Clinical Review

Extracts from “Clinical Evidence”

Menopausal symptoms

BMJ 2000; 321 doi: 10.1136/bmj.321.7275.1516 (Published 16 December 2000)
Cite this as: BMJ 2000;321:1516

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

  1. Janice Rymer, senior lecturer and consultant in obstetrics and gynaecologya,
  2. Edward P Morris, senior registrar and honorary lecturer (eddie.morris{at}virgin.net)b
  1. a Guy's, King's, and St Thomas's Medical School, London,
  2. b HRT Research Unit, Guy's Hospital, London SE1 9RT
  1. Correspondence to: E P Morris

    Background

    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

    Interventions

    • Beneficial:

      Oestrogens

      Tibolone

    • Likely to be beneficial:

      Progestogens

      Clonidine

    • Unknown effectiveness:

      Phyto-oestrogens

      Testosterone

      Antidepressants

    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.

    Footnotes

    • 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.


    • Embedded Image

    • If you are interested in being a contributor or peer reviewer for Clinical Evidence please visit the Clinical Evidence website (http://www.clinicalevidence.com/)

    • Clinical Evidence is published by BMJ Publishing Group. The fourth issue will be available this month, and Clinical Evidence will be updated and expanded every six months. Individual subscription rate, issues 4 and 5 £75/$US110/$C160; institutional rate £160/ $US240/$C345; student rate £55/$US80/$C120. For more information including how to subscribe, please visit the Clinical Evidence website at www.clinicalevidence.com/

      Access to the full text of this article requires a subscription or payment

      Subscribe

      Article access

      Article access for 1 day

      Purchase this article for £20 $30 €32*

      The PDF version can be downloaded as your personal record

      * Prices do not include VAT

      Rapid responses

      THIS WEEK'S POLL

      BMJ most popular