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Menopause

Jill Patton, DO and Christiana Shoushtari, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Natural menopause: defined retrospectively after 12 consecutive months of amenorrhea in a nonpregnant woman ≥40 years of age; mean age of 51 years

    • Results from loss of ovarian activit...

DIAGNOSIS

HISTORY

  • Cessation of menses:

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

  • Vasomotor symptoms reported by 80%:

    • Sudden fee...

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 (1). 
  • The pr...

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
North American Menopause Society. The 2012 hormone therapy position statement of the North American Menopause Society. Menopause.  2012;19(3):257–271. [View Abstract on OvidMedline]
2
M...

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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