Maturitas RSS feed: Current Issue. Official Journal of the European Menopause and Andropause Society (EMAS) . Affiliated with the Australasian Menopause Society (AMS) . Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines. The scope encompasses all aspects of postreproductive health in both genders ranging from basic science to health and social care. Maturitas will publish in the following areas: • predictors, effects and management of chronic diseases • sex steroid deficiency in both genders • epidemiology, health and social care • therapeutic advances • complementary and alternative medicines We offer Fast Track publication for clinical trials and research articles which present ground-breaking results that justify rapid dissemination. Articles accepted through this route can expect less than 8 weeks editorial time from submission to publication online. Articles submitted for this route will be checked by the Editor-in-Chief to determine if the criterion for fast publication has been met; if not, articles will be redirected to the normal route of category article. http://www.maturitas.org/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Maturitas0378-5122722June 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.maturitas.org/article/PIIS0378512212001296/abstract?rss=yesEditorial Board10.1016/S0378-5122(12)00129-6Maturitas 72, 2 (2012)2012-06-01Maturitas2012-06-01722S0378-5122(12)X0006-9CO2CO2http://www.maturitas.org/article/PIIS0378512212001016/abstract?rss=yesStatins have been shown to reduce the risk of cardiovascular events in numerous trials of primary and secondary prevention populations with few exceptions, providing an apparently low-risk approach to improve cardiovascular health . This has led to widespread use of statins and claims by some that statins should be ‘put in the water’. Formal guidelines generally recommend the use of statins in those with a 10 year risk of cardiovascular events >10% to 20%. However, evidence that there are a million statin prescriptions per week in England alone and that a third of adults aged >50 are currently on statins , coupled with the increasing use of stronger statins like atorvastatin (which is now off-patent) and rosuvastatin, shows a clear direction of travel – statins will be used in progressively lower cardiovascular risk populations over time.Statin therapy and new-onset diabetes: A cause for concern?David Preiss10.1016/j.maturitas.2012.02.014Maturitas 72, 2 (2012)2012-03-14Maturitas2012-03-14722S0378-5122(12)X0006-9Editorials9596http://www.maturitas.org/article/PIIS0378512212001090/abstract?rss=yesA variety of medications can adversely influence the risk of osteoporosis and fractures. Some are well known, with corticosteroid use being a common cause of osteoporosis whilst heparin treatment for example is a rare cause. An association between the use of antacid medications and an increased fracture risk was reported in 2006 . Since then, the use of proton pump inhibitors (PPIs), which are now widely used for the self-medication of dyspepsia, has been associated with an increased risk of fractures, and particularly hip fractures, in a number of studies. This resulted in the issuing of a warning by the US drug regulatory authorities in 2010. The association between PPI use and hip fracture has now been investigated in the Nurses Health Study . Almost 80,000 postmenopausal women were followed for a 6 year period, with data collected on anthropometric and lifestyle factors, on medication use, and on self-reported hip fracture. The main finding was of a significant increase in hip fracture associated with PPI use, with a smaller but still significant increase in users of histamine receptor-2 (H2) blockers. The increased risk with PPI use was seen after 2 years of use, which was the first follow-up interval, and increased further with longer duration. The increased risk only disappeared after PPI use had ceased for more than 2 years. The concomitant use of drugs used for the prevention and treatment of osteoporosis, namely hormone replacement therapy (HRT), bisphosphonates and calcium supplements, did not modify the fracture risk difference between users and non-users of PPIs. However, smoking was found to play a major role. The increased risk of hip fracture in PPI users was only seen in current and former smokers, but not in non-smokers. What is the biological explanation for these observational findings? The underlying conditions necessitating the use of PPIs do not themselves appear responsible as the authors were able to show that these conditions were not independently associated with hip fracture risk. Any impairment of calcium absorption seems an implausible explanation, and indeed the use or non-use of calcium supplements did not influence the fracture risk. A direct and specific effect of the PPIs themselves is also unlikely since an increased fracture risk was also seen with H2-receptor blockers, although this is in contrast to another study where H2-receptor blockers reduced hip fracture risk . Osteoclastic action is exquisitely