Gaps in menopause knowledge

The average middle aged woman goes through a volatile period of endocrine fluctuations as she passes through menopause and the stages that precede and follow it. Ovarian hormones are steroid hormones. They readily cross the cell and nuclear membranes and influence transcription of numerous genes. Such influences are tissue specific and state specific. In short, changes in ovarian hormones mean that a women will experience changes in her entire body systems. When an individual woman's constitutional factors, pathologic states, medications, environmental exposures are taken into consideration, the integrated changes become too complex to predict. Inter-study sampling differences with the complexities in the backdrop may have led to conflicting conclusions in menopause research. This paper reviews some of the controversies in the care of menopausal women.