Menopause

Menopause is a physiological event in a woman’s life caused by the permanent cessation of menses. It manifests in humeral, and body changes due to loss of ovarian follicular function and aging. Menopause impacts more than half of the population with variable presentation depending on demographics and the individual’s life course. Menopause is a retrospective clinical diagnosis 12 consecutive months after the final menstrual period, diagnosis is supported by consistently elevated high follicle-stimulating hormone (FSH) levels. Menopausal transition and early menopause may be symptomatic enough to compromise a woman’s quality of life and indicate increased disease risk. Menstrual changes and vasomotor symptoms (VMS) are the most common clinical presentation. Lifestyle prescription and open dialogue are valuable first-line therapy to manage menopausal syndromes. Menopausal hormone therapy (MHT) is the first-line treatment for premature menopause, moderate to severe VMS, and genitourinary syndrome of menopause (GSM) when deemed safe. MHT is associated with the reduction of osteoporosis when initiated in early menopause. Non-hormonal pharmacotherapy is geared toward symptom management and disease risk reduction. Menopausal symptoms are often transient but may persist in 10% of women who may require life-long treatment. The risks and benefits of pharmacotherapy should be assessed periodically with patients. Further research on menopausal transition and its impact on cognition is a work in progress.