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Feature Article

Navigating the menopause

Fiona Jane, Susan R Davis

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Abstract

During or after the menopause transition, women may present with a constellation of mild to severe symptoms. Treatment is intended to alleviate symptoms that impair quality of life and to optimise health and wellbeing.

Key Points

  • Women may present during or after the menopause transition with problems such as menstrual irregularity, hot flushes and night sweats, change in sleep quality, depression and anxiety, arthralgia and symptoms of urogenital atrophy.
  • Diagnosis of natural menopause is based on change in menstrual flow and eventually amenorrhoea, with the last menstrual period being the date of menopause. It is a retrospective diagnosis after 12 months of amenorrhoea.
  • Diagnosis of premature ovarian failure requires oestradiol and gonadotrophin levels to be measured.
  • Hormone levels are not informative for diagnosing menopause in women using systemic combined contraception but may be useful for women who have had a hysterectomy or endometrial ablation or have a progestin intrauterine device in situ.
  • Treatment goals for the menopausal woman are to alleviate symptoms that impair quality of life and to optimise health and wellbeing.

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