Induction and Reversal of Menstrual Disturbances in Exercising Women

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (15 download)

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Book Synopsis The Role of Energy Availability in the Induction and Reversal of Menstrual Disturbances in Exercising Women by : Jay Lieberman

Download or read book The Role of Energy Availability in the Induction and Reversal of Menstrual Disturbances in Exercising Women written by Jay Lieberman and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The Female Athlete Triad is a medical condition describing interrelated clinical conditions characterized by low energy availability, menstrual disturbances, and poor bone health. A singular focus on the causal role of energy availability in the development of the Female Athlete Triad has overshadowed an exploration of potential factors that moderate the risk for this condition. Moreover, more translational research is needed on the usefulness of a particular method to monitor energy availability to assess risk of exercise associated menstrual disturbances. Whether the underlying physiological mechanisms associated with the induction and reversal of exercise related menstrual disturbances are similar is unclear. Lastly, because key physiological consequences of exercise related suppression of menstrual function are the result of prolonged hypoestrogenism, the accuracy of urinary determinations of ovarian hormones will be assessed. Our results demonstrate that energy availability is indeed an important metric to monitor in active women in order to prevent menstrual disturbances. However, it appears to interact with reproductive maturity such that those with fewer years since first menses are at greater risk for menstrual disturbances during periods of low energy availability. Our results also suggest that the goal for treating women with exercise related amenorrhea should be to increase body fat, not simply increase energy availability. Lastly, the assessment of ovarian function using the analysis of urinary estrogen and progesterone metabolites should include more sophisticated quantitative approaches. In conclusion, our studies advance our understanding of the significance of energy availability and its practical application in relation to menstrual health.

The Female Athlete Triad

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Publisher : Springer
ISBN 13 : 148997525X
Total Pages : 187 pages
Book Rating : 4.4/5 (899 download)

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Book Synopsis The Female Athlete Triad by : Catherine M. Gordon

Download or read book The Female Athlete Triad written by Catherine M. Gordon and published by Springer. This book was released on 2014-10-28 with total page 187 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the first book of its kind to focus solely on the female athlete triad - its origins, its recognition, and most importantly, its management. Since the symptoms themselves cover a range of medical specialties, chapters are written by experts in a number of relevant fields - sports medicine, orthopedics, endocrinology, and pediatrics - with an eye toward overall care of the young female athlete. Additionally, each chapter includes suggestions on how to educate and communicate with young athletes and their parents, as well as trainers and coaches, on how to manage the illness outside of the direct clinical setting. The female athlete triad is often seen in sports where low body weight is emphasized, such as gymnastics, figure skating, and running, though it can appear in any sport or activity. The interrelated symptoms - eating disorders, amenorrhea, and low bone mass - exist on a spectrum of severity and are serious and potentially life-threatening if not properly treated. Psychological problems, in addition to medical ones, are not uncommon. The Female Athlete Triad: A Clinical Guide discusses all of these areas for a well-rounded and in-depth approach to the phenomenon and will be a useful reference for any clinician working with female athletes across the lifespan.

Physiological Adaptations to Energy Deficiency and Risk Factors for the Female Athlete Triad in Exercising Women

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (119 download)

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Book Synopsis Physiological Adaptations to Energy Deficiency and Risk Factors for the Female Athlete Triad in Exercising Women by : Kristen Koltun

