Menopause

Susan R. Davis, Irene Lambrinoudaki, Maryann Lumsden, Gita D. Mishra, Lubna Pal, Margaret Rees, Nanette Santoro, Tommaso Simoncini

Abstract


Menopause is an inevitable component of ageing and encompasses the loss of ovarian reproductive function, either occurring spontaneously or secondary to other conditions. It is not yet possible to accurately predict the onset of menopause, especially early menopause, to give women improved control of their fertility. The decline in ovarian oestrogen production at menopause can cause physical symptoms that may be debilitating, including hot flushes and night sweats, urogenital atrophy, sexual dysfunction, mood changes, bone loss, and metabolic changes that predispose to cardiovascular disease and diabetes. The individual experience of the menopause transition varies widely. Important influential factors include the age at which menopause occurs, personal health and wellbeing, and each woman’s environment and culture. Management options range from lifestyle assessment and intervention through to hormonal and non-hormonal pharmacotherapy, each of which has specific benefits and risks. Decisions about therapy for perimenopausal and postmenopausal women depend on symptomatology, health status, immediate and long-term health risks, personal life expectations, and the availability and cost of therapies. More effective and safe therapies for the management of menopausal symptoms need to be developed, particularly for women who have absolute contraindications to hormone therapy


Keywords


menopause; premenopausе; classification STRAW; vasomotor symptoms; vaginal atrophy; menopausal osteoporosis

References


Soules, M.R., et al. “Executive summary: Stages of Reproductive Aging Workshop (STRAW).” Fertil Steril, 76(2001): 874–878.

Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging.” Menopause, 19(2012): 387–395.

Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging.” Fertil Steril, 97(2012): 843–851.

Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging.” Climacteric, 15(2012): 105–114.

Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging.” J Clin Endocrinol Metabolism, 97(2012): 1159–1168.

Jane, F.M., Davis, S.R. “A practitioner’s toolkit for managing the menopause.” Climacteric, 17(2014): 1–16.

Tom, S.E., Mishra, G.D. Current Topics in Menopause: a Life Course Approach to Reproductive Aging. Bentham Science Publishers Ltd (2013).

Kok, H.S., et al. “Genetic studies to identify genes underlying menopausal age.” Hum Reprod Update, 11(2005): 483–493.

Van Asselt, K.M., et al. “Heritability of menopausal age in mothers and daughters.” Fertil Steril, 82(2004): 1348–1351.

Murabito, J.M., Yang, O., Fox, C., Wilson, P.W., Cupples, L.A. “Heritability of age at natural menopause in the Framingham Heart Study.” J Clin Endocrinol Metab, 90(2005): 3427–3430.

Torgerson, D.J., Thomas, R.E., Reid, D.M. “Mothers and daughters menopausal ages: is there a link?” Eur J Obstet Gynecol Reprod Biol, 74(1997): 63–66.

Cramer, D.W., Xu, H., Harlow, B.L. “Family history as a predictor of early menopause.” Fertil Steril, 64 (1995): 740–745.

Nejat, E.J., Chervenak, J.L. “The continuum of ovarian aging and clinicopathologies associated with the menopausal transition.” Maturitas, 66(2010): 187–190.

Archer, D.F., et al. “Menopausal hot flushes and night sweats: where are we now?” Climacteric, 14(2011): 515–528.

Zervas, I.M., et al. “Additive effect of depressed mood and vasomotor symptoms on postmenopausal insomnia.” Menopause, 16(2009):837–842.

Al-Safi, Z.A., Santoro, N. “Menopausal hormone therapy and menopausal symptoms.” Fertil Steril, 101(2014):905–915.

Vivian-Taylor, J., Hickey, M. “Menopause and depression: is there a link?” Maturitas, 79(2014): 142–146.

Bay-Jensen, A.C., et al. “Role of hormones in cartilage and joint metabolism: understanding an unhealthy metabolic phenotype in osteoarthritis.” Menopause, 20(2013): 578–586.

Blumel, J.E., et al. “Menopause could be involved in the pathogenesis of muscle and joint aches in mid-aged women.” Maturitas, 75(2013): 94–100.

