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Published on: February 12, 2018
The menopause.
G A Greendale1, N P Lee, E R Arriola
1Division of Geriatrics, School of Medicine, Center for Health Sciences, University of California, Los Angeles 90095-1687, USA.
Lancet (London, England)
|February 24, 1999
Summary
Menopause, the cessation of ovarian function, typically occurs around age 51. Hormone replacement therapy offers benefits for symptom relief and chronic disease prevention, but requires personalized decision-making.
Area of Science:
- Reproductive endocrinology
- Gerontology
- Women's health
Background:
- Menopause is defined as 12 months of amenorrhea due to permanent ovarian function cessation, with a mean age of 51.
- The perimenopause, a transition period preceding menopause, involves changing ovarian function and symptom onset, like hot flashes.
- The physiology and clinical aspects of the menopausal transition are not fully understood.
Purpose of the Study:
- To review the evidence for associations between menopause and various symptoms and diseases.
- To discuss hormone replacement therapy (HRT) for symptom relief and chronic disease prevention.
- To highlight the importance of individualized HRT decisions based on benefits, risks, and patient preferences.
Main Methods:
- Review of existing evidence on menopause-related symptoms and diseases.
- Analysis of hormone replacement therapy (HRT) indications, regimens, and complications.
- Examination of observational data on HRT and all-cause mortality.
Main Results:
- Observational studies suggest HRT use is associated with a 30-50% reduction in all-cause mortality in postmenopausal women.
- HRT can be used for symptom management and chronic disease prevention, with varying doses and routes.
- Unexpected vaginal bleeding during HRT may indicate endometrial hyperplasia, necessitating careful monitoring.
Conclusions:
- Postmenopausal hormone therapy is a complex intervention with both positive and negative health effects.
- Individualized decision-making for HRT is crucial, involving a joint discussion between women and healthcare providers.
- Patient preferences regarding health outcomes should guide the choice to use hormone replacement therapy.
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