Research opportunities for reducing the burden of menopause-related symptoms

The National Institutes of Health (NIH) State-of-the-Science (SoS) Conference on the Management of Menopause-Related Symptoms identified a number of important gaps in our understanding of the natural history of the menopausal transition and the etiology and course of menopause-related symptoms. Updated information is needed from prospective studies of reproductive aging in diverse populations of women, especially of younger women in their mid reproductive years, to better understand the underlying biology of ovarian aging as well as the etiology of conditions leading to premature spontaneous or surgical menopause. To facilitate this goal, a number of methodologic issues must be addressed, including the development of (1) consensus definitions of menopause-related terms and stages, and (2) standard measures and methods for assessing progression through the menopausal transition and related symptoms and outcomes. Estrogen therapy is highly efficacious in relieving menopausal symptoms and was the treatment of choice until 2002, when findings of unexpected harm from the Women's Health Initiative (WHI) were published. Consequently, there has been a burgeoning interest in a number of botanical products as well as other complementary and alternative medicine strategies, such as acupuncture, magnets, homeopathy, and behavioral regimens. However the benefits of most of these strategies are either very limited or equivocal, and related safety issues are poorly understood. Future research is needed to identify new efficacious strategies, to understand side effects and safety issues, and to provide new options to women who are burdened by bothersome menopause-related symptoms.