Objective: Perimenopause refers to the time period around menopause. The cl
inical goal of perimenopause therapy is to optimize the woman's health duri
ng and after this transitional period. However, clinical trial data are ins
ufficient to establish evidence-based treatment standards regarding the dia
gnosis and treatment for both acute and chronic symptoms and conditions of
perimenopausal women. Accordingly, The North American Menopause Society (NA
MS) sought to develop a consensus opinion on clinical approaches to perimen
opause,
Design: NAMS held a closed conference of experts in the field to review the
current literature, share clinical experience, and make recommendations ab
out how to help women achieve optimal health throughout perimenopause, The
proceedings of the conference were used to assist the NAMS Board of Trustee
s in developing this consensus opinion of the Society.
Results: On the basis of the conference proceedings, NAMS established the f
ollowing recommendations for the treatment of perimenopausal women: (1) The
annual health examination is valuable in the perimenopausal woman and shou
ld include comprehensive screening for physical and psychological problems
as well as for appropriate lifestyle counseling. (2) Sufficient clinical da
ta exist to provide recommendations for developing management plans for acu
te perimenopausal symptoms, as well as counseling for potential chronic dis
eases related to postmenopause. (3) The importance of individualized screen
ing and management approaches for each woman is evident, as is the need for
including the woman in the management decision-making process. (4) Because
clinical research data on women in perimenopause are Limited, healthcare p
roviders may consider extrapolating data on postmenopausal women, as well a
s relying on clinical experience when considering management options. (5) M
anagement of perimenopausal symptoms may include doing nothing (many sympto
ms may be self-limiting) or recommending a combination of treatments.
Conclusions: Although perimenopause is largely unstudied, many therapeutic
approaches to the management of perimenopause disturbances exist, both pres
cription and nonprescription, NAMS established these consensus opinions to
be a resource for clinicians when designing a healthcare plan for a perimen
opausal woman. The perimenopausal woman's health and quality of life can be
maintained and improved through preventive care, lifestyle modifications,
early diagnosis of disease or increased risk for disease, and interventions
when appropriate. However, more research is needed in all areas concerning
perimenopausal women. (Menopause 2000;7:5-13. (C) 2000, The North American
Menopause Society.).