Nappi, R.E., Kokot-Kierepa, M. “Vaginal Health: Insights, Views and Attitudes (VIVA) – results from an international survey.” Climacteric, 15(2012): 36–44.

Nappi, R.E., Palacios, S. “Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause.” Climacteric, 17(2014): 3–9.

Clarke, B.L., Khosla, S. “Physiology of bone loss.” Radiol Clin North Am, 48(2010): 483–495.

Sapir-Koren, R., Livshits, G. “Is interaction between age-dependent decline in mechanical stimulation and osteocyte-estrogen receptor levels the culprit for postmenopausal-impaired bone formation?” Osteoporos Int, 24(2013), 1771–1789.

Shuster, L.T., Rhodes, D.J., Gostout, B.S., Grossardt, B.R., Rocca, W. A. “Premature menopause or early menopause: long-term health consequences.” Maturitas, 65(2010): 161–166.

Davis, S.R., et al. “Understanding weight gain at menopause.” Climacteric, 15(2012): 419–429.

Wallace, R.B., Sherman, B.M., Bean, J.A., Treloar, A.E., Schlabaugh, L. “Probability of menopause with increasing duration of amenorrhea in middle-aged women.” Am J Obstet Gynecol, 135(1979): 1021–1024.

Burger, H.G., Dudley, E.C., Cui, J., Dennerstein, L., Hopper, J.L. “A prospective longitudinal study of serum testosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globulin levels through the menopause transition.” J Clin Endocrinol Metab, 85(2000): 2832–2838.

Metcalf, M.G., D.Onald, R.A., Livesey, J.H. “Pituitary-ovarian function before, during and after the menopause: a longitudinal study.” Clin Endocrinol (Oxf), 17(1982): 489–494.

Davison, S.L., Bell, R., Donath, S., Montalto, J.G., Davis, S.R. “Androgen levels in adult females: changes with age, menopause, and oophorectomy.” J Clin Endocrinol Metab, 90(2005): 3847–3853.

Modi, D., Bhartiya, D., Puri, C. “Developmental expressionand cellular distribution of Mullerian inhibiting substance in the primate ovary.” Reproduction, 132(2006): 443–453.

Sowers, M.R., et al. “Anti-mullerian hormone and inhibin B in the defintion of ovarian aging and the menopause transition.” J Clin Endocrinol Metab, 93(2008): 3478–3483.

Santoro, N., et al. “Helping midlife women predict the onset of the final menses, SWAN, the Study of Women’s Health Across the Nation.” Menopause, 14(2007): 415–424.

Freeman, E.W., Sammel, M.D., Lin, H., Boorman, D.W., Gracia, C.R. “Contribution of the rate of change of antimullerian hormone in estimating time to menopause for late reproductive-age women.” Fertil Steril, 98(2012): 1254–1259.

La Marca, A., et al. “Anti-Mullerian hormone-based prediction model for a live birth in assisted reproduction.” Reprod Biomed Online, 22(2011): 341–349.

Hansen, K.R., Craig, L.B., Zavy, M.T., Klein, N.A., Soules, M.R. “Ovarian primordial and non-growing follicle counts according to the Stages of Reproductive Aging Workshop (STRAW) staging system.” Menopause, 19(2012): 164–171.

De Villiers, T.J., et al. “Global Consensus Statement on menopausal hormone therapy.” Maturitas, 74(2013): 391–392.

Furness, S., Roberts, H., Marjoribanks, J., Lethaby, A. “Hormone therapy in postmenopausal women and risk of endometrial hyperplasia.” Cochrane Database Syst Rev, 8(2012): CD000402.

Hall, E., Frey, B.N., Soares, C.N. “Non-hormonal treatment strategies for vasomotor symptoms: a critical review.” Drugs, 71(2011): 287–304.

Borrelli, F., Ernst, E. “Alternative and complementary therapies for the menopause.” Maturitas, 66(2010): 333–343.

Rossouw, J., et al. “Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative Randomised Controlled Trial.” JAMA, 288(2002): 321–333.

Utian, W.H. “Psychosocial and socioeconomic burden of vasomotor symptoms in menopause: a comprehensive review.” Health Qual Life Outcomes, 3(2005): 47.

De Villiers, T.J., et al. “Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health.” Climacteric, 16(2013): 316–337.