sensitive to protons , but there is no evidence that the inhibition of gastric proton release results in any form of metabolic acidosis, and thus a general increase in bone resorption is unlikely to result from PPI use. Thus we are left with no obvious explanation for the observed association. What is the size of the problem? A 35% increase in hip fractures sounds alarming. However, the absolute risk is an increase of 5 fractures per 10,000 women years, which is exactly the same absolute increase in risk of sub-trochanteric femoral shaft fractures seen with long term bisphosphonate use . This magnitude of risk is considered small . However, if the use of PPIs continues to grow then theoretically the increased numbers of hip fractures could become a clinical burden. What can be done about this? Firstly, any patient going onto PPI treatment must be advised to give up smoking. Secondly, for patients with pre-existing increased risk for hip fractures PPIs should be used with caution and perhaps given for a limited period of time. This immediately presents a problem as patients on oral corticosteroids for various conditions may require long term anti-ulcer medication. Perhaps H2-receptor blockers might be more suitable for such patients. Thirdly, could prophylactic anti-fracture therapy be given to women who require long term PPI treatment? It would appear from the Nurses Health Study findings that both HRT and bisphosphonates were ineffective in preventing such fractures, but is this correct? With regard to bisphosphonate use, only 6% used these drugs, so no firm conclusions as to their effect in prevention can be reached. With regard to HRT use, just under 50% were current users, but that was in the year 2000. With the decline in HRT use after the publication of the preliminary findings from the Women's Health Initiative in 2002, it is not clear how many women still continued on the HRT during the subsequent 6-year study period. But it is unlikely to be as high as 40–45%, unless American nurses are more sensible than the physicians. Whether other osteoporotic therapies, such as strontium ranelate or denosumab, would be effective for fracture prevention in those taking PPIs is unknown, but such an approach would inflict a considerable financial burden. Probably the best approach would be to perform bone densitometry on all women who are starting, or continuing, on long term PPI treatment, and those that have osteoporosis, or are deemed at high risk, should be put on preventive treatment, namely HRT or bisphosphonates. But should we also be taking a similar approach for women who are on long term treatment with other commonly used drugs such as certain antidepressants and thiazolidinediones?Will heartburn break your leg?John C. Stevenson10.1016/j.maturitas.2012.03.005Maturitas 72, 2 (2012)2012-03-22Maturitas2012-03-22722S0378-5122(12)X0006-9Editorials9798http://www.maturitas.org/article/PIIS0378512212000965/abstract?rss=yesAbstract: The Life Span Study (LSS) is a follow-up study of atomic bomb (A-bomb) survivors to investigate the radiation effects on human health and has collected data for over 60 years. The LSS cohort consists of 93,741 A-bomb survivors and another 26,580 age and sex-matched subjects who were not in either city at the time of the bombing. Radiation doses have been computed based on individual location and shielding status at the time of the bombings. Age at death and cause of death are gathered through the Japanese national family registry system and cancer incidence data have been collected through the Hiroshima and Nagasaki cancer registries. Noncancer disease incidence and health information are collected through biannual medical examinations among a subset of the LSS. Radiation significantly increases the risks of death (22% at 1Gy), cancer incidence (47% at 1Gy), death due to leukemia (310% at 1Gy), as well as the incidence of several noncancer diseases (e.g. thyroid nodules, chronic liver disease and cirrhosis, uterine myoma, and hypertension). Significant effects on maturity (e.g. growth reduction and early menopause) were also observed. Long-term follow-up studies of the A-bomb survivors have provided reliable information on health risks for the survivors and form the basis for radiation protection standards for workers and the public.Long-term follow-up of atomic bomb survivorsRitsu Sakata, Eric J. Grant, Kotaro Ozasa10.1016/j.maturitas.2012.02.009Maturitas 72, 2 (2012)2012-03-07Maturitas2012-03-07722S0378-5122(12)X0006-9Reviews99103http://www.maturitas.org/article/PIIS0378512212001028/abstract?rss=yesAbstract: Gender inequalities in the financial resources in later life result from the combined effect of women's atypical life courses, which include interrupted employment records and periods of care provision, and the fact that pension systems have generally been slow in mitigating ‘diversions’ from continuous and full-time working lives. Gender differentials in financial resources can often result in a greater likelihood of facing poverty for older women compared to