Menopause
Evaluation
General—menopause is the lasting termination of menstruation.
Etiology—age at menopause is thought to be attributable to genetics.
Epidemiology—mean age of occurrence is 51; therefore, the average woman will live 30 years beyond menopause.
Menopausal symptoms and treatment options
Vasomotor symptoms
Clinical—hot flashes (“flushes”) (worsenwith fatigue/stress), night sweats, insomnia
Usually last 1 to 2 years after menopause, but in some they can last a decade.
Mechanism—likely due to estrogen withdrawal rather than low estrogen blood levels
Epidemiology—affect approximately 75% of perimenopausal females
Treatment options
Hormonal therapy
Systemic estrogen
Progestin alone—medroxyprogesterone (Provera), megestrol (Megace)
Centrally acting agents
Clonidine (Catapres-TTS) patch—0.1 mg per week
Urogenital symptoms
Clinical—vaginal dryness, pruritus, dyspareunia (painful coitus), urethral irritation, and urinary tract infection
Mechanism—without estrogen, urogenital tissues atrophy; hence, vaginal thinning, and so on
Treatment options
Hormonal therapy
Systemic estrogenRelated posts:
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