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

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]

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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