Skip to main content
SpringerLink
Log in
Book cover

Endocrinology and Diabetes pp 159–171Cite as

Menopause

  • Chapter
  • First Online:

  • 2987 Accesses

Abstract

Menopause is defined as the cessation of menstrual periods occurring from the genetically programmed loss of ovarian follicles (McKinlay et al., Ann Intern Med 103(3):350, 1985). The transition between the woman’s fertile period and menopause begins with variations in the duration of menstrual cycle and an increase in serum concentrations of follicle-stimulating hormone (FSH) and ends with the final menstrual cycle, unrecognized until 12 months of amenorrhea is completed (Soules et al., Fertil Steril 76(5):874, 2001).

This chapter reviews the epidemiological aspects, clinical manifestations, diagnosis, differential diagnosis, current treatment, and new perspectives in the treatment of the menopause.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Cramer DW, Barbieri RL, Xu H, Reichardt JK. Determinants of basal follicle-stimulating hormone levels in premenopausal women. J Clin Endocrinol Metab. 1994;79(4):1105.

    Article  PubMed  CAS  Google Scholar 

  2. Stolk L, Zhai G, van Meurs JBJ, et al. Loci at chromosomes 13, 19 and 20 influence age at natural menopause. Nat Genet. 2009;41:645.

    Article  PubMed  CAS  Google Scholar 

  3. de Vries BB, Halley DJ, Oostra BA, Niermeijer MF. The fragile X syndrome. J Med Genet. 1998;35(7):579.

    Article  PubMed  Google Scholar 

  4. Cramer DW, Xu H, Harlow BL. Family history as a predictor of early menopause. Fertil Steril. 1995;64:740–5.

    PubMed  CAS  Google Scholar 

  5. Soules MR, Sherman S, Parrott E, Rebar R, Santoro N, Utian W, Woods N. Executive summary: stages of reproductive aging workshop (STRAW). Fertil Steril. 2001;76(5):874.

    Article  PubMed  CAS  Google Scholar 

  6. McKinlay SM, Bifano NL, McKinlay JB. Smoking and age at menopause in women. Ann Intern Med. 1985;103(3):350.

    Article  PubMed  CAS  Google Scholar 

  7. Cramer DW, Harlow BL, Xu H, Fraer C, Barbieri R. Cross-sectional and case-controlled analyses of the association between smoking and early menopause. Maturitas. 1995;22(2):79–87.

    Article  PubMed  CAS  Google Scholar 

  8. Cooper GS, Hulka BS, Baird DD, Savitz DA, Hughes Jr CL, Weinberg CR, Coleman RA, Shields JM. Galactose consumption, metabolism, and follicle-stimulating hormone concentrations in women of late reproductive age. Fertil Steril. 1994;62(6):1168.

    PubMed  CAS  Google Scholar 

  9. Hall JE. Neuroendocrine physiology of the early and late menopause. Endocrinol Metab Clin North Am. 2004;33(4):637.

    Article  PubMed  CAS  Google Scholar 

  10. Nagamani M, Stuart CA, Doherty MG. Increased steroid production by the ovarian stromal tissue of postmenopausal women with endometrial cancer. J Clin Endocrinol Metab. 1992;74(1):172.

    Article  PubMed  CAS  Google Scholar 

  11. Woods NF, Mitchell ES. Symptoms during the perimenopause: prevalence, severity, trajectory, and significance in women’s lives. Am J Med. 2005;118(Suppl 12B):14.

    Article  PubMed  Google Scholar 

  12. Berman JR, Berman L, Goldstein I. Female sexual dysfunction: incidence, pathophysiology, evaluation, and treatment options. Urology. 1999;54(3):385.

    Article  PubMed  CAS  Google Scholar 

  13. Dennerstein L, Dudley EC, Hopper JL, Burger H. Sexuality, hormones and the menopausal transition. Maturitas. 1997;26(2):83.

    Article  PubMed  CAS  Google Scholar 

  14. Freeman EW, Sammel MD, Liu L, Gracia CR, Nelson DB, Hollander L. Hormones and menopausal status as predictors of depression in women in transition to menopause. Arch Gen Psychiatry. 2004;61(1):62.

