Gonadal system - menopause
Description
- Final menstrual period, diagnosed retrospectively after 12 months of amenorrhoea with no other cause
| Term | Definition |
|---|---|
| Perimenopause | Cycle variability >=7 days -> to 12 months after FMP. Fertility is reduced but not zero - contraception still needed |
| Menopause | 12 months amenorrhoea; median age 51-52 in Australia |
| Early menopause | 40-45 years |
| Premature ovarian insufficiency (POI) | <40 years - a different disease with a different treatment imperative |
| Surgical/iatrogenic | Bilateral oophorectomy, chemotherapy, pelvic radiotherapy - abrupt, more severe symptoms |
Symptom domains
- Vasomotor - hot flushes, night sweats; ~80% of women, median duration ~7-10 years (longer if onset in early perimenopause, and in Black and Hispanic cohorts)
- Genitourinary syndrome of menopause (GSM) - vaginal dryness, dyspareunia, urinary urgency, recurrent UTI
- *Progressive and does not remit* - unlike flushes
- Sleep disturbance, mood (new or recurrent depression, especially perimenopause), brain fog
- Musculoskeletal - arthralgia, frozen shoulder
- Accelerated bone loss - fastest in the 1-2 years around the FMP
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