Menopause

 

Menopause describes the changes to the body occurring with the end of ovulation.

The mean age of onset is 51 for Canadian women. With an average life span of 81 years, a woman will spend over 1/3 her life in menopause.

 

Clinical Features of Menopause

urogenital tract: atrophy, vaginal dryness, incontinence.

blood vessels and heart: vasomotor instability, hot flashes, increased risk of CVD

bone: bone loss, fractures, loss of height

brain: depression, mood swings, memory loss

 

Management

Encourage healthy living: exercise, smoking cessation, and a balanced diet.

 

Diet

Important to supplement with 1500 mg/800 IU daily.

 

Hormone replacement therapy (HRT)

Routine use of HRT is no longer recommended due to increased risk of breast cancer, CAD, stroke, and pulmonary embolism. However, risks of osteoporotics fractures and colorectal cancer appear to decrease, along with the symptoms of estrogen deprivation.

Accordingly, a thorough discussion of the patient's wishes and desires, history, symptoms, and risk factors is very important.

 

Venlafaxine, SSRI, or gabapentin can all be used to help with vasomotor instability.