    Article  PubMed  CAS  Google Scholar 

  15. Bromberger JT, Meyer PM, Kravitz HM, Sommer B, Cordal A, Powell L, Ganz PA, Sutton-Tyrrell K. Psychologic distress and natural menopause: a multiethnic community study. Am J Public Health. 2001;91(9):1435.

    Article  PubMed  CAS  Google Scholar 

  16. Matthews KA, Wing RR, Kuller LH, Meilahn EN, Plantinga P. Influence of the perimenopause on cardiovascular risk factors and symptoms of middle-aged healthy women. Arch Intern Med. 1994;154(20):2349.

    Article  PubMed  CAS  Google Scholar 

  17. Mohyi D, Tabassi K, Simon J. Differential diagnosis of hot flashes. Maturitas. 1997;27(3):203.

    Article  PubMed  CAS  Google Scholar 

  18. North American Menopause Society. The 2012 hormone therapy position statement of The North American Menopause Society. Menopause. 2012;19(3):257–71.

    Google Scholar 

  19. Schiff I, Tulchinsky D, Cramer D, Ryan KJ. Oral medroxyprogesterone in the treatment of postmenopausal symptoms. JAMA. 1980;244:1443–5.

    Article  PubMed  CAS  Google Scholar 

  20. Nelken RS, Ozel BZ, Leegant AR, Felix JC, Mishell DR. Randomized trial of estradiol vaginal ring versus oral oxybutynin for the treatment of overactive bladder. Menopause. 2011;18:962–6.

    Article  PubMed  Google Scholar 

  21. Waetjen LE, Brown JS, Vittinghoff E, et al. for the Ultra Low Dose Transdermal Estrogen Assessment (ULTRA) Study. The effect of ultralow-dose transdermal estradiol on urinary incontinence in postmenopausal women. Obstet Gynecol. 2005;106:946–52.

    Article  PubMed  CAS  Google Scholar 

  22. Maalouf NM, Sato AH, Welch BJ, et al. Postmenopausal hormone use and the risk of nephrolithiasis: results from the Women’s Health Initiative hormone therapy trials. Arch Intern Med. 2010;170:1678–85.

    Article  PubMed  CAS  Google Scholar 

  23. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med. 1993;329:753–6.

    Article  PubMed  CAS  Google Scholar 

  24. Eriksen BC. A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women. Am J Obstet Gynecol. 1999;80:1072–9.

    Article  Google Scholar 

  25. Gass M, Cochrane BB, Larson JC, et al. Patterns and predictors of sexual activity among women in the Hormone Therapy trials of the Women’s Health Initiative. Menopause. 2011;18:1160–71.

    Article  PubMed  Google Scholar 

  26. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288(3):321.

    Article  PubMed  CAS  Google Scholar 

  27. LaCroix AZ, Chlebowski RT, Manson JE, et al. for the WHI Investigators. Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy: a randomized controlled trial. JAMA. 2011;305:1305–14.

    Article  PubMed  CAS  Google Scholar 

  28. Hulley S, Grady D, Bush T, et al. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA. 1998;280(7):605.

    Article  PubMed  CAS  Google Scholar 

  29. Grady D, Herrington D, Bittner V, et al. Cardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II). JAMA. 2002;288(1):49.

    Article  PubMed  Google Scholar 

  30. Hulley S, Furberg C, Barrett-Connor E, et al. Noncardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II). JAMA. 2002;288(1):58.

    Article  PubMed  CAS  Google Scholar 

  31. Manson JE, Allison MA, Rossouw JE, et al. for the WHI and WHICACS Investigators. Estrogen therapy and coronary-artery calcification. N Engl J Med. 2007;356:2591–602.

    Article  PubMed  CAS  Google Scholar 

  32. Prentice RL, Manson JE, Langer RD, et al. Benefits and risks of postmenopausal hormone therapy when it is initiated soon after menopause. Am J Epidemiol. 2009;170:12–23.

