Management of Symptoms During the Menopausal Transition

Abstract

The failure in ovarian estrogen production at the menopause transition usually results in physical symptoms such as menstrual irregularities and abnormal uterine bleedings. Later on, vasomotor symptoms ensue, soon to be followed by urogenital atrophy, sexual dysfunction, mood changes, bone loss, and metabolic changes that predispose to cardiovascular disease and diabetes. A number of lifestyle modification strategies and hormonal and nonhormonal interventions can be used to alleviate perimenopausal symptoms. Each of these has specific benefits and risks. Decisions about therapy for perimenopausal and postmenopausal women depend on symptomatology, health status, immediate and long-term health risks, and personal life outlooks, as well as on the availability and cost of therapies. There is a constant need for the development of effective and safe therapies for the management of menopausal symptoms, particularly for women who have absolute contraindications to hormone therapy.