title: The treatment of climacteric symptoms.
abstract: BACKGROUND
  Peri- and postmenopausal women commonly suffer from climacteric symptoms. In this article, we provide information to help physicians recognize climacteric symptoms and treat them appropriately.
  
  
  METHODS
  The information presented here is based on a selective search of the literature for pertinent articles that appeared from 2008 to early 2011, including the German S3 guideline on hormone therapy (HT) during and after menopause, which was published in 2009.
  
  
  RESULTS
  Perimenopausal women often suffer from climacteric symptoms. Typically, women undergoing menopause complain of heat waves and vaginal dryness. According to randomized controlled trials as well as national and international guidelines, HT is the most effective treatment for vasomotor symptoms and also improves vulvovaginal atrophy; for the latter indication, HT is preferably administered locally. Vaginal estrogen therapy lowers the frequency of recurrent urinary tract infections. However, HT is associated with an increased risk for a number of diseases, including stroke, thromboembolic events, gall-bladder diseases, and breast cancer. Alternative treatments for climacteric symptoms have little or no efficacy.
  
  
  CONCLUSIONS
  HT should only be used to treat climacteric symptoms after extensive patient education about its benefits and risks. Participatory decision-making is desirable. The generalized use of HT by all women with climacteric symptoms cannot be recommended.
authors.affiliation: Department of Obstretics and Gynecology, University Medical Center Regensburg, Germany. olaf.ortmann@klinik.uni-regensburg.de
authors.forename: Olaf
authors.initials: O
authors.lastname: Ortmann
authors.forename: Claus
authors.initials: C
authors.lastname: Lattrich
mesh_terms: D001943:Breast Neoplasms / Q000139:chemically induced* / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000517:prevention & control; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000379:methods*; D004967:Estrogens / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D005705:Gallbladder Diseases / Q000139:chemically induced* / Q000517:prevention & control; D006801:Humans; D017698:Postmenopause / Q000187:drug effects*
chemical_list: D004967:Estrogens