[Age fifty and menopause. Complaints expressed and unexpressed by women. Practitioners' perception and therapeutic...

Identification of symptoms appearing at the time of menopause, and evaluation of their spontaneous expression level, connection with menopause and therapeutic impact.

Opinion survey carried out with 1229 French gynaecologists.

The classical symptoms of menopause (hot flushes, night sweats, dry vagina) are spontaneously expressed by women. Atypical symptoms of menopause (sexual, relational and neuropsychological disorders) are less expressed. They are considered by practitioners as related to menopause, but less than classical symptoms. The ageing symptoms (muscle loss, joint pain, skin ageing, and disappearance of phantasms...) are scarcely expressed by women and connected with menopause by a minority of gynaecologists. The stronger the connection with menopause is, the more the symptom justifies a hormonal treatment of menopause. Thus, when classical symptoms are present, the hormonal treatment is almost always justified but it is less justified in case of atypical symptoms, and more disputable for the ageing symptoms.

Beyond the most evident signs of menopause, several other symptoms scarcely expressed by women can justify a hormonal treatment of menopause even when the connection with menopause is not demonstrated. Improvement of menopause treatment strategy requires taking into account all these symptoms, and a hormonal substitution that might be sometimes broader than the estrogenic therapy (androgenic, for example).