Menopausal symptoms

Definition Menopause begins one year after the last menstrual period. Sympt oms often begin in the perimenopausal years. Incidence/prevalence In the United Kingdom the mean age for the menopause i s 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) fou nd that 84% had experienced at least one of the classic menopausal symptoms , with 45% finding one or more symptoms a problem.(1) Aetiology/risk factors Urogenital symptoms of menopause are caused by decre ased oestrogen concentrations, but the cause of vasomotor symptoms and psyc hological effects is complex and remains unclear. Prognosis 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 r esolve with time.(2) However, some symptoms, such as genital atrophy, may r emain the same or worsen. Aims To reduce or prevent menopausal symptoms, and to improve quality of li fe with minimum adverse effects. Outcomes Frequency and severity of vasomotor, urogenital, and psychological symptoms; quality of life. Methods Clinical Evidence search and appraisal December 1999. We included o nly randomised controlled trials (RCTs) and systematic reviews that met Cli nical Evidence quality criteria.