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Menopause

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Natural menopause: defined retrospectively after 12 consecutive months of amenorrhea in a nonpregnant woman ≥40 years of age:

    • Results from loss of ovarian activity

    • Not associated wit...

DIAGNOSIS

HISTORY

  • Cessation of menses:

    • Generally preceded by a period of irregular cycles with heavy vaginal bleeding followed by diminished vaginal bleeding

  • Vasomotor symptoms: sudden feeling of warmt...

TREATMENT

MEDICATION

First Line

Hormone therapy (HT): developing an individual risk–benefit profile is essential. Treatment goal is to minimize menopausal symptoms to improve quality of life. 
  • The primar...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

A DEXA scan is indicated at age 65 years for all women and for younger women with risk equivalent to age 65 years. 

DIET

Calcium-rich diet and vit...

REFERENCES

1
Purdue-Smithe AC, Whitcomb BW, Szegda KL, et al. Vitamin D and calcium intake and risk of early menopause. Am J Clin Nutr.  2017;105(6):1493–1501. [View Abstract on OvidMedline]
2
Macl...

ADDITIONAL READING

  • ACOG Practice bulletin no. 141: management of menopausal symptoms. Obstet Gynecol.  2014;123(1):202–216. [View Abstract on OvidMedline]

  • Mørch LS, Løkkegaard E, Andreasen AH, et...

CODES

ICD10

  • E28.310 Symptomatic premature menopause

  • N95.1 Menopausal and female climacteric states

  • Z78.0 Asymptomatic menopausal state

  • E89.40 Asymptomatic postprocedural ovarian failure

  • E28.319 Asymptomati...

CLINICAL PEARLS

  • Menopause is usually diagnosed by history alone.

  • HT can be used short term for relief of moderate to severe vasomotor symptoms but should not be used for long-term prevention of CVD.

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