Management of Libido Problems in Menopause
By Jeanne L. Leventhal, MD

This article reviews the causes and treatment of the common decrease in sexual activity and satisfaction experienced by many menopausal women. Causes include physiologic changes, depression, decreased sexual functioning of the partner, and individual cultural or psychological factors. Treatment, which includes counseling and medications, needs to be individualized according to the specific identified etiologic factors.
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A substantial minority of women who experience a first heart attack or stroke do not have known major risk factors, as here documented from Kaiser Permanente hospitalization databases. Age differences in presence of individual risk factors were also noted, with smoking more prevalent in younger women and hypertension more prevalent in older women. The data have implications both for clinical evaluation of women with symptoms and with respect to screening needs for all women.
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Kaiser Permanente Medicine 50 Years Ago: The Gynecological Cancer Detection Clinic
By Wilson Footer, MD
Commentary by Steven A. Vasilev, MD, MBA

The reprinted 56-year-old article by an early Kaiser Permanente physician shows that Permanente Medicine in the 1940s was clearly on the cutting edge of early diagnosis of gynecologic cancers. The described clinic was one of the few in operation at the time. Dr Vasilev's accompanying current Commentary authoritatively reviews the history of this topic. He details major technological advances over the past half century as well as ongoing limitations. He points out the needs for more education and more universal application of this cornerstone of preventive medicine in women's health.
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