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Menopause is a normal physiological condition and most women do not need treatment for the menopause. At least ten percent of women however may seek medical advice for relief of symptoms of menopause. Mild symptoms may be managed at home but more severe symptoms and associated medical conditions need attention.
Menopause is associated with several emotional and physical changes. There is initial menstrual irregularity followed by a complete cessation of menstruation. A slight increase in the amount of menstrual blood loss is also common. For many women missing three consecutive months of periods or an average cycle length longer than 42 days predicts impending menopause. Approximately 10% of women have an abrupt cessation of periods.
Some of the common symptoms include:-
Investigations are of limited value in diagnosis of menopause and it is detected clinically. Raised blood levels of FSH may provide clues to diagnosis of menopause. Women with suspected premature menopause or following a hysterectomy need assessment of FSH to detect premature ovarian failure.
Treatment options of menopause include hormone replacement therapy (HRT), tibolone (hormonal therapy), clonidine, vaginal lubricants and antidepressants.
There are three main types of HRT – estrogen-only (for women who have had their womb and ovaries removed), combined HRT (with both estrogen and progesterone) and continuous HRT for long term use in postmenopausal women. HRT is also available as cream or gel, skin patches or implants to be applied locally. They can be taken as pills as well. HRT is associated with numerous side effects like weight gain, breast tenderness, nausea, headaches and mood changes.