The Breast and Sexual Well-being in Menopausal Patients, Putrajaya Marriott Hotel - 28 July 2006
By Dr Evelyn Ho Organon (M) Sdn Bhd organised a lecture cum workshop on A Practical Approach to Livial: What, When, Whom and Why to address the uncertainty among healthcare professionals and patients. There were some 40 participants at the meeting.
Professor Bo von Schoultz, Professor and Chairman, Department of Obstetrics and Gynaecology from the Karolinska Hospital, Sweden spoke on Breast Tissue, Breast Density, Breast Cancer Risk and the Effects of Various Hormone Replacement (HRT) Therapy Regimes. HRT has been shown to increase breast cancer risk especially after using HRT for 5 years or more. Using estrogen alone as HRT was associated with a reduced risk while adding progestogen may increase the risk. This was because progestogen may enhance the proliferation of the breast epithelium. 
| Professor Dr Bo Von Schoultz from the Karolinska Hospital, Sweden | 
| Professor Dr Nik Mohd Nasri from Islamic University College of Malaysia | 
| Prof Dr Kim Won-whe from the Pusan National University, Korea | 
| Participants at the workshop |
Mammographic density (which relates to the pattern on the mammogram) is an independent risk factor for breast cancer. The relative risk ranged from 2.0 – 6.0. The breasts respond to HRT by variable increase in density (degree and extent of “whitish tissue” seen on the mammogram). The degree of breast response to the HRT appears to depend on the dose, the regimen, the sensitivity of the breast tissue and perhaps Body Mass Index. There is a dose-response relation between breast density and risks. The mammographic density can be changed by intervention. Since breast density was an independent risk factor, it would be important to state in the mammographic report that such a change is seen. Any increase in mammographic density and breast cell proliferation were to be considered as unwanted side effects of therapy. There is a marked individual response to HRT. A response if present would be seen within 1 to 3 months. Livial as the HRT was reported as not or only minimally affecting the breast density.
Other topics included Prof Dr Nik Mohd Nasri presenting the findings of a survey of 300 women on menopause and sexual well being in Malaysian women. Prof Nik is President of the Malaysian Menopause Society, Dean – Faculty of Medicine and Health Sciences, Islamic University College of Malaysia and a Consultant Obstetrician and Gynaecologist.
Clinical experience with Livial in breast cancer survivors was presented by Prof Dr Yip Cheng Har and is the principal investigator for the LIBERATE trial in the University Malaya Medical Centre.
Prof Dr Kim Won-whe brought the most laughter and woke everyone up with his enlightening and light hearted account of Women’s Sexual Well-being after menopause. He shared the Korean experience and also addressed therapeutic options, principles and practice of addressing sexuality. Prof Kim is Honorary Professor at Pusan National University and Extraordinary Professor at Seoul Women’s University.
Workshops on the management of breast cancer survivors and menopause therapy as well as Counselling and addressing sexual well-being among women above 50 years old were held as well.
At the end of the afternoon session, the participants were “treated” to an evening cruise and dinner at Tasik Putrajaya.
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