Menopause

The definition of menopause is a clinical one ...and not based on a blood test.

It refers to cessation of menstrual periods for 12 months , and the usual onset is around aged 52. Women usually track their mothers however and so it is always useful to ask your Mom when she went through menopause .

In the menopause transition you may or may not have symptoms and that transition phase can last sometimes between 2-4 years .

There is little point in trying to make a frank diagnosis based on a blood test ( traditionally the FSH measurement ) in the age 50 age group as this has been shown to vary widely from 3mmol one day to 100 mmol another day and so you may be falsely reassured . Unless you are 12 months without a period , you can theoretically STILL get pregnant, so don't get caught out,

Many women may be profoundly symptomatic and be decimated by daytime & nighttime sweating and flushing . Unfortunately the bad press of 2 major trials ( Physicians Health Study & the HERS2 Study ) meant that the prescription of HRT ( hormone replacement therapy ) was halted . However the recent studies looking at pre specified group in these trials have provided great reassurance about initiating HRT in our patients today .

The position statement from the European Society of Endocrinology ( ESE) & the American Endocrine Society for example have endorsed HRT prescription in the APPROPRIATE patient .

There are unfortunately still subsets of patients in whom HRT is still contraindicated but there are other pharmacological , non hormone treatments that have been evaluated in clinical trials and that can be used as an alternate option.