Download or read book Physiological Adaptations to Energy Deficiency and Risk Factors for the Female Athlete Triad in Exercising Women written by Kristen Koltun and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The Female Athlete Triad (Triad) is a syndrome of energy deficiency/low energy availability, menstrual dysfunction, and low bone mineral density that affects up to 60% of exercising women. Due to the prevalence and potential long-term consequences of the Triad, it is essential that we continue to advance our understanding of the underlying physiology and resultant clinical conditions, as well as improve our ability to screen for those at greatest risk for Triad-related health consequences. Therefore, the overall purpose of this dissertation was to better understand how energetic status relates to menstrual function and improve our ability to identify those at risk for developing Triad-related clinical conditions, such as bone stress injuries. Specifically, I aimed to: 1) understand the effects of reductions in energy availability on menstrual function, as assessed by luteinizing hormone (LH) pulsatility and the induction of menstrual disturbances, 2) identify the potential role of non-energetic factors, such as elevated androgens, as contributors to the development of menstrual disturbances in exercising women, 3) test whether a 12-month nutritional intervention of increased energy intake in exercising women with menstrual disturbances was associated with increased energy availability and changes in physiological markers of metabolism, 4) qualitatively assess the Female Athlete Triad Coalition cumulative risk assessment tool and compare athlete clearance decisions to those resulting from use of the Relative Energy Deficiency in Sport (RED-S) tool, and 5) recommend alternative scoring strategies for the Female Athlete Triad Coalition cumulative risk assessment tool for when a specific risk factor (i.e., bone mineral density) cannot be assessed. Key findings of the studies in this dissertation include: 1) reductions in energy availability are associated with reductions in LH pulse frequency and, in turn, reductions in LH pulse frequency are predictive of the induction of subclinical menstrual disturbances (luteal phase defects), 2) a subset of exercising women with severe menstrual disturbances (oligo/amenorrhea) exhibit evidence of elevated androgens, which may be contributing to menstrual dysfunction, 3) a 12-month nutritional intervention designed to increase energy intake in exercising women with severe menstrual disturbances (oligo/amenorrhea) also improved energy availability and was associated with changes in physiological markers of metabolism, 4) the Female Athlete Triad Coalition cumulative risk assessment tool results in more conservative clearance decisions compared to the RED-S tool, and 5) alternative scoring strategies based on self-report data are available and result in similar clearance categorizations to the original Female Athlete Triad Coalition cumulative risk assessment tool. Together, these studies highlight the importance of ensuring that exercising women are maintaining appropriate energetic status to sustain their overall health and wellbeing and improve our ability to identify those at greatest risk for developing Triad-related health consequences.

The Role of Psychosocial Stress in the Etiology of Exercise-Associated Menstrual Disturbances

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Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (12 download)

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Book Synopsis The Role of Psychosocial Stress in the Etiology of Exercise-Associated Menstrual Disturbances by : Clara Etter

Download or read book The Role of Psychosocial Stress in the Etiology of Exercise-Associated Menstrual Disturbances written by Clara Etter and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: AbstractBackground: Low energy availability and psychosocial stress have been shown to suppress reproductive function in mammals independently and in combination. The unique contributions of psychosocial stress on the severity of exercise associated menstrual dysfunction have not been identified and there are few prospective studies that demonstrate such effects. Objectives: To determine the contribution of psychosocial stress to the induction of menstrual disturbances in response to a diet and exercise program that induced modest weight loss. We tested the hypothesis that increases in psychosocial stress were associated with the induction of menstrual disturbances during the original intervention. Design: A secondary analysis was performed on data collected during a prior randomized controlled trial designed to assess the impact of three months of low (8 2%), moderate (22 3%), or high (42 3%) levels of an energy deficit created through varying combinations of controlled caloric restriction and supervised exercise on menstrual function in ovulatory, sedentary women. We tested the hypothesis that increases in psychosocial stress were associated with the induction of menstrual disturbances during the original intervention. Methods: In the original trial, 36 women (age 18-24 yrs, BMI 21-29 kg/m2) were studied during a Baseline menstrual cycle followed by three successive menstrual cycles during which they exercised 5 d/wk, 50-85% VO2max for 20-75 min and all food was provided to participants according to study group assignment. Metabolic and anthropometric measures were repeated throughout the intervention. Menstrual disturbances (luteal cycle defects, oligomenorrhea, and anovulation) were detected using daily measures of urinary estrone-1-glucuronide (E1G), pregnanediol glucuronide (PdG), mid-cycle luteinizing hormone (LH) and menstrual calendars. Perceived stress was measured every two weeks with the 14-item Perceived Stress Scale (Cohen, 1983). For the secondary analysis, logistic regression and chi-square analyses were performed to test the association between perceived stress and menstrual disturbances induced during the intervention. For some analyses, participants were divided into tertiles based on their change in perceived stress across the intervention: Low Stress -12.5 to 0.5 (n = 13), Moderate Stress 1.0 to 4.5 (n = 11), and High Stress 5.0 to 36.5 (n = 12). ANOVA was used to detect group differences in reproductive hormone secretion and other measures. Baseline anthropometrics, age, aerobic fitness, scores for depression and eating attitudes, and reproductive factors were investigated as possible contributors to the change in perceived stress. Results: The intervention caused moderate weight loss (-2.57 0.35 kg) and increases in aerobic fitness (p

The Endocrine System in Sports and Exercise

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Publisher : John Wiley & Sons
ISBN 13 : 0470757809
Total Pages : 648 pages
Book Rating : 4.4/5 (77 download)

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Book Synopsis The Endocrine System in Sports and Exercise by : William J. Kraemer

Download or read book The Endocrine System in Sports and Exercise written by William J. Kraemer and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 648 pages. Available in PDF, EPUB and Kindle. Book excerpt: This valuable new addition to the Encyclopaedia of Sports Medicine series provides a comprehensive and logical look at the principles and mechanisms of endocrinology as related to sports and exercise. It looks at growth hormone factors involved in exercise and the endocrinology of sport competition. It considers various factors and stresses on the body that may alter sporting performance. It covers topics from the acute responses and chronic adaptations of the human endocrine system to the muscular activity involved in conditioning exercise, physical labor, and sport activities. This book is an essential reference for helping to plan better programs of physical fitness, to prepare for sports competitions, and to manage the medical care of athletes.

