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Managing the menopause

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Women are now living with menopause for far longer Women are now living with menopause for far longer

The menopause is a retrospective clinical diagnosis which may be confirmed after 1 year of amenorrhoea in women that are not using hormonal contraception. In healthy women over the age of 45 that have been amenorrhoeic, there is a history of perimenopausal symptoms such as irregular periods and vasomotor symptoms1.

Perimenopausal women in their 40s and 50s may present with less frequent and irregular periods. In the perimenopause there may be anovulatory cycles as well as intermittent ovulation. An increase in serum FSH level may indicate a degree of ovarian failure but it is not predictive of the menopause in itself1.

NICE advises that in most cases the menopause is a clinical diagnosis; that is laboratory testing is not required2.


When diagnosing the menopause it is important to discuss common symptoms as well as the risks and benefits of symptomatic treatment. Symptoms include changes in bleeding pattern, vasomotor symptoms such as hot flushes and sweating, mood disturbance, vaginal dryness, dyspareunia and reduced libido2.

Menopausal symptoms may last on average for 4 years3. Women spend nearly a third of their lives being post-menopausal with the increases we have seen in life expectancy. Therefore considering treatment options is important in women with debilitating symptoms2.

Managing short-term menopausal symptoms

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