Ed Jo Ann Rosenfeld

Cambridge University Press, £47.50, pp 613 

ISBN 0 521 78833 1

Rating:

The term "women's health" is best used to describe an approach to the care of a woman by her health providers rather than to denote a specialty. Editor Jo Ann Rosenfeld sets out to consider "the woman and her health needs in her position in her life cycle, her family, and society."

Her book is well organised and has sections on preventive care, sexuality, genitourinary medicine, breast disorders, psychological disorders, and common medical problems. Eating disorders, breast conditions, urinary incontinence, female cancers, and depression and premenstrual syndrome get special emphasis. There are separate chapters on lifestyle issues such as smoking and exercise. Of particular value are the chapters on issues with lesbian patients, woman battering, and breast disorders.

However, although this is a comprehensive text on women's health, it is neither useful as a handbook (being too large to carry) nor does it take the current evidence based approach. Its authors refer predominantly to organisational publications, position statements, and reviews for specific recommendations, often neglecting to identify the original or landmark studies. They rarely give the levels of evidence for making clinical recommendations or grade their recommendations. Also, there is little evaluation of the quality of the studies that they reference.

There are notable exceptions, however: the chapter on breast cancer screening evaluates the evidence and grades some of its recommendations, and the chapter on lesbian patients includes excellent clinical recommendations and approaches with a clear reference to the lack of quantity and quality of much of the data and the need to depend upon "best knowledge."

This book points out the societal as well as the biological differences between men and women. As such it makes a welcome addition to the office library of any doctor interested in women's health. I recommend it as a well referenced text rather than as an evidence based handbook.

Debra R Judelson, medical director. 

Women's Heart Institute, Cardiovascular Medical Group of Southern California Judelson{at}cvmg.com