[Laboratory follow-up in menopause]

Menopause is not an illness. Nevertheless, nowadays, it is medically approached. We know now with precision the consequences of the estrogen deficiency on about fifty woman's wellbeing, on her metabolism, her cardiovascular system, her bones. A substitutive hormonal therapy is more and more often proposed in order to correct the immediate functional disorders and to prevent the long term consequences (cardiovascular diseases and osteoporosis especially). What is the place of biology in the follow-up of a menopausal patient? Even if clinic observation is predominant for the diagnosis of menopause, plasmatic FSH and estradiol assays are of precious aid in particular cases (hysterectomised patients for example). Whether or not we consider a substitutive hormonotherapy, menopause installation is a good opportunity for detection of metabolic diseases, beginning often in this part of life or clinically suspected. Before beginning a substitutive treatment, biological assays contribute to define the patients's metabolic profile in order to adjust the choice between oral or percutaneous estrogenotherapy and to detect contra-indications. The biological markers of osteoporosis risk are objective arguments to incite indecisive women for beginning or for continuation of a treatment. Under hormonotherapy, plasmatic estradiol's assay should aid to confirm the correct adequation of substitutive doses, but in practice it is not much used: clinical examination is generally adequate to detect under or over dosage. In post-menopause, wether or not she receive a substitutive hormonal therapy, every women should have the benefit of a regular biological follow-up, in the same way as a mammography and cervical smears are recommended. Age being by oneself the main factor for metabolic risk, early detection and early correction of abnormalities will be the main part to ensure quality, for women and also for men, of the second half time of their life.