older men, and such risk can be experienced for longer periods for women, as a result of their higher life expectancy on average. For example, across the EU-27, 16% of men compared to 23% of women aged 65 and over faced a poverty risk, and at age 65, men can expect to live another 17 years on average, while women another 21 years. Although modern pension systems are increasingly recognising the diversity of women's patterns of paid and unpaid work, for example by accounting for periods of childcare in the calculation of the state pension, research continues to show a ‘penalty’ for women who have spent significant periods of their life providing care to children or dependent adults in and outside the household. Reducing such penalty is particularly important as population ageing and an increasing demand for formal and informal care are likely to present challenges with critical policy implications for societies and individuals alike.Financial inequality and gender in older peopleAthina Vlachantoni10.1016/j.maturitas.2012.02.015Maturitas 72, 2 (2012)2012-03-14Maturitas2012-03-14722S0378-5122(12)X0006-9Reviews104107http://www.maturitas.org/article/PIIS0378512212001065/abstract?rss=yesAbstract: Diethylstilboestrol (DES) is an endocrine disrupter which causes cancer in rodents. It was prescribed in large amounts to treat women with gynaecological problems; some of the daughters of these women subsequently developed a rare cancer (vaginal clear cell adenocarcinoma) while genital abnormalities were found in some of the sons. It was used for decades in livestock feed and this may have contaminated the food chain leading to the exposure of the more general population. DES appears to cause epigenetic effects in animals and there is some evidence that this also occurs in man. The mechanisms of carcinogenesis are complex and the effects are difficult to prove due to the background of dietary and environmental phyto- and xenooestrogens. It has been suggested that, like other endocrine disrupters, DES may have acted as an obesogen in the human population.Diethylstilboestrol—A long-term legacyR.M. Harris, R.H. Waring10.1016/j.maturitas.2012.03.002Maturitas 72, 2 (2012)2012-03-19Maturitas2012-03-19722S0378-5122(12)X0006-9Reviews108112http://www.maturitas.org/article/PIIS0378512212001053/abstract?rss=yesAbstract: Cardiovascular disease (CVD) is the predominant cause of mortality in type 2 diabetic (T2DM) patients. Dyslipidemia is a modifiable risk factor that should be treated early for CVD prevention. Further, dietary supplement intake is increasing in popularity worldwide. This review examines the recent meta-analyses and clinical studies on dietary supplements, specifically psyllium, garlic and green tea, on plasma lipids levels and glycemic control, as well as other potential CVD risk factors in T2DM patients. Generally, results demonstrate that psyllium supplements improve lipid profiles as well as glycemic control beyond a traditional diet in patients with T2DM. On the other hand, the results on the usefulness of garlic and green tea supplementation for dyslipidemia and hyperglycemia are uncertain. Overall, the addition of dietary supplements may be a therapeutic alternative to lower CVD risk factors in T2DM; however, more well-designed intervention studies are needed to assess the benefit of these dietary supplements.Lipid lowering with dietary supplements: Focus on diabetesIwona Rudkowska10.1016/j.maturitas.2012.03.001Maturitas 72, 2 (2012)2012-03-19Maturitas2012-03-19722S0378-5122(12)X0006-9Reviews113116http://www.maturitas.org/article/PIIS0378512212001120/abstract?rss=yesAbstract: The purpose of this review is to optimize treatment for women with schizophrenia during the menopause. Recommendations are based on a relatively sparse literature derived from searching PubMed, PsychINFO, SOCINDEX with appropriate search terms for all years subsequent to 2000. Attention needs to be paid to menopausal symptoms in women with schizophrenia and to the possibility that psychotic symptoms may worsen at this time and that general health may deteriorate. Antipsychotic treatment may need to be modified and cardiac and metabolic health indices closely monitored.Treating schizophrenia at the time of menopauseMary V. Seeman10.1016/j.maturitas.2012.03.008Maturitas 72, 2 (2012)2012-04-03Maturitas2012-04-03722S0378-5122(12)X0006-9Reviews117120http://www.maturitas.org/article/PIIS0378512212001119/abstract?rss=yesAbstract: PMS (premenstrual syndrome) affects 30–40% of the reproductive female population and hence creates significant impairment amongst women of working age . Having such an economical and financial impact makes it an important disorder to know more about in terms of diagnosis and treatment. In this article, as well as addressing diagnosis and treatments, we focus mainly on peri-menopausal women who are equally (if not more) affected by this disorder and who are subjected to PMS via a host of widely used hormonal treatments. We describe the vicious cycle that exists between exogenous progestogen stimulating PMS-like