The Menstrual Cycle and Its Disorders

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Publisher : Springer
ISBN 13 :
Total Pages : 212 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Menstrual Cycle and Its Disorders by : Karl M. Pirke

Download or read book The Menstrual Cycle and Its Disorders written by Karl M. Pirke and published by Springer. This book was released on 1989-07-31 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Altered eating behavior and exercise habits frequently affect the menstrual cycle, particularly in young women. This book summarizes the state of art of knowledge of behavioral effects on reproductive endocrine function. An attempt is made to characterize the hypothalamic pulse generator biochemically and to determine factors which influence hypothalamic pulsatility. These new results are then discussed in view of the malfunctioning of the hypothalamic pulse generator in anorectic and bulimic patients. This book offers a new perspective, i.e. from behavior to hormonal mechanisms, unlike most literature dealing with the relationship from the perspective of hormones to behavior.

The Female Athlete, An Issue of Clinics in Sports Medicine, E-Book

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Publisher : Elsevier Health Sciences
ISBN 13 : 0323546897
Total Pages : pages
Book Rating : 4.3/5 (235 download)

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Book Synopsis The Female Athlete, An Issue of Clinics in Sports Medicine, E-Book by : Siobhan M. Statuta

Download or read book The Female Athlete, An Issue of Clinics in Sports Medicine, E-Book written by Siobhan M. Statuta and published by Elsevier Health Sciences. This book was released on 2017-09-14 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of Clinics in Sports Medicine, edited by Dr Siobhan Statuta, will cover a variety of topics related to The Female Athlete. Articles will discuss topics including, but not limited to: Congenital Cardiac and Nuances; Concussion overview in female athlete; Anxiety, Stress, and Depression; Gastrointestinal Conditions; Female Athlete Triad/Tetrad; Training Principles to Avoid Injury in Female Athletes; Nutritional concerns; Exercise in Pregnancy; and Osteopenia in the Older Female Athlete.

Nutritional Influences on Bone Health

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Publisher : Springer
ISBN 13 : 3319984640
Total Pages : 275 pages
Book Rating : 4.3/5 (199 download)

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Book Synopsis Nutritional Influences on Bone Health by : Connie M. Weaver

Download or read book Nutritional Influences on Bone Health written by Connie M. Weaver and published by Springer. This book was released on 2018-10-24 with total page 275 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book comprehensively covers the topics and discussions covered at the 10th International Symposium on Nutritional Aspects of Osteoporosis. It is the only international meeting that exclusively covers the role of nutrition on musculoskeletal health and function. Current thinking on the role of nutrition on bone and muscle development and health, and as a means of preventing osteoporosis, falls and fractures is covered. The latest evidence on the potential roles that protein, potassium, B vitamins, vitamin D, omega-3 fatty acids, and flavonoids in the context of bone and muscle health are also discussed. Nutritional Influences on Bone Health reviews the role of nutrition in bone health and its potential role in preventing osteoporosis and sarcopenia in ageing populations, providing a valuable and practically applicable resource for practising and trainee health and medical professionals.

Handbook of Sports Medicine and Science

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Publisher : John Wiley & Sons
ISBN 13 : 1118862201
Total Pages : 144 pages
Book Rating : 4.1/5 (188 download)

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Book Synopsis Handbook of Sports Medicine and Science by : Margo Mountjoy

Download or read book Handbook of Sports Medicine and Science written by Margo Mountjoy and published by John Wiley & Sons. This book was released on 2014-10-06 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new International Olympic Committee (IOC) handbook covers the science, medicine and psycho-social aspects of females in sports at all levels of competition. Each chapter focuses on the specific issues that female athletes confront both on and off the field, such as bone health, nutritional recommendations, exercise/competition during menstruation and pregnancy, and much more. Fully endorsed by the IOC and drawing upon the experience of an international team of expert contributors, no other publication deals with the topic in such a concise and complete manner. The Female Athlete is recommended for all health care providers for women and girl athletes internationally for all sports and all levels of competition. It is a valuable resource for medical doctors, physical and occupational therapists, nutritionists, and sports scientists as well as coaches, personal trainers and athletes.

