From The New England Journal of Medicine
This book is an unparalleled and valuable compendium of data for anyone interested in women's health. The editors have done a superb job: despite their choice of enlisting almost 200 experts as contributing authors, the chapters have a consistently uniform, clear style, which makes the whole book efficient to use and easy to read. There is very little irrelevant or disproportionately detailed discussion. The data in each section are carefully referenced, and the bibliographies, individually and collectively, are an invaluable resource for interested readers. Evidence of meticulous editing is found in the unifying themes that run through most of the chapters. Many of the authors refer to the paucity of data about lesbians' health, mention the effect of pregnancy on the incidence and severity of disease, and present well-documented insights into the effects of social, economic, and cultural factors on health. Epidemiologic information, data about the economic cost of illness, and where available, quantitative and qualitative data about the symptoms and course of specific diseases are included in each section. All of these are important for making intelligent decisions about treatment and follow-up in clinical practice.
The book begins with an overview of the history of women's health and continues with a series of comprehensive discussions of diseases that affect women in particular. There is an unusual and important section called "Poorly Understood Conditions" that will be valuable to physicians caring for women; it is impossible to find all these puzzling and difficult-to-treat disorders discussed in depth in any other single source.
A considerable part of the book deals with gynecologic problems in premenopausal patients. Internists who care for women will profit from the careful descriptions of common urologic and gynecologic problems and easily performed diagnostic tests that can obviate the need to refer patients with common illnesses to a specialist. Unfortunately, the reverse is not true. This is not a comprehensive medical textbook that can help gynecologists who see problems such as hypertension or dyslipidemia. The book is not meant to fulfill that function, and although it does provide current information on some general medical problems, it has other important advantages. It covers in superb detail some important issues in women's health. For example, Holubkov and Reis discuss the troubling results of the Heart and Estrogen Replacement Study, which make the decision to start hormone-replacement therapy in women with established coronary artery disease more complex than it was before those data were released. The same chapter deals elegantly with the topic of prejudice on the basis of sex in the care of women with coronary artery disease and reviews the most important data indicating that the treatment of coronary artery disease can be less aggressive in women than in men.
There are some inevitable, minor deficiencies in the book. A few chapters do not seem to be as comprehensive as might be expected. For example, Harlow's discussion of disorders of the length of the menstrual cycle was meticulous, but I was left wondering about the causes of variations in the periodicity and length of menses. Similarly, neither Parker's chapter on nutrition, weight, and body image nor Flegal's chapter on obesity reviews the role of leptin in maintaining body weight and composition or the redistribution of body fat during pregnancy, during lactation, and with aging. Nonetheless, Parker's chapter is filled with extensive and thoughtful commentary about body image and the history of society's standards for feminine beauty.
This book is more than a compendium of information about women; the authors are clearly interested in the differences between men and women and mention these differences wherever such information is available. All of us who are interested in women's health inevitably contrast the information we have about female patients with what we know about male patients. If we consider the female patient in isolation and do not modify our essentially male models of physiology and disease, we are missing an invaluable opportunity.
Some commentary on technical matters is in order. The next edition of this book might be offered in two or even three volumes, since the book is almost too heavy to be practical (it is more than 1200 pages long) -- especially given the fact that it will be consulted often and extensively. Another problem is the size of the type, which is at the lowest limit of comfort and tolerance. These are minor inconveniences, however, and the book is one of the most useful I have yet seen in the emerging field of women's health.
Marianne J. Legato, M.D.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
Review
"The chapters are uniformly well researched and written, with extensive bibliographies and relevant Web sites. ...The book could serve well as the key text for a graduate or medical school course on women's health. It is also an excellent guide for planning and developing women's health curricula for medical students and residents in internal medicine, family medicine, and obstetrics and gynecology."
-Anne W. Moulton, MD, Rhode Island Hospital, ANNALS OF INTERNAL MEDICINE (March 2001)
"This book is an unparalleled and valuable compendium of data for anyone interested in women's health. The editors have done a superb job... the book is one of the most useful I have yet seen in the emerging field of women's health."
-Marianne J. Legato, Columbia University College of Physicians and Surgeons, in THE NEW ENGLAND JOURNAL OF MEDICINE (August 2000)
"Every so often a book is published which simply
must be on your bookshelf. The new edition of
Women and Health is just such a book. ...it is refreshing to see such an excellent integration of medicine, social science and basic research. ...a monumental achievement and is testimony to how far we have come in both our understanding and our sensitivities. It is wonderful to have so much information presented so authoritatively and to have the controversies and perspectives that are inherent to the field covered so eloquently. Certainly, this is a highly recommended text."
-Jeanne Mager Stellman, Columbia University, in WOMEN & HEALTH (2000)
"This first of its kind, easy-to-read, comprehensive text is an excellent contribution to the field of women's health and the epidemiologic literature."
-DOODY'S PUBLISHING (2000)
"Editors Goldman and Hatch offer an extremely well referenced, clearly organized, comprehensive, and manageable large handbook with research reviews that will also stimulate new ideas...A must purchase for all academic libraries."
-- CHOICE (2000)