Rada, G., et al. “Non-hormonal interventions for hot flushes in women with a history of breast cancer.” Cochrane Database Syst Rev, 9(2010): CD004923.

Gartoulla, P., Worsley, R., Bell, R.J., Davis, S.R. “Moderate-severe vasomotor and sexual symptoms remain problematic for 60–65 year old women.” Menopause, [http://dx.doi.org/10.1097/GME.0000000000000383] (2014), last accessed 15 May 2015


GOST Style Citations


1. Soules, M.R., et al. “Executive summary: Stages of Reproductive Aging Workshop (STRAW).” Fertil Steril, 76(2001): 874–878.

2. Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging.” Menopause, 19(2012): 387–395.

3. Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging.” Fertil Steril, 97(2012): 843–851.

4. Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging.” Climacteric, 15(2012): 105–114.

5. Harlow, S.D., et al. “Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging.” J Clin Endocrinol Metabolism, 97(2012): 1159–1168.

6. Jane, F.M., Davis, S.R. “A practitioner’s toolkit for managing the menopause.” Climacteric, 17(2014): 1–16.

7. Tom, S.E., Mishra, G.D. Current Topics in Menopause: a Life Course Approach to Reproductive Aging. Bentham Science Publishers Ltd (2013).

8. Kok, H.S., et al. “Genetic studies to identify genes underlying menopausal age.” Hum Reprod Update, 11(2005): 483–493.

9. Van Asselt, K.M., et al. “Heritability of menopausal age in mothers and daughters.” Fertil Steril, 82(2004): 1348–1351.

10. Murabito, J.M., Yang, O., Fox, C., Wilson, P.W., Cupples, L.A. “Heritability of age at natural menopause in the Framingham Heart Study.” J Clin Endocrinol Metab, 90(2005): 3427–3430.

11. Torgerson, D.J., Thomas, R.E., Reid, D.M. “Mothers and daughters menopausal ages: is there a link?” Eur J Obstet Gynecol Reprod Biol, 74(1997): 63–66.

12. Cramer, D.W., Xu, H., Harlow, B.L. “Family history as a predictor of early menopause.” Fertil Steril, 64 (1995): 740–745.

13. Nejat, E.J., Chervenak, J.L. “The continuum of ovarian aging and clinicopathologies associated with the menopausal transition.” Maturitas, 66(2010): 187–190.

14. Archer, D.F., et al. “Menopausal hot flushes and night sweats: where are we now?” Climacteric, 14(2011): 515–528.

15. Zervas, I.M., et al. “Additive effect of depressed mood and vasomotor symptoms on postmenopausal insomnia.” Menopause, 16(2009):837–842.

16. Al-Safi, Z.A., Santoro, N. “Menopausal hormone therapy and menopausal symptoms.” Fertil Steril, 101(2014):905–915.

17. Vivian-Taylor, J., Hickey, M. “Menopause and depression: is there a link?” Maturitas, 79(2014): 142–146.

18. Bay-Jensen, A.C., et al. “Role of hormones in cartilage and joint metabolism: understanding an unhealthy metabolic phenotype in osteoarthritis.” Menopause, 20(2013): 578–586.

19. Blumel, J.E., et al. “Menopause could be involved in the pathogenesis of muscle and joint aches in mid-aged women.” Maturitas, 75(2013): 94–100.

20. Nappi, R.E., Kokot-Kierepa, M. “Vaginal Health: Insights, Views and Attitudes (VIVA) – results from an international survey.” Climacteric, 15(2012): 36–44.

21. Nappi, R.E., Palacios, S. “Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause.” Climacteric, 17(2014): 3–9.

22. Clarke, B.L., Khosla, S. “Physiology of bone loss.” Radiol Clin North Am, 48(2010): 483–495.

23. Sapir-Koren, R., Livshits, G. “Is interaction between age-dependent decline in mechanical stimulation and osteocyte-estrogen receptor levels the culprit for postmenopausal-impaired bone formation?” Osteoporos Int, 24(2013), 1771–1789.

24. Shuster, L.T., Rhodes, D.J., Gostout, B.S., Grossardt, B.R., Rocca, W. A. “Premature menopause or early menopause: long-term health consequences.” Maturitas, 65(2010): 161–166.

