Session 3	Hormone Replacement Therapy (HRT), Quo Vadis?
Capsule	WHI has brought about a sharp decline in hormone replacement therapy (HRT/HT) in asymptomatic and symptomatic women. A key criticism of WHI is the age of the population selected, which is well above the critical age window where HT is still expected to prevent (if at all) cardiovascular disease (CVD)
	Debate: Is There Evidence for a HT critical window to Prevent Disease? Yes No Discussion
Panel Discussion	Should we continue treating well-informed, asymptomatic women? Should HT be considered as the first choice for all climacteric symptoms? Should HT be a choice in young menopausal women with mild osteoporosis? For how long should HT be given in symptomatic women? Should all women with early menopause be offered treatment with HT? Should androgens be added to HT? To whom? What are the perils? Where should we go from here?
Objectives	Upon completion of this session, the audience will learn:
	* Whether HT can prevent CVD * About the critical window, and what proof of its existence * Whether it is still customary to prescribe HT, and to whom * If HT is a must in premature menopause? * The place of androgens in HT

Session 4	Family Planning
Capsule	New compound promises to diversify female choice, but do they all deserve the self "claim to fame"?
Hot Controversies	Expert Opinions on:
	Do we have an optimal estrogen (E) or progesterone (P) for oral contraceptive? What do we expect from optimal E or P? What are the gaps? Is nomegestrol acetate an optimal P? Does CMA/ethinyl estradiol provide any advantages beyond contraception? Does drosperinone offer a solution beyond reproductive years? What do we expect from emergency contraception? Are they all to our expectation? Progesterone-only contraception: What are the indications?
Objectives	Upon completion of these sessions, the audience will learn:
	* Disadvantages and advantages of current contraceptive methods * The ideal E and P? What is available * New compounds: Whether they offer any advantages

Session 5	What is in the Pipeline for Hypoactive Sexual Desire Disorder (HSDD)?
Capsule	The complexity of female sexual response probably explains why HSDD, that includes physical, psychological and hormonal factors, was found to be so common. Despite being common, controversy on diagnosis and treatment continues. According to the 1999 AMA survey, over 40% of women are affected, complaining mainly of low sexual desire, difficulty reaching orgasm, insufficient lubrication and painful coitus. While local lubricants, estrogens and systemic estrogens, and androgens may be helpful in certain situations, the need to develop the armamentarium to cover other causes of HSDD is clear. What can we expect in coming years?
	Debate: Should HSDD be Medically Treated? Proposition : Sexuality of women is complex, diagnosis is unclear, and treatments fail to meet expectations Opposition: Treatments should be individualized when symptoms cause distress Discussion
	Testosterone always with Estrogens?
	Flibanserin: What future does it offer?
Objectives	To acquire knowledge about the following:
	* Classification and prevalence of HSDD * The differences in etiology of SD * Clinical efficacy and safety of testosterone and flibanserin * Future options

Session 6	Serum Estrogen Receptor Modulators (SERM's): Present and Future
Capsule	The ideal SERM prevents osteoporotic fractures, decreases breast cancer risk, and improves cardiovascular risk, with no or minimal side effects: Where do we stand today?
	Debate: SERM's: The Future of Menopausal Treatment? Proposition : Raloxifene is a class on its own and the future of SERM's is bright Opposition: It is not easy to find a candidate for SERM's, since there are better alternatives Discussion
Objectives	To acquire knowledge about the following:
	* Clinical trials with raloxifene * New SERM’s approved * The benefit and safety of SERM's * Which SERM for which patient

Session 7	Postmenopausal Osteoporosis
Capsule	The usual patients with low bone mineral density and fracture risk who are seen by a gynecologist are often younger than 65 years, while research on drugs is undertaken on women over this age
	Debate: SERM's: Should we Treat Women with Low Bone Mineral Density who are Younger than 65 Years, and How? Proposition : Evidence for the effectiveness of drugs at this age is lacking, and treatment is not cost-effective Opposition: There is enough experience to manage these patients, but therapy should be individualized Discussion
	Should we test and treat premenopausal women with osteoporosis?
Objectives	To acquire knowledge of the following:
	* DEXA indication * Risk factors and prevalence of osteoporotic fractures in women over 65 years * Fracture index in this age group * Risk factors and prevalence of osteoporotic fractures in premenopausal women

Session 8	Obesity in Menopausal Women
Capsule	Obesity is a major risk factor for older women: Can we prevent it?
	Obesity: The silent killer that impacts menopausal treatment?
	Impact of obesity on menopausal symptoms?
	Menopausal women with polycystic ovaries (PCO): What do we know and what don't we know?
	HRT: Should all menopausal women with metabolic syndrome be treated?
Objectives	To acquire knowledge regarding the following :
	* The interrelationships between obesity and menopause * Impact of obesity on menopause treatment * PCO on menopause transition * The relationship between metabolic syndrome and the need for HR

Session 9	Women and Ovarian Cancer: From Conception to Diagnosis
Capsule	Early diagnosis of ovarian cancer can improve prognosis!
	Pelvic mass in pregnancy: When do we need to intervene?
	Pelvic mass risk assessment: Who is at high risk for ovarian cancer?
	Ovarian cancer screening: The European perspective
	Ovarian cancer screening in the breast cancer (BRCA) patient
	Zona pellucida (ZP) and ovarian cancer

