[Climacteric symptomatology: relation with hormone levels and trophic features of the external genitalia]

During the last decade the development of a great amount of knowledge about the menopause has allowed to establish almost standardized hormonal treatments in order to prevent its symptoms and its late sequelae. Nevertheless, up to now the relationship between typical climacteric symptoms and the actual risk of late sequelae has not been assessed. The climacteric symptoms have hence been related to the involutional aspects of the external genitalia and to the levels of the sex steroids and gonadotropin hormones. An inverse relation between neuropsychical manifestations (insomnia, anxiety, depression, reduced memory, reduced libido) and 17-beta-oestradiol and progesterone levels has been shown. On the contrary, FSH and LH levels showed a direct relationship with neurovegetative symptoms. The relationship between the involutional aspects of the external genitalia and the atrophy related and the neuropsychical symptoms shows the need to evaluate these classes of symptoms, which appear to be most related to oestrogen and progesterone deprivation, in decision making toward hormonal replacement therapy.