25. Davis, S.R., et al. “Understanding weight gain at menopause.” Climacteric, 15(2012): 419–429.

26. Wallace, R.B., Sherman, B.M., Bean, J.A., Treloar, A.E., Schlabaugh, L. “Probability of menopause with increasing duration of amenorrhea in middle-aged women.” Am J Obstet Gynecol, 135(1979): 1021–1024.

27. Burger, H.G., Dudley, E.C., Cui, J., Dennerstein, L., Hopper, J.L. “A prospective longitudinal study of serum testosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globulin levels through the menopause transition.” J Clin Endocrinol Metab, 85(2000): 2832–2838.

28. Metcalf, M.G., D.Onald, R.A., Livesey, J.H. “Pituitary-ovarian function before, during and after the menopause: a longitudinal study.” Clin Endocrinol (Oxf), 17(1982): 489–494.

29. Davison, S.L., Bell, R., Donath, S., Montalto, J.G., Davis, S.R. “Androgen levels in adult females: changes with age, menopause, and oophorectomy.” J Clin Endocrinol Metab, 90(2005): 3847–3853.

30. Modi, D., Bhartiya, D., Puri, C. “Developmental expressionand cellular distribution of Mullerian inhibiting substance in the primate ovary.” Reproduction, 132(2006): 443–453.

31. Sowers, M.R., et al. “Anti-mullerian hormone and inhibin B in the defintion of ovarian aging and the menopause transition.” J Clin Endocrinol Metab, 93(2008): 3478–3483.

32. Santoro, N., et al. “Helping midlife women predict the onset of the final menses, SWAN, the Study of Women’s Health Across the Nation.” Menopause, 14(2007): 415–424.

33. Freeman, E.W., Sammel, M.D., Lin, H., Boorman, D.W., Gracia, C.R. “Contribution of the rate of change of antimullerian hormone in estimating time to menopause for late reproductive-age women.” Fertil Steril, 98(2012): 1254–1259.

34. La Marca, A., et al. “Anti-Mullerian hormone-based prediction model for a live birth in assisted reproduction.” Reprod Biomed Online, 22(2011): 341–349.

35. Hansen, K.R., Craig, L.B., Zavy, M.T., Klein, N.A., Soules, M.R. “Ovarian primordial and non-growing follicle counts according to the Stages of Reproductive Aging Workshop (STRAW) staging system.” Menopause, 19(2012): 164–171.

36. De Villiers, T.J., et al. “Global Consensus Statement on menopausal hormone therapy.” Maturitas, 74(2013): 391–392.

37. Furness, S., Roberts, H., Marjoribanks, J., Lethaby, A. “Hormone therapy in postmenopausal women and risk of endometrial hyperplasia.” Cochrane Database Syst Rev, 8(2012): CD000402.

38. Hall, E., Frey, B.N., Soares, C.N. “Non-hormonal treatment strategies for vasomotor symptoms: a critical review.” Drugs, 71(2011): 287–304.

39. Borrelli, F., Ernst, E. “Alternative and complementary therapies for the menopause.” Maturitas, 66(2010): 333–343.

40. Rossouw, J., et al. “Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative Randomised Controlled Trial.” JAMA, 288(2002): 321–333.

41. Utian, W.H. “Psychosocial and socioeconomic burden of vasomotor symptoms in menopause: a comprehensive review.” Health Qual Life Outcomes, 3(2005): 47.

42. De Villiers, T.J., et al. “Updated 2013 International Menopause Society recommendations on menopausal hormone therapy and preventive strategies for midlife health.” Climacteric, 16(2013): 316–337.

43. Rada, G., et al. “Non-hormonal interventions for hot flushes in women with a history of breast cancer.” Cochrane Database Syst Rev, 9(2010): CD004923.

44. Gartoulla, P., Worsley, R., Bell, R.J., Davis, S.R. “Moderate-severe vasomotor and sexual symptoms remain problematic for 60–65 year old women.” Menopause, [http://dx.doi.org/10.1097/GME.0000000000000383] (2014), last accessed 15 May 2015





DOI: https://doi.org/10.18370/2309-4117.2015.22.77-84

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