    Article  PubMed  Google Scholar 

  33. Simon JA, Hsia J, Cauley JA, et al. Postmenopausal hormone therapy and risk of stroke: the Heart and Estrogen-progestin Replacement Study (HERS). Circulation. 2001;103:638–42.

    Article  PubMed  CAS  Google Scholar 

  34. Viscoli CM, Brass LM, Kernan WN, Sarrel PM, Suissa S, Horwitz RI. A clinical trial of estrogen-replacement therapy after ischemic stroke. N Engl J Med. 2001;345:1243–9.

    Article  PubMed  CAS  Google Scholar 

  35. Taylor HS, Manson JE. Update in hormone therapy use in menopause. J Clin Endocrinol Metab. 2011;96(2):255–64.

    Article  PubMed  CAS  Google Scholar 

  36. Miller VM, Black DM, Brinton EA, et al. Using basic science to design a clinical trial: baseline characteristics of women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS). J Cardiovasc Transl Res. 2009;2:228–39.

    Article  PubMed  CAS  Google Scholar 

  37. Canonico M, Oger E, Plu-Bureau G, et al. Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens. The ESTHER study. Circulation. 2007;115:840–5.

    Article  PubMed  CAS  Google Scholar 

  38. Margolis KL, Bonds DE, Rodabough RJ, et al. Effect of estrogen plus progestin on the incidence of diabetes in postmenopausal women: results from the Women’s Health Initiative Hormone Trial. Diabetologia. 2004;47:1175–87.

    Article  PubMed  CAS  Google Scholar 

  39. Grady D, Gebretsadik T, Kerlikowske K, Ernster V, Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol. 1995;85:304–13.

    Article  PubMed  CAS  Google Scholar 

  40. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet. 1997;350:1047–59.

    Article  Google Scholar 

  41. Chlebowski RT, Hendrix SL, Langer RD, et al. for the WHI Investigators. Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women’s Health Initiative Randomized Trial. JAMA. 2003;289:3243–53.

    Article  PubMed  CAS  Google Scholar 

  42. Beral V, Reeves G, Bull D, Green J. for the Million Women Study Collaborators. Breast cancer risk in relation to the interval between menopause and starting hormone therapy. J Natl Cancer Inst. 2011;103:296–305.

    Article  PubMed  CAS  Google Scholar 

  43. Lacey Jr JV, Mink PJ, Lubin JH, et al. Menopausal hormone replacement therapy and risk of ovarian cancer. JAMA. 2002;288:334–41.

    Article  PubMed  CAS  Google Scholar 

  44. Beral V, Bull D, Green J, Reeves G, Million Women Study Collaborators. Ovarian cancer and hormone replacement therapy in Million Women Study. Lancet. 2007;369:1703–10.

    Article  PubMed  CAS  Google Scholar 

  45. Chlebowski RT, Schwartz AG, Wakelee H, et al. for the Women’s Health Initiative Investigators. O estrogen plus progestin and lung cancer in postmenopausal women (Women’s Health Initiative trial): a post-hoc analysis of a randomised trial. Lancet. 2009;374:1243–51.

    Article  PubMed  CAS  Google Scholar 

  46. Hogervorst E, Williams J, Budge M, Riedel W, Jolles J. The nature of the effect of female gonadal hormone replacement therapy on cognitive function in postmenopausal women: a meta-analysis. Neuroscience. 2000;101:485–512.

    Article  PubMed  CAS  Google Scholar 

  47. Maki PM, Henderson VW. Hormone therapy, dementia, and cognition: the Women’s Health Initiative 10 years on. Climacteric. 2012;15(3):256–62.

    Article  PubMed  CAS  Google Scholar 

  48. Bachmann GA, Schaefers M, Uddin A, Utian WH. Lowest effective transdermal 17A-estradiol dose for relief of hot flushes in postmenopausal women: a randomized controlled trial. Obstet Gynecol. 2007;110:771–9.

    Article  PubMed  CAS  Google Scholar 

  49. Renoux C, Dell’aniello S, Garbe E, Suissa S. Transdermal and oral hormone replacement therapy and the risk of stroke: a nested case control study. BMJ. 2010;340:c2519.