symptoms and the progestogen that is required for endometrial protection and ways of avoiding this. The treatment should address all concerns of the individual, namely contraceptive requirements, control of PMS and menopausal symptoms. The main theory behind treatment of PMS is to suppress ovulation along the hypothalamo-pituitary-ovarian axis, however neurotransmitters are also implicated in reducing sensitivity to progesterone via receptors, and therefore selective serotonin reuptake inhibitors are also useful. Surgical methods are strongly discouraged and are a last resort. With so many pitfalls, this article aims to tackle the issues commonly encountered with diagnosis and treatment of PMS in the peri-menopause.Premenstrual syndrome (PMS): A peri-menopausal perspectiveL.J. Baker, P.M.S. O’Brien10.1016/j.maturitas.2012.03.007Maturitas 72, 2 (2012)2012-04-12Maturitas2012-04-12722S0378-5122(12)X0006-9Reviews121125http://www.maturitas.org/article/PIIS0378512212000989/abstract?rss=yesAbstract: Elderly patients are at high risk of malnutrition and sarcopenia, promoting further morbidity which in turn decreases quality of life and increases the claiming of medical services and associated costs. Early and sustained administration of oral nutritional supplements has been shown to improve the nutritional status with robust clinical benefit. Many patients however, poorly adhere to prescribed supplements, so consistent monitoring is needed. Clinical monitoring usually ends with the discharge rendering the continuation of nutritional supplement therapy in the patient's home problematic. We developed a telemedicine based health care concept for intensive home monitoring. In a first randomized controlled prospective study we analyzed the feasibility of this innovative approach. The intervention group received oral nutritional supplements and telemedical monitoring with daily assessment of body weight, number of taken oral energy supplements and state of health. The control group received usual care. 13 patients were included in each group, eight patients of the intervention group left the study prematurely, five patients were closely monitored and used the devices for a mean 67±63.5 days. Follow up data of body weight and BMI showed no relevant differences between both groups.The results and experiences gained in this pilot study demonstrate that telemedical systems provide encouraging new options to enable an intensive monitoring of malnourished patients. A continuous intensive therapy monitoring of this patient group however, is a particular challenge. Albeit possibilities, limitations and useful parameters were identified, which will be used to improve the conception in an ongoing prospective randomized trial.Development of a telemedical monitoring concept for the care of malnourished geriatric home-dwelling patients: A pilot studyMatthias Kraft, Neeltje van den Berg, Kathleen Kraft, Stefanie Schmekel, Simone Gärtner, Janine Krüger, Jens Meyer, Markus M. Lerch, Wolfgang Hoffmann10.1016/j.maturitas.2012.02.011Maturitas 72, 2 (2012)2012-03-09Maturitas2012-03-09722S0378-5122(12)X0006-9Research articles126131http://www.maturitas.org/article/PIIS0378512212001004/abstract?rss=yesAbstract: Objectives: This study was to explore the independent influence of menopause on cardiovascular disease (CVD) and its risk factors in rural Chinese females.Study design: This cross-sectional population-based study enrolled 2245 premenopausal and 2498 postmenopausal women aged 40–59 years in Fangshan district, Beijing, China. Data was collected by face-to-face interview, physical examination and biochemical examination during 2009 and 2010. General liner models were employed to calculate age-adjusted means of cardiovascular risk factors (CRFs). The comparisons of CVD and it risk factors according to menopausal status, and calculation of adjusted odds ratios/coefficients and their 95% confidence intervals for the associations of quartiles of elapsed time since menopause and age at menopause with CVD and its risk factors was performed by multivariate logistic/liner regression models separately.Results: After adjustment for age and other confounders, no statistically significant association of menopause with CVD was observed in our participants; however, dyslipidemia prevalence and levels of waist-to-hip ratio, triglycerides, total cholesterol and low-density lipoprotein cholesterol were presented higher in postmenopausal group, compared to the premenopausal one (P<0.05). Compared to women who had been menopausal for less than1 year, those with the elapsed time since menopause of 2–3 years had higher CHD prevalence, higher triglycerides level and lower high-density lipoprotein cholesterol level (P<0.05).Conclusions: Postmenopausal women in rural China had worse CRFs profile than the premenopausal ones, which implied menopause might aggravate the CRFs epidemic beyond effects of aging, and would increase the CVD burden during and after their middle ages.Menopause with cardiovascular disease and its risk factors among rural Chinese women in Beijing: A population-based studyL. He, X. Tang, N. Li, Y.Q. Wu, J.W. Wang, J.R. Li, Z.X. Zhang, H.D. Dou, J.J. Liu, L.P. Yu, H.T. Xu, J.G. Zhang, Y.H. Hu10.1016/j.maturitas.2012.02.013Maturitas 72, 2 (2012)2012-03-14Maturitas2012-03-14722S0378-5122(12)X0006-9Research articles132138http://www.maturitas.org/article/PIIS0378512212001077/abstract?rss=yesAbstract: Objective: To investigate the expression levels of genes encoding phase I and phase II estradiol-metabolizing enzymes, and their association with breast cancer risk in Chinese women.Methods: The mRNA expression levels of cytochrome P450 (CYP) 1A1, 1B1 and 3A4 and catechol-O-methyltransferase (COMT) were examined in the breast tumor tissues, matched adjacent non-tumor tissues and the tissues with benign breast disease (BBD) by fluorescent quantitative real-time PCR.Results: Compared to BBD tissue, the mRNA expression of CYP1A1, CYP1B1 and CYP3A4 significantly reduced by 81.8%, 77.5%, and 85.6%, respectively, in the breast tumor tissue and by 27.2%, 38.8%, and 51.3%, respectively, in the adjacent non-tumor tissue in average (p<0.0001). COMT mRNA was 6.9 and 6.4 fold higher in the breast tumor and match non-tumor tissue (p<0.0001) than in the BBD, respectively. The level of COMT detected in pre-menopausal group and lymph nodal stage N1–N2 group was lower than that in post-menopausal group (p=0.0292) and N0 group (p=0.0389), respectively.Conclusion: Significantly deceased expression of estradiol-metabolizing enzymes might result in the excess exposure of intratumoural E2, which could be one of the important risk factors for breast cancer. Significantly elevated COMT expression suggested that COMT could play a key role in breast tumor formation.Relative imbalances in the expression of catechol-O-methyltransferase and cytochrome P450 in breast cancer tissue and their association with breast carcinomaYa-Nan Zhao, Wei Zhang, Yuan-Cheng Chen, Fang Fang, Xiao-Quan Liu10.1016/j.maturitas.2012.03.003Maturitas 72, 2 (2012)2012-03-22Maturitas2012-03-22722S0378-5122(12)X0006-9Research articles139145http://www.maturitas.org/article/PIIS0378512212001144/abstract?rss=yesAbstract: Background: We aimed to determine the prospective association between measured hearing impairment, self-reported hearing handicap and hearing aid use with quality of life.Study design: 829 Blue Mountains Hearing Study participants (≥55 years) were examined between 1997–1999 and 2007–2009. The shortened version of the hearing handicap inventory was administered. Hearing levels were measured using pure-tone audiometry. Quality of life was assessed using the 36-Item Short-Form Survey (SF-36); higher scores reflect better quality of life.Results: Hearing impairment at baseline compared with no impairment was associated with lower mean SF-36 mental composite score 10 years later (multivariable-adjusted p=0.03). Physical composite score and mean scores for seven of the eight SF-36 domains after 10-year follow-up were significantly lower among participants who self-reported hearing handicap at baseline. Differences in the adjusted means between participants with and without hearing handicap ranged from 2.7 (physical composite score) to 10.4 units (‘role limitations due to physical problems’ domain). Individuals who developed incident hearing impairment compared to those who did not, had adjusted mean scores 9.5- and 7.7-units lower in the ‘role limitation due to physical problems’, and ‘bodily pain’ domains, respectively, at the 10-year follow-up. Hearing aid users versus non-users at baseline showed a 1.82-point (p=0.03) and 3.32-point (p=0.01) increase in SF-36 mental composite score and mental health domain over the 10-year follow-up, respectively.Conclusion: Older adults with self-perceived hearing handicap constitute a potential risk group for overall deterioration in quality of life, while hearing aid use could help improve the well-being of hearing impaired adults.Hearing handicap, rather than measured hearing impairment, predicts poorer quality of life over 10 years in older adultsBamini Gopinath, Julie Schneider, Louise Hickson, Catherine M. McMahon, George Burlutsky, Stephen R. Leeder, Paul Mitchell10.1016/j.maturitas.2012.03.010Maturitas 72, 2 (2012)2012-04-12Maturitas2012-04-12722S0378-5122(12)X0006-9Research articles146151http://www.maturitas.org/article/PIIS0378512212001089/abstract?rss=yesAbstract: Background: Studies reporting on resilience (capacity to overcome life adversity) and the menopausal transition are scarce.Objective: To assess resilience and related factors in mid-aged Ecuadorian women.Method: This was a cross sectional study in which 904 women aged 40–59 completed the 14-item Wagnild and Young Resilience Scale (WYRS) and a general socio-demographic questionnaire containing personal and partner data. Lower total WYRS scores indicate less resilience. Internal consistency of the tool was also assessed.Results: Median age of all surveyed women was 49 years. A 51.1% were postmenopausal, 43.8% lived high altitude, 43.5% were abdominally obese, 12.6% used hormone therapy and 80.8% had a partner. Internal consistency was high for the WYRS tool (Cronbach's alpha: 0.94). Multiple linear regression analysis determined that lower total WYRS scores (less resilience) correlated with high altitude residency, more severe hot flushes, sedentarism, higher abdominal circumferences and having a partner with erectile dysfunction. Contrary to this, higher WYRS scores correlated with higher parity and sexual activity.Conclusion: As assessed with the WYRS tool, lower resilience of this mid-aged Ecuadorian female sample was related to various female and partner lifestyle and health issues, not necessarily related per se to the ageing process. More research using the tool is warranted.Resilience and related factors during female Ecuadorian mid-lifePeter Chedraui, Faustino R. Pérez-López, Gino Schwager, Hugo Sánchez, Wellington Aguirre, Nalo Martínez, Octavio Miranda, María S. Plaza, Cesar Astudillo, Jorge Narváez, Juan C. Quintero, Branly Zambrano10.1016/j.maturitas.2012.03.004Maturitas 72, 2 (2012)2012-03-19Maturitas2012-03-19722S0378-5122(12)X0006-9Short communication152156http://www.maturitas.org/article/PIIS0378512212001107/abstract?rss=yesAbstract: Objective: To review the evidence that isoflavones are effective treatments for menopausal symptoms and to present the safety data.Methods: The databases Scopus, ScienceDirect and Primo Central Index were searched and preference was given to systematic reviews and meta-analyses.Results: The available evidence suggests that isoflavones do not relieve menopausal vasomotor symptoms any better than placebo. Long-term safety studies suggest that women who consume a diet high in isoflavones may have a lower risk of endometrial and ovarian cancer.Conclusions: Isoflavones cannot be recommended for the relief of hot flushes.Phytoestrogens for menopausal symptoms: A reviewJohn A. Eden10.1016/j.maturitas.2012.03.006Maturitas 72, 2 (2012)2012-04-03Maturitas2012-04-03722S0378-5122(12)X0006-9Mini reviews157159http://www.maturitas.org/article/PIIS0378512212001132/abstract?rss=yesAbstract: Aims: The aim of this paper is to explore the potential value of questionnaires in routine clinical practice to assess female sexual dysfunction (FSD), and to identify if this could increase the competence of a physician in the initial management of women with these problems. The rationale to encourage Health Care Professionals (HCPs) to engage women in dialogue about their sexual health is that it may enhance a woman's quality of life (which may lead to improved general health) and might lead to timely interventions and possible preventative measures for certain diseases.Method: A short literature review of the most relevant publications was undertaken evaluating current practice.Results: FSD can have a negative impact on women's well-being and can also be an early symptom of underlying disease. Many HCPs do not broach the subject, consequently women do not get the opportunity either to voice their sexual concerns or access appropriate services. Review of currently available FSD questionnaires suggests that many but not all are generally inappropriate for use in routine clinical practice. Kriston et al.’s STEFFI-2 may be an appropriate starting point. Evidence suggests that this would facilitate discussion of sexual matters between the HCP and the women, and increase the likelihood of FSD being diagnosed.Conclusions: Following this review of the literature, the authors strongly recommend that HCPs include FSD questionnaires as part of their routine engagement with women. However, the questionnaire would need to be used as part of the overall assessment and cannot replace a detailed case history and examination, which should lead to effective treatment and management of FSD. The authors recommend further research in the following areas:Should questionnaires of female sexual dysfunction be used in routine clinical practice?Mary Clegg, Alison Towner, Kevan Wylie10.1016/j.maturitas.2012.03.009Maturitas 72, 2 (2012)2012-04-12Maturitas2012-04-12722S0378-5122(12)X0006-9Mini reviews160164http://www.maturitas.org/article/PIIS0378512212001156/abstract?rss=yesAbstract: Institutions and journals both have important duties relating to research and publication misconduct. Institutions are responsible for the conduct of their researchers and for encouraging a healthy research environment. Journals are responsible for the conduct of their editors, for safeguarding the research record, and for ensuring the reliability of everything they publish. It is therefore important for institutions and journals to communicate and collaborate effectively on cases relating to research integrity. To achieve this, we make the following recommendations.Institutions should:Journals should:Cooperation between research institutions and journals on research integrity cases: Guidance from the Committee on Publication Ethics (COPE)Elizabeth Wager, Sabine Kleinert10.1016/j.maturitas.2012.03.011Maturitas 72, 2 (2012)2012-04-12Maturitas2012-04-12722S0378-5122(12)X0006-9Guidelines165169