Endocrinology of Physical Activity and Sport

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Publisher : Humana
ISBN 13 : 9783030333751
Total Pages : 578 pages
Book Rating : 4.3/5 (337 download)

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Book Synopsis Endocrinology of Physical Activity and Sport by : Anthony C. Hackney

Download or read book Endocrinology of Physical Activity and Sport written by Anthony C. Hackney and published by Humana. This book was released on 2020-02-27 with total page 578 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now in its fully revised and expanded third edition, this comprehensive text represents a compilation of the critical endocrinology topics in the areas of sports medicine, kinesiology and exercise science, written by leading experts in the field. As in previous editions, the focus here is on the critical issues involved in understanding human endocrinology and hormonal workings with regards to physical activity, exercise and sport and how such workings impact the full range of medical conditions, overall health and physiological adaptation. Chapters included discuss the effect of exercise on the HPA axis, the GH-IGF-1 axis, thyroid function, diabetes, and the male and female reproductive systems, among other topics. Additional chapters present the current evidence on circadian endocrine physiology, exercise in older adults, exercise and hormone regulation in weight control, and the effects of overtraining in sports. Chapters brand new to this edition present the role of hormones in muscle hypertrophy, the effect of exercise on hormones in metabolic syndrome patients, how exercise impacts appetite-regulating hormones in clinical populations, and the relative energy deficiency in sport (RED-S) condition.

Knobil and Neill's Physiology of Reproduction

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Publisher : Academic Press
ISBN 13 : 0080535275
Total Pages : 3269 pages
Book Rating : 4.0/5 (85 download)

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Book Synopsis Knobil and Neill's Physiology of Reproduction by :

Download or read book Knobil and Neill's Physiology of Reproduction written by and published by Academic Press. This book was released on 2005-12-12 with total page 3269 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 3rd edition, the first new one in ten years, includes coverage of molecular levels of detail arising from the last decade's explosion of information at this level of organismic organization. There are 5 new Associate Editors and about 2/3 of the chapters have new authors. Chapters prepared by return authors are extensively revised. Several new chapters have been added on the topic of pregnancy, reflecting the vigorous investigation of this topic during the last decade.The information covered includes both human and experimental animals; basic principels are sought, and information at the organismic and molecular levels are presented. *The leading comprehensive work on the physiology of reproduction*Edited and authored by the world's leading scientists in the field*Is a synthesis of the molecular, cellular, and organismic levels of organization*Bibliogrpahics of chapters are extensive and cover all the relevant literature

Activity Anorexia

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Publisher : Psychology Press
ISBN 13 : 1134794509
Total Pages : 232 pages
Book Rating : 4.1/5 (347 download)

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Book Synopsis Activity Anorexia by : W. Frank Epling

Download or read book Activity Anorexia written by W. Frank Epling and published by Psychology Press. This book was released on 2013-06-17 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume provides researchers and clinicians with an insight into recent developments in activity anorexia. Much of the basic information on the topic has come from animal literature; the theory of activity anorexia is built on an animal model of self-starvation (rats placed on a single daily feeding run more and more, over days stop eating, and die of starvation). Additionally, experiments that for ethical or practical reasons could not be done with humans may be conducted with other animals. The animal research is extending the understanding of biologically-based reward mechanisms that regulate eating and exercise, environment-behavior interactions that affect anorexia, and the biochemical changes that accompany physical activity and starvation. Increasingly, however, the impact of physical activity on human anorexia is being directly investigated--eight out of fourteen research chapters in this volume are based on human research. Some researchers are interested in the impact of hyperactivity and caloric restriction on human reproductive function. Other authors are investigating physically active subgroups of people considered to be at risk for anorexia. Finally, several clinician/researchers suggest how physical activity and extreme dieting interact for anorexia nervosa patients. Chapter authors were asked to present their views independent of the editors' argument that, when it is present, physical activity is central to anorexia. Many of the contributors disagree with the editors about the details of activity anorexia. A few suggest that excessive physical activity is either incidental to, or an epiphenomenon of, anorexia. Most authors are, however, in accord with the view that physical activity reduces food consumption which further drives up activity that results in even less caloric intake. No matter what their perspective, all contributors agree that hyperactivity frequently accompanies self-starvation in humans and other animals. The end result is a lively book that provides a source of ideas for both researchers and practitioners.