    Article  PubMed  Google Scholar 

  50. Pitkin J. Alternative and complementary therapies for the menopause. Menopause Int. 2012;18(1):20–7.

    Article  PubMed  Google Scholar 

  51. Wren BG, Brown LB. A double blind trial with clonidine and a placebo to treat hot flushes. Med J Aust. 1986;144:369–70.

    PubMed  CAS  Google Scholar 

  52. Nelson H, Vesco K, Haney E, et al. Non-hormonal therapies for menopausal hot flushes : systematic review and meta-analysis. JAMA. 2006;295:2057–71.

    Article  PubMed  CAS  Google Scholar 

  53. Panjari M, Davis SR. DHEA for postmenopausal women: a review of the evidence. Maturitas. 2010;66:172–9.

    Article  PubMed  CAS  Google Scholar 

  54. Lissin LW, Cooke JP. Phytoestrogens and cardiovascular health. J Am Coll Cardiol. 2000;35(6):1403.

    Article  PubMed  CAS  Google Scholar 

  55. Elsabagh S, Hartley S, File S. Limited cognitive benefits in Stage þ2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psychopharmacol. 2005;19:173–81.

    Article  PubMed  CAS  Google Scholar 

  56. Koebnick C, Reimann M, Carlsohn A, et al. The acceptability of isoflavones as a treatment of menopausal symptoms: a European survey among postmenopausal women. Climacteric. 2005;8:230–42.

    Article  PubMed  CAS  Google Scholar 

  57. Cummings SR, Ettinger B, Delmas PD, et al. The effects of tibolone in older postmenopausal women. N Engl J Med. 2008;359(7):697.

    Article  PubMed  CAS  Google Scholar 

  58. Barton DL, Loprinzi CL, Quella SK, et al. Prospective evaluation of vitamin E for hot flashes in breast cancer survivors. J Clin Oncol. 1998;16(2):495.

    PubMed  CAS  Google Scholar 

  59. Nedrow A, Miller J, Walker M, et al. Complementary and alternative therapies for the management of menopause-related symptoms: a systematic evidence review. Arch Intern Med. 2006;166(14):1453.

    Article  PubMed  Google Scholar 

  60. Deng G, Vickers A, Yeung S, et al. Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. J Clin Oncol. 2007;25(35):5584.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Endocrinology and Metabology, Hospital Agamenom Magalhães, Estrada Do Arraial, 2723, Recife, PE, 52051-380, Brazil

    Thyciara Fontenelle M.S.

  2. Division of Endocrinology and Diabetes, University of Pernambuco Medical School, Hospital Agamenom Magalhães, Recife, PE, Brazil

    Luiz Griz M.D., Ph.D.

Authors
  1. Thyciara Fontenelle M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luiz Griz M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thyciara Fontenelle M.S. .

Editor information

Editors and Affiliations

  1. Professor Associado e Livre-Docente, Disciplina de Endocrinologia da Faculdade de Ciências Medicas da Universidade de Pernambuco, Chefe da Divisão de Endocrinologia e Diabetes do Hospital Agamenon, Magalhães-MS/UPE, Recife, Brazil

    Francisco Bandeira

  2. American Thyroid Association Past President, American Association of Clinical Endocrinologists, Professor of Medicine, Mayo Clinic College of Medicine President-Elect, Rochester, Minnesota, USA

    Hossein Gharib

  3. Federal Foundation and School of Medical Sciences, Porto Alegre, Brazil

    Airton Golbert

  4. Department of Medicine, University of Pernambuco School of Medicine, Recife, Brazil

    Luiz Griz

  5. Department of Medicine, University of Maranhao School of Medicine, Sao Luis, Brazil

    Manuel Faria

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Fontenelle, T., Griz, L. (2014). Menopause. In: Bandeira, F., Gharib, H., Golbert, A., Griz, L., Faria, M. (eds) Endocrinology and Diabetes. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8684-8_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8684-8_14

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8683-1

  • Online ISBN: 978-1-4614-8684-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation