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Recent Submissions

Now showing 1 - 5 of 30
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    International society for the study of women's sexual health clinical practice guideline for the use of systemic testosterone for hypoactive sexual desire disorder in women
    (Journal of Women's Health, 2021-04-19) Parish, Sharon J.; Simon, James A.; Davis, Susan R.; Giraldi, Annamaria; Goldstein, Irwin; Goldstein, Sue W.; Kim, Noel N.; Kingsberg, Sheryl A.; Morgentaler, Abraham; Nappi, Rossella E.; Park, Kwangsung; Stuenkel, Cynthia A.; Traish, Abdulmaged M.; Vignozzi, Linda
    Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male formulations can be used cautiously with dosing appropriate for women. Patients should be assessed for signs of androgen excess and total testosterone levels monitored to maintain concentrations in the physiologic premenopausal range. Compounded products cannot be recommended because of the lack of efficacy and safety data. Clinical Implications: This clinical practice guideline provides standards for safely prescribing testosterone to women with HSDD, including identification of appropriate patients, dosing, and monitoring. Strengths & Limitations: This evidence-based guideline builds on a recently published comprehensive meta-analysis and the Global Position Statement endorsed by numerous societies. The limitation is that testosterone therapy is not approved for women by most regulatory agencies, thereby making prescribing and proper dosing challenging. Conclusion: Despite substantial evidence regarding safety, efficacy, and clinical use, access to testosterone therapy for the treatment of HSDD in women remains a significant unmet need.
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    Postpartum endometritis and infection following incomplete or complete abortion: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data
    (Vaccine, 2019-12-10) Rouse, C.E.; Eckert, L.O.; Muñoz, F.M.; Stringer, J.S.A.; Kochhar, S.; Bartlett, L.; Sanicas, M.; Dudley, D.J.; Harper, D.M.; Bittaye, M.; Meller, L.; Jehan, F.; Maltezou, H.C.; Šubelj, M.; Bardaji, A.; Kachikis, A.; Beigi, R.; Gravett, M.G.
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    A global database of abortion laws, policies, health standards and guidelines
    (Bulletin of the World Health Organization, 2017-06-09) Johnson, Brooke Ronald Jr.; Mishra, Vinod; Lavelanet, Antonella Francheska; Khosla, Rajat; Ganatraa, Bela
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    Serah: supporting expanded roles for safe abortion care by health workers—a working group to enable the implementation of the who guidelines for expanded roles of health workers in safe abortion and postabortion care
    (International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 2016-07) Sorhaindo, Annik M.; Morris, Jessica L.
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    Integrating rights and evidence: a technical advance in abortion guideline development
    (BMJ Global Health, 2021-02-08) Londras, Fiona de; Cleeve, Amanda; Rodriguez, Maria Isabel; Lavelanet, Antonella
    As part of its core work, the WHO generates, translates and disseminates knowledge, including through guideline development. In recent years, substantial work has been undertaken to revise the Evidence to Decision framework in order to fully integrate inter alia human rights. This paper describes an innovative methodological approach taken by the authors to inform law and policy recommendations for the forthcoming third edition of the Safe Abortion: Technical and Policy Guidance for Health Systems. The methodology described here effectively integrates human rights protection and enjoyment as part of health outcomes and analysis, ensuring that subsequent recommendations are consistent with international human rights standards. This will allow guideline users to make informed decisions on interventions, including legal and policy reform, to fulfil relevant human rights including the right to health.