Explaining Divergent Levels of Longevity in High-Income Countries

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Publisher : National Academies Press
ISBN 13 : 0309217105
Total Pages : 200 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Explaining Divergent Levels of Longevity in High-Income Countries by : National Research Council

Download or read book Explaining Divergent Levels of Longevity in High-Income Countries written by National Research Council and published by National Academies Press. This book was released on 2011-06-27 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.

Exercise in Health and Disease

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Publisher : Saunders
ISBN 13 :
Total Pages : 760 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Exercise in Health and Disease by : Michael L. Pollock

Download or read book Exercise in Health and Disease written by Michael L. Pollock and published by Saunders. This book was released on 1990 with total page 760 pages. Available in PDF, EPUB and Kindle. Book excerpt: Focuses on exercise and fitness for both healthy individuals and those with conditions such as cardiovascular disease and obesity. The text discusses basic etiology and pathophysiology and details the role of exercise in prevention and rehabilitation. Emphasis is on prescribing effective exercise programs. Presents discussions on etiology of disease, principles of exercise prescription, value of exercise, fitness measurement and more! Includes numerous illustrations and references.

Diagnosis and Management of Ovarian Disorders

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Publisher : Elsevier
ISBN 13 : 008049451X
Total Pages : 595 pages
Book Rating : 4.0/5 (84 download)

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Book Synopsis Diagnosis and Management of Ovarian Disorders by : Albert Altchek

Download or read book Diagnosis and Management of Ovarian Disorders written by Albert Altchek and published by Elsevier. This book was released on 2003-09-04 with total page 595 pages. Available in PDF, EPUB and Kindle. Book excerpt: This updated second edition of Diagnosis and Management of Ovarian Disorders provides thorough, yet succinct insight into the ever-changing realm of ovarian disorders. It presents a novel multidisciplinary approach to the subject as described by clinicians, surgeons, pathologists, basic scientists and related medical researchers. Topics covered include reproductive technology, early diagnosis of ovarian cancer, and management of menopause among others. The breadth of information provided by this book will appeal to clinicians and researchers involved in the study and treatment of ovarian disorders. KEY FEATURES* Includes updated information on early diagnosis of ovarian cancer* Reviews new diagnostic techniques for ovarian disorders* Discusses latest information on reproductive technology* Presents translational treatment linking laboratory research with clinical medicine

The Active Female

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Publisher : Springer Nature
ISBN 13 : 3031154851
Total Pages : 621 pages
Book Rating : 4.0/5 (311 download)

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Book Synopsis The Active Female by : Jacalyn J. Robert-McComb

Download or read book The Active Female written by Jacalyn J. Robert-McComb and published by Springer Nature. This book was released on 2023-02-27 with total page 621 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now in a revised and expanded third edition, the aims of The Active Female are threefold: first, to increase the awareness of wellness and fitness issues for active females and their family members; second, to provide an avenue for medical practitioners, allied health professionals, health educators/providers, and certified individuals in sports medicine/athletics to gain critical, updated knowledge of a field specific to active females; and third, to introduce the concept of obesity as a growing health concern even for normal weight individuals. Part I of the book offers a foundation for understanding the interrelationships between female physiology, body image and other psychological issues, the female reproductive cycle, and the musculoskeletal anatomy and physiology of females that makes their health risks and concerns unique. In Part II, the concepts of eating disorders from a global perspective and the health disparities and inequities in women’s health are discussed in detail. Part III describes the prevention and management of common musculoskeletal injuries in active females across the lifespan, including the management of osteoporosis. Appropriate exercise and nutritional guidelines and recommendations for active females are discussed in detail in Parts IV and V. Part VI is a new addition to the book and highlights the obesity epidemic and co-morbid diseases associated with obesity even for normal weight obese individuals. Each chapter is bookended by clear learning objectives and review questions for additional pedagogical appeal. An invaluable addition to the literature, The Active Female: Health Issues throughout the Lifespan, 3e will be of great interest to all clinicians and allied health care professionals concerned with women’s health and related issues, from sports medicine and family practitioners to endocrinologists, gynecologists and orthopedic surgeons.

Clinical Gynecology

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Publisher : Cambridge University Press
ISBN 13 : 1107040396
Total Pages : 1127 pages
Book Rating : 4.1/5 (7 download)

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Book Synopsis Clinical Gynecology by : Eric J. Bieber

Download or read book Clinical Gynecology written by Eric J. Bieber and published by Cambridge University Press. This book was released on 2015-04-23 with total page 1127 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.