Menopausal Symptoms and Their Management

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Key points

  • The late menopause transition (when women begin to experience 60 or more days of amenorrhea) is the point in time when hot flashes, adverse mood, vaginal dryness, and sleep complaints accelerate in prevalence.

  • The duration of hot flashes (vasomotor symptoms) maybe longer than previously thought, with newer studies indicating durations of as long as 10 or more years.

  • There are nonestrogenic alternatives that are now approved by the US Food and Drug Administration (FDA) for the treatment of

Epidemiology

Population-based, epidemiologic studies of menopausal women have recently been conducted and are yielding reliable and consistent information about the incidence, prevalence, and severity of several menopausal symptoms. However, the field is relatively new, and it is likely that there are subsets of women who are more or less vulnerable to particular symptoms or sets of symptoms. In 2005, a state-of-the-science conference on menopausal symptoms was convened, with a worldwide panel of expert

Summary

The menopausal transition and postmenopausal years are associated with significant symptoms. Vasomotor symptoms and adverse mood often demonstrate improvement after a woman is postmenopausal, whereas sleep complaints, vaginal dryness/dyspareunia, and cognitive complaints tend to persist or worsen in association with aging. There is evidence that the changing hormone milieu, with significant changes in estrogen levels, can affect the brain systems involved in mood and cognition. Patients often

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References (54)

  • S.M. Phillips et al.

    Effects of estrogen on memory function in surgically menopausal women

    Psychoneurodocrinology

    (1992)
  • S.M. Phillips et al.

    Variations in memory function and sex steroid hormones across the menstrual cycle

    Psychoneurodocrinology

    (1992)
  • M.F. Folstein et al.

    “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician

    J Psych Res

    (1975)
  • S. Sherman et al.

    NIH State-of-the-Science Conference on Management of Menopause-Related Symptoms, March 21–25, 2005

    Am J Med

    (2005)
  • L. Cohen et al.

    Risk for new onset of depression during the menopausal transition: the Harvard study of moods and cycles

    Arch Gen Psychiatry

    (2006)
  • J.R. Guthrie et al.

    Health care-seeking for menopausal problems

    Climacteric

    (2003)
  • E.W. Freeman et al.

    Symptoms associated with menopausal transition and reproductive hormones in midlife women

    Obstet Gynecol

    (2007)
  • ACOG practice bulletin No. 141: management of menopausal symptoms

    Obstet Gynecol

    (2014)
  • G.A. Greendale et al.

    Effects of the menopause transition and hormone use on cognitive performance in midlife women

    Neurology

    (2009)
  • S.D. Reed et al.

    Premenopausal vasomotor symptoms in an ethnically diverse population

    Menopause

    (2014)
  • M.C. Politi et al.

    Revisiting the duration of vasomotor symptoms of menopause: a meta-analysis

    J Gen Intern Med

    (2008)
  • N.F. Col et al.

    Duration of vasomotor symptoms in middle-aged women: a longitudinal study

    Menopause

    (2009)
  • E.B. Gold et al.

    Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: Study of Women's Health Across the Nation

    Am J Public Health

    (2006)
  • L. Kligman et al.

    Management of hot flashes in women with breast cancer

    Curr Oncol

    (2010)
  • S. Leiblum et al.

    Vaginal atrophy in the postmenopausal woman. The importance of sexual activity and hormones

    JAMA

    (1983)
  • J.E. Rioux et al.

    17beta-estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis

    Menopause

    (2000)
  • S.L. Hendrix et al.

    Effects of estrogen with and without progestin on urinary incontinence

    JAMA

    (2005)
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    N. Santoro has investigator-initiated grant support from Bayer and stock options in Menogenix. C.N. Epperson and S.B. Matthews have nothing to disclose.

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