"Extracts from "Clinical evidence": Menopausal symptoms.
BACKGROUND
Menopause begins one year after the last menstrual period. Symptoms often begin in the perimenopausal years. INCIDENCE/PREVALENCE: In the United Kingdom the mean age for the menopause is 50 years 9 months. The median onset of the perimenopause is between 45.5 and 47.5 years. One Scottish survey (of 6096 women aged 45 to 54 years) found that 84% had experienced at least one of the classic menopausal symptoms, with 45% finding one or more symptoms a problem. AETIOLOGY/RISK FACTORS: Urogenital symptoms of menopause are caused by decreased oestrogen concentrations, but the cause of vasomotor symptoms and psychological effects is complex and remains unclear.


CONCLUSIONS
Menopause is a physiological event. Its timing may be genetically determined. Although endocrine changes are permanent, menopausal symptoms such as hot flushes, which are experienced by about 70% of women, usually resolve with time. However, some symptoms, such as genital atrophy, may remain the same or worsen.


OBJECTIVE
To reduce or prevent menopausal symptoms, and to improve quality of life with minimum adverse effects.


RESULTS
Frequency and severity of vasomotor, urogenital, and psychological symptoms; quality of life.


METHODS
Clinical Evidence search and appraisal December 1999. We included only randomised controlled trials (RCTs) and systematic reviews that met Clinical Evidence quality criteria.
Rymer
J
J
Guy's, King's, and St Thomas's Medical School, London. eddie.morris@virgin.net
Morris
E P
EP
D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D052776:Female Urogenital Diseases / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009652:Norpregnenes / Q000627:therapeutic use; D011372:Progestins / Q000627:therapeutic use; D013739:Testosterone / Q000627:therapeutic use
D004967:Estrogens; D009652:Norpregnenes; D011372:Progestins; D013739:Testosterone; C027385:tibolone