Menopausal symptomsBMJ 2000; 321 doi: http://dx.doi.org/10.1136/bmj.321.7275.1516 (Published 16 December 2000) Cite this as: BMJ 2000;321:1516
- Janice Rymer, senior lecturer and consultant in obstetrics and gynaecologya,
- Edward P Morris, senior registrar and honorary lecturer ()b
- a Guy's, King's, and St Thomas's Medical School, London,
- b HRT Research Unit, Guy's Hospital, London SE1 9RT
- Correspondence to: E P Morris
Definition: Menopause begins one year after the last menstrual period. Symptoms often begin in the perimenopausal years.
Incidence/prevalence: In the United Kingdom the mean age for the menopause is 50 years 9 months. The median onset of the perimenopause is between 45.5 and 47.5 years. One Scottish survey (of 6096 women aged 45 to 54 years) found that 84% had experienced at least one of the classic menopausal symptoms, with 45% finding one or more symptoms a problem.1
Likely to be beneficial:
Aetiology/risk factors: Urogenital symptoms of menopause are caused by decreased oestrogen concentrations, but the cause of vasomotor symptoms and psychological effects is complex and remains unclear.
Prognosis: Menopause is a physiological event. Its timing may be genetically determined. Although endocrine changes are permanent, menopausal symptoms such as hot flushes, which are experienced by about 70% of women, usually resolve with time.2 However, some symptoms, such as genital atrophy, may remain the same or worsen.
Aims: To reduce or prevent menopausal symptoms, and to improve quality of life with minimum adverse effects.
Outcomes: Frequency and severity of vasomotor, urogenital, and psychological symptoms; quality of life.
Methods: Clinical Evidence search and appraisal December 1999. We included only randomised controlled trials (RCTs) and systematic reviews that met Clinical Evidence quality criteria.
Competing interests JR has been sponsored to attend conferences by Organon, Solvay Healthcare Ltd, Wyeth, Novo Nordisk, and Janssen-Cilag and has received research funding from Organon and consultancy fees from Organon, Wyeth, and Janssen-Cilag. EPM has been sponsored to attend conferences and has received speaker's fees from Eli Lilly, Organon, and AstraZeneca.
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