Menopause

Abstract

In the United Kingdom, menopause occurs in women at around the age of 51 years, and is part of the normal ageing process. It occurs as a result of a decrease in the number of primordial follicles after the age of 40 years, but can occur prematurely in 1% of women secondary to a number of aetiologies. This chapter covers the definition, and staging, of menopause and, using recently published guidance from the National Institute for Health and Care Excellence, gives recommendations on making a diagnosis. Hot flushes and night sweats (vasomotor symptoms) are the most commonly reported symptoms, but menopause may also be associated with urogenital atrophy, and long-term consequences include osteoporosis, cardiovascular disease, and dementia. Hormone therapy is effective in reducing flushing, but it is not suitable for all women and the evidence for its benefit and long-term consequences is controversial. Non-hormonal therapies are available, but best evidence must be considered when suggesting these alternatives.