Session 10	Cervical Cancer and Human Papilloma Virus (HPV)
Capsule	Does vaccination mark the end of cervical cancer?
Hot Controversies	Expert Opinions on:
	The difference between quadrivalent or bivalent HPV vaccine The efficacy of vaccination in adolescents and women over 30 years of age? For how long does immunization provide immunity Whether current knowledge implies immunization against cancer, or merely precancerous stages? If we are certain that vaccination prevents all cervical cancers Is vaccination cost-effective Protection of vaccines against other HPV subtypes, as well as HPV 16 and 18, and whether there is cross reactivity The ages to be considered for vaccination Is there concern that migration to other types of HPV will become the main cause of HPV-related cervical cancer Should males be vaccinated? Is the Pap smear obsolete in immunized patients? Do we still need HPV-DNA typing? Routine inclusion of colposcopy in a pelvic examination. If so, how often? Booster after 10 years: Pros and Cons

 

Session 11	Ovarian Cancer
Capsule	Adjuvant chemotherapy is a mainstay of ovarian cancer treatment. Recent data suggest that intraperitoneal or neoadjuvant (primary) chemotherapy might be superior to standard i. v. chemotherapy following cytoreductive surgery.
	Debate: Proposition: Intraperitoneal  chemotherapy       Pro / Con Discussion
	Debate: Neodjuvant Chemotherapy for ovarian cancer      Pro / Con Discussion

Objectives	Upon completion of this debate, the audience will learn:
	* Is intraperitoneal chemotherapy for ovarian cancer better than i. v. application? * If so, in which patients? * Is neoadjuvant (primary) chemotherapy followed by interval cytoreductive surgery better than surgery followed by chemotherapy? * If so, in which patient group?

Session 12	Endometrial Cancer
Capsule	Pelvic and paraaortic lymphadenectomy (LNE) is part of the FIGO staging system. Recent prospective randomized trials suggest that LNE might not improve survival in endometrial cancer. For decades external beam pelvic radiotherapy has been used as adjuvant therapy in endometrial cancer. Recent randomized trials suggest that this approach does not improve survival.
	Debate: Role of Lymphadenectomy  for  Endometrial Cancer       Pro / Con Discussion
	Debate: Role of Radiotherapy for Endometrial Cancer      Pro / Con Discussion

Objectives	Upon completion of this debate, the audience will learn:
	* Has LNE a therapeutic effect in endometrial cancer? If so, in which patients? * Has LNE a benefit in directing adjuvant therapy? * Does external beam pelvic radio therapy improve local control in EC patients better than vaginal brachy therapy? * Does it improve overall or disease specific survival? * Are multimodal adjuvant strategies more efficacious than radiotherapy?

Session 13	Operative Procedures: Tricks of the Trade
Capsule	Results of surgery depend on choosing the right procedure for the right patient, and recognizing the pitfalls and risks of the operation. Good results also depend on a meticulous technique. How can all these be improved?
	Creation of a neovagina: Techniques and pitfalls
	Surgery on the external female genitalia: A cosmetic procedure or by indication? Techniques and pitfalls
	How to reduce the risk to future fertility during myomectomy procedure? Techniques and pitfalls
Objectives	Upon completion of this session, the audience will learn:
	* A new technique for creation of a neovagina * The new surge in popularity of cosmetic genital surgery * Prevention of complications during myomectomy can be achieved

Session 14	Evidence-Based Medicine (EBM): "Holy Grail" or More Doubts?
Capsule	This debate is certain to continue: Evidence-based medicine (EBM) has become the new “Holy Grail” of clinical decision-making. Of course, EBM is, however, only as good (or bad) as the best available evidence (BAE). BAE, in turn, is dependent on quality of published studies, which are often weak because of poor study design, flawed statistical evaluations, or outright fraud. Meta-analyses of randomized clinical trials (as propagated by Cochrane) have become a favored tool in establishing BAE, often overlooking that many of these trials are seriously underpowered and, therefore, do not allow for the conclusions they claim. EBM may, therefore, possibly be viewed with the same healthy degree of skepticism as that for IBM programmers who brought “garbage in, garbage out!” to the early days of software development.
	Debate: EBM: What's Next? Proposition : EBM represents the only valid approach towards medical decision making Opposition: EBM has limited value in daily clinical care and cannot replace clinical judgment Discussion
	Can we really conduct efficacy trials in intracytoplasmic sperm injection (ICSI) with pregnancy as the outcome when the conclusion is likely to be worthless because of postrandomization manipulation?
Objectives	Upon completion of this debate, the audience will learn:
	* How BAE is established * Advantages and limitations of BAE * Levels of evidence and how they are established * Different clinical study formats and their respective advantages and disadvantages

Session 15	Estrogen (E) and Progesterone (P) for Pelvic Pathology
Capsule	Estrogens and progestins are emerging as new treatments for various pathological pelvic conditions
	Are estroprogestins a good treatment for uterine fibroma?
	Adenomyosis: Difficult diagnosis and treatment
	Premenstrual disorders: Are the estroprogestins the best treatment?
Objectives	To acquire knowledge regarding the following :
	* Possible noninvasive treatment of fibroids * Management of adenomyosis * Role of hormones in premenstrual syndrome (PMS)

Session 16	Polycystic Ovarian Syndrome (PCOS)
Capsule	As the relationships among PCOS glucose intolerance, insulin resistance, obesity and metabolic syndrome are deciphered, the need for the gynecologist to be updated increases. The question is when does PCOS start and whether it is possible to contain it earlier? The role played by the primary gynecologist in limiting this very common endocrinopathy is of prime interest for patients and physicians alike!
	Glucose metabolism and infertility: Should all patients be tested?
	Debate: Should Metformin be Routinely Used in Infertile Patients with PCOS? Pros: Metformin during stimulation improves pregnancy outcome Cons: Systemic review does not show consistent effect! Discussion
	Obesity: Should all gynecological patients be advised? From whom?
Objectives	Upon completion of this debate, the audience will learn:
	* About the risk for glucose intolerance in PCOS patients * Whether we should actively look for diabetes in asymptomatic patients * Which tests are the most appropriate * The new role of the gynecologist as a